HomeMy WebLinkAboutCity of Tamarac Resolution R-2003-232Temporary Resolution 10242
September 23, 2003
First Revision: September 30, 2003
Second Revision: October 2, 2003
Page 1
CITY OF TAMARAC, FLORIDA
RESOLUTION NO. R- 2003- ),3 ;.
A RESOLUTION OF THE CITY COMMISSION OF
THE CITY OF TAMARAC, FLORIDA AUTHORIZING
THE AWARD OF BID NO. 03-29B FOR THE
PURCHASE OF SELF CONTAINED BREATHING
APPARATUS AND ASSOCIATED EQUIPMENT TO
FISHER SCIENTIFIC CO., LLC AT A TOTAL COST
OF $194,091; PROVIDING FOR CONFLICTS;
PROVIDING FOR SEVERABILITY; AND PROVIDING
FOR AN EFFECTIVE DATE.
WHEREAS, the City of Tamarac Fire Rescue Department has increased in size
over the last six years; and
WHEREAS, the City provides its fire rescue personnel with Self Contained
Breathing Apparatus (SCBA) units and associated equipment; and
WHEREAS, the City wishes to purchase additional SCBA units and update
existing SCBA units to ensure that the most current equipment is available to all fire
rescue personnel; and
WHEREAS, the City Commission of the City of Tamarac is committed to
enhancing fire rescue personnel safety through the acquisition of SCBA units for all
on -duty fire rescue personnel; and
WHEREAS, the City of Tamarac publicly advertised Bid No. 03-29B for SCBA
units in the Sun -Sentinel on August 10, 2003, a copy of said Bid is hereto attached as
Exhibit 1; and
WHEREAS, on August 27, 2003 two (2) bids were received from Fisher Scientific
Co., LLC and from Pro -Am; and
Temporary Resolution 10242
September 23, 2003
First Revision: September 30, 2003
Second Revision: October 2, 2003
Page 2
WHEREAS, both bids were opened and reviewed in order to determine cost and
responsiveness to the City's technical specifications; and
WHEREAS, Fisher Scientific Co., LLC provided the lowest responsive and
responsible bid for the SCBA units as per the copy of the Bid and bid tabulation being
attached hereto as "Exhibit 2;" and
WHEREAS, funding is available in the adopted Fire Rescue operating budget for
said purpose and through a grant from the Federal Emergency Management Agency;
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WHEREAS, the City Manager and the Fire Chief recommend that the City award
Bid No. 03-29B to Fisher Scientific Co., LLC; and
WHEREAS, the City Commission of the City of Tamarac deems it to be in the
best interest of the citizens and residents of the City of Tamarac to award Bid
No. 03-29B to Fisher Scientific Co., LLC to provide SCBA units and associated
equipment for the Tamarac Fire Rescue Department to serve the needs of our
residents.
NOW,THEREFORE, BE IT RESOLVED BY THE CITY COMMISSION OF THE
CITY OF TAMARAC, FLORIDA:
Section 1: The foregoing "WHEREAS" clauses are hereby ratified and confirmed
as being true and correct and are hereby made a specific part of this Resolution.
Section 2: Bid No. 03-29B for the purchase of Self Contained Breathing
Apparatus units and associated equipment in the amount of $194,091 is hereby
awarded to Fisher Scientific Co., LLC.
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Temporary Resolution 10242
September 23, 2003
First Revision: September 30, 2003
Second Revision: October 2, 2003
Page 3
Section 3: All resolutions in conflict herewith are hereby repealed to the extent of
such conflict.
Section 4: If any clause, section, other part or application of this Resolution is
held by any court of competent jurisdiction to be unconstitutional or invalid, in part or in
application, it shall not affect the validity of the remaining portions or applications of
this Resolution.
Section 5: This Resolution shall become effective immediately upon its adoption.
PASSED, ADOPTED AND APPROVED this 8t" day of October, 2003.
ATTEST:
MARION ENSON, CMC
CITY CLERK
I HEREBY CERTIFY that
I have approved this
RESOLUTION as,to form.
MITCHELL S. KRAFT
CITY ATTORNEY
JOE SCHREIBER, MAYOR
RECORD OF COMMISSION VOTE:
MAYOR SCHREIBER
DIST 1: COMM. PORTNER
DIST 2: COMM. FLANSBAUM-TALABISCO y
DIST 3: COMM. SULTANOF "
DIST 4: V/M ROBERTS __
Purchasing and
Contracts Division
City of Tamarac
"Committed to Excellence... Always"
INVITATION TO BID
BID NO. 03-29B
EXHIBIT 1
TR # 1 H242
Sealed bids, addressed to the Purchasing and Contracts Manager of the City of Tamarac,
Broward County, Florida, will be received in the Purchasing Office, 7525 NW 88th Avenue,
Tamarac, Florida 33321-2401 until Wednesday, August 27, 2003 at 2:00 p.m., at which
time bids will be publicly opened and announced for:
Self -Contained Breathing Apparatus
All bids received after the date and time stated above will be returned unopened to the
Bidder. All Bidders are invited to attend the opening.
The City of Tamarac is hereby requesting Bids, from qualified vendors, to provide Scott
brand self-contained breathing apparatus and accessories, as per the conditions and
specifications contained in this document.
One (1) original and two (2) copies of the bid should be submitted on the official Bid
Form furnished with the bid package and those submitted otherwise may not be considered
responsive. The bid submittal shall be plainly marked "Bid No. 03-29B, "Self -Contained
Breathing Apparatus" on the outside of the envelope.
The City reserves the right to accept or reject any or all bids, or any part of any bid, to
waive any informalities, and to award in the best interest of the City of Tamarac.
Bid documents will be available for review and may be obtained from the Purchasing Office
at the above address. For non -technical inquiries, contact the Purchasing Office at (954)
724-2450; and for technical issues, contact Blaine Long at (954) 724-2531.
Steven J. Beamsderfer
Buyer
Publish Sun -Sentinel 8/10/2003 and 8/17/2003
7525 NW 88th Avenue ■ Tamarac, Florida 33321-2401 ■ (954) 724-2450 a Fax (954) 724-2408 ■ www.tamorac.org
Equal Opportunity Employer
City of Tamarac F Purchasing & Contracts Division
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INSTRUCTIONS TO BIDDERS
BID NO. 03-29B
It is the intent of the City to award this bid to the lowest responsible and responsive bidder.
The City reserves the right to accept or reject any or all bids and to waive any informality
concerning the bids when such rejection or waiver is deemed to be in the best interest of The
City of Tamarac. The City reserves the right to award the bid on a split order basis, lump sum
or individual item basis unless otherwise stated.
GENERAL TERMS AND CONDITIONS
These general terms and conditions apply to all offers made to the City of Tamarac by all
prospective Bidders including but not limited to Request for Quotes, Request for Bids and
Request for Proposals. As such the words "bid" and "proposal" are used interchangeably in
reference to all offers submitted by prospective bidders.
1. SUBMISSION OF THE BID:
The Bidder is directed to deliver sealed bids to the City's Purchasing Office, City of Tamarac,
7525 N. W. 88th Avenue, Tamarac, Florida 33321, on Wednesday, August 27, 2003, no
later than 2:00 PM. At this time the bids will be opened, the names of all Bidders will be
announced and all bids shall become a matter of public record. All Bidders and their
representatives are invited to attend. The Bidder must show the bid number and bid name on
the outside of the sealed bid package. Delivery of the sealed bids to the Purchasing Office on
or before the above date is solely and strictly the responsibility of the Bidder. Late bids will be
returned unopened to the Bidder.
It is the Bidder's responsibility to read and understand the requirements of this bid. Unless
otherwise specified the Bidder must use the Bid Form furnished in the bid document. The
Bidder should submit one (1) original accompanied by two (2) copies of the bid. However,
copies must be submitted within 3 business days of the City's request to be considered
responsive. The original bid must be manually and duly signed in ink by a Corporate
Officer, Principal, or Partner with the authority to bind the bidding company or firm by
his/her signature. All Bid Forms must be typewritten or filled in with pen and ink. The Bidder
must initial in ink any erasures or corrections. All prices, terms and conditions quoted in the
submitted bid will be firm for acceptance for sixty days from the date of the bid opening
unless otherwise stated by the City.
2. BONDING
Not applicable for this bid.
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3. WITHDRAWAL OF BID
Any Bidder may withdraw its bid prior to the indicated opening time. The request for
withdrawal must be submitted in writing to the City Purchasing Office.
4. PUBLIC ENTITY CRIMES STATEMENT
A person or affiliate who has been placed on the convicted vendor list following a conviction
for public entity crime may not submit a bid on a contract to provide any goods or services to
a public entity, may not submit a bid on a contract with a public entity for the construction or
repair of a public building or public work, may not submit bids on leases of real property to
public entity, may not be awarded or perform work as a contractor, supplier, subcontractor, or
consultant under a contract with any public entity, and may not transact business with any
public entity in excess of the threshold amount provided in Section 287.017, for Category
Two for a period of 36 months from the date of being placed on the convicted vendor list.
5. NON -COLLUSIVE AFFIDAVIT
Each Contractor shall complete the Non -Collusive Form and shall submit the form with the
Proposal. CITY considers the failure of the Contractor to submit this document to be a major
irregularity and may be cause for rejection of the Proposal.
6. QUANTITIES
Quantities shown are estimates only. No guarantee or warranty is given or implied by the City
as to the total amount that may or may not be purchased from any resulting contract. The
City reserves the right to decrease or increase quantities or add or delete any item from the
contract if it is determined that it best serves the interests of the City.
7. PRICES PAYMENTS AND DISCOUNTS
Bid prices shall be fixed and firm to the extent required under Special Conditions. Payment
will be made only after receipt and acceptance of materials/services. Cash discounts may be
offered for prompt payment; however, such discounts shall not be considered in determining
the lowest net cost for bid evaluation.
Bidders are encouraged to provide prompt payment terms in the space provided on the Bid
Form. If no payment discount is offered, the Bidder shall enter zero (0) for the percentage
discount to indicate net 30 days. If the Bidder does not enter a percentage discount, it is
understood and agreed that the payment terms shall be 2% 10 days, net 30 days effective on
the date that the City receives an accurate invoice or accepts the product, whichever is the
later date. Payment is deemed made on the date of the mailing of the check.
8. DELIVERY
All items shall be delivered F.O.B. destination to a specific City address. All delivery costs
and charges must be included in the bid price. The City reserves the right to cancel orders or
any part thereof, without obligation if delivery is not made at the time specified in the bid.
ikkCity of Tamarac � Purchasing & Contracts Division
9. BRAND NAMES
The City is restricting bids to those vendors capable of supplying Scott Brand SCBA, for
reasons of compatibility with existing equipment, and interchangeability with equipment of
surrounding municipalities.
10. SAMPLES AND DEMONSTRATIONS
When requested, samples are to be furnished free of charge to the City. If a sample is
requested it must be delivered within seven days of the request unless otherwise stated in
the bid. Each sample must be marked with the bidder's name and manufacture's brand
name. The City will not be responsible for returning samples. The City may request a full
demonstration of any product or service before the award of a contract. All demonstrations
will be done at the expense of the Bidder.
11. CONDITIONS OF MATERIALS
All materials and products supplied by the Bidder in conjunction with this bid shall be new,
warranted for their merchantability, fit for a particular purpose, free from defects and
consistent with industry standards. The products shall be delivered to the City in excellent
condition. In the event that any of the products supplied to the City are found to be defective
or do not conform to the specifications, the City reserves the right to return the product to the
Bidder at no cost to the City.
12. COPYRIGHTS OR PATENT RIGHTS
The Bidder warrants that there has been no violation of copyrights or patent rights in
manufacturing, producing or selling the goods shipped or ordered as a result of this bid. The
seller agrees to hold the City harmless from all liability, loss or expense occasioned by any
such violation.
13. SAFETY STANDARDS
The Bidder warrants that the product(s) supplied to the City conforms with all respects to the
standards set forth in the Occupational Safety and Health Act and its amendments to any
industry standards if applicable.
14. PERFORMANCE
Failure on the part of the Bidder to comply with the conditions, terms, specifications and
requirement of the bid shall be just cause for the cancellation of the bid award. The City may,
by written notice to the Bidder, terminate the contract for failure to perform. The date of
termination shall be stated in the notice. The City shall be the sole judge of nonperformance.
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City of 7'am<ar,�C �� Purchasing & Contracts Division
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15. DEFAULT
In the event that the Bidder defaults on the contract or the contract is terminated for cause
due to performance, the City reserves the right to obtain the materials or services from the
next lowest Bidder or other source during the remaining term of the contract. Under this
arrangement the City will charge the Bidder any excess cost occasioned or incurred thereby
and shall apply to any bid bond required.
16. TERMINATION FOR CONVENIENCE OF CITY
Upon seven (7) calendar days written notice delivered by certified mail, return receipt
requested, to the Bidder, the CITY may without cause and without prejudice to any other right
or remedy, terminate the agreement for the CITY's convenience whenever the CITY
determines that such termination is in the best interest of the CITY. Where the agreement is
terminated for the convenience of the CITY the notice of termination to the Bidder must state
that the contract is being terminated for the convenience of the CITY under the termination
clause and the extent of termination. Upon receipt of the notice of termination for
convenience, the Bidder shall promptly discontinue all work at the time and to the extent
indicated on the notice of termination, terminate all outstanding sub -contractors and
purchase orders to the extent that they relate to the terminated portion of the Contract and
refrain from placing further orders and sub -contracts except as they may be necessary, and
complete any continued portions of the work.
17. ASSIGNMENT
The Bidder shall not transfer or assign the performance required by this bid without the prior
written consent of the City. Any award issued pursuant to this bid and monies that may
become due hereunder are not assignable except with prior written approval of the City.
18. EMPLOYEES
Employees of the Bidder shall at all times be under its sole direction and not an employee or
agent of the City. The Bidder shall supply competent and physically capable employees. The
City may require the Bidder to remove an employee it deems careless, incompetent,
insubordinate or otherwise objectionable. Bidder shall be responsible to the City for the acts
and omissions of all employees working under its directions.
19. TAXES
The City of Tamarac is exempt from all Federal, State, and Local taxes. An exemption
certificate will be provided where applicable upon request.
20. BID PREPARATION EXPENSE
The Bidder preparing a bid in response to this bid shall bear all expenses associated with its
preparation. The Bidder shall prepare a bid with the understanding that no claim for
reimbursement shall be submitted to the City for the expense of bid preparation and/or
presentation.
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City of Tamarac. Purchasing & Contracts Division
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21. OMISSION OF DETAILS
Omission of any essential details from these specifications will not relieve the Bidder of
supplying such product(s) as specified.
22. INSURANCE REQUIREMENTS
The following insurance requirements may be required if the City awards Group 2, SEMS
Devices, and requires on -site training as listed on Bid Form. If award is based on delivery
only, insurance will not apply.
Bidder agrees to, in the performance of work and services under this Agreement, comply with
all federal, state, and local laws and regulations now in effect, or hereinafter enacted during
the term of this agreement that are applicable to Contractor, its employees, agents, or
subcontractors, if any, with respect to the work and services described herein.
Bidder shall obtain at Bidder's expense all necessary insurance in such form and amount as
required by the City's Risk & Safety Manager before beginning work under this Agreement.
Bidder shall maintain such insurance in full force and effect during the life of this Agreement.
Bidder shall provide to the City's Risk & Safety Manager certificates of all insurance required
under this section prior to beginning any work under this Agreement. Bidder shall indemnify
and save the City harmless from any damage resulting to it for failure of either Bidder or any
subcontractor to obtain or maintain such insurance.
The following are required types and minimum limits of insurance coverage, which the Bidder
agrees to maintain during the term of this contract:
Limits
Line of Business/ Coverage Occurrence Aggregate
Commercial General Liability $1,000,000 $1,000,000
Including:
Premises/Operations
Contractual Liability
Personal Injury
Explosion, Collapse, Underground Hazard
Products/Completed Operations
Broad Form Property Damage
Cross Liability and Severability of Interest Clause
Automobile Liability $1,000,000 $1,000,000
Workers' Compensation & Employer's Liability Statutory
The City reserves the right to require higher limits depending upon the scope of work under
this Agreement.
Neither Bidder nor any subcontractor shall commence work under this contract until they
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have obtained all insurance required under this section and have supplied the City with
evidence of such coverage in the form of an insurance certificate and endorsement. The
Bidder will ensure that all subcontractors will comply with the above guidelines and will
maintain the necessary coverages throughout the term of this Agreement.
All insurance carriers shall be rated at least A-VII per Best's Key Rating Guide and be
licensed to do business in Florida. Policies shall be "Occurrence" form. Each carrier will give
the City sixty (60) days notice prior to cancellation.
The Bidder's liability insurance policies shall be endorsed to add the City of Tamarac as an
"additional insured". The Bidder's Worker's Compensation carrier will provide a Waiver of
Subrogation to the City. The Bidder shall be responsible for the payment of all deductibles
and self -insured retentions. The City may require that the Bidder purchase a bond to cover
the full amount of the deductible or self -insured retention. If the Bidder is to provide
professional services under this Agreement, the Bidder must provide the City with evidence
of Professional Liability insurance with, at a minimum, a limit of $1,000,000 per occurrence
and in the aggregate. "Claims -Made" forms are acceptable for Professional Liability
insurance.
23. INDEMNIFICATION
The Bidder shall indemnify and hold harmless the City of Tamarac, its elected and appointed
officials and employees from any and all claims, suits, actions, damages, liability, and
expenses (including attorneys' fees) in connection with loss of life, bodily or personal injury,
or property damage, including loss of use thereof, directly or indirectly caused by, resulting
from, arising out of or occurring in connection with the operations of the Bidder or his
Subcontractors, agents, officers, employees or independent contractors, excepting only such
loss of life, bodily or personal injury, or property damage solely attributable to the gross
negligence or willful misconduct of the City of Tamarac or its elected or appointed officials
and employees.
24. CLARIFICATION TO TERMS AND CONDITIONS
Where there appears to be variances or conflicts between the General Terms and Conditions
and the Special Conditions and/or Detailed Specifications outlined in this bid, the Special
Conditions and/or the Detailed Specifications shall prevail.
The Bidder shall examine all bid documents and shall judge all matters relating to the
adequacy and accuracy of such documents. Any inquires, suggestions, request concerning
clarification or solicitation for additional information shall be submitted in writing, seven (7)
days prior to bid opening, to the Purchasing and Contracts Manager. The City shall not be
responsible for oral interpretations given by any City employee or its representative.
25. BID TABULATION
Bidders who wish to receive a copy of the bid tabulation can submit an e-mail to
purchasing@tamarac.or�c . Or, Bidders may download bid results from the City's website at
http://www.tamarac.org/De t/fin/r)urch/results.html. Bid results will not be given out by
telephone. The City does not notify unsuccessful bidders of contract awards.
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City of Tamarac Purchasing & Contracts Division
Pursuant to Florida Statute Chapter 119, Section 7(m), sealed bids or proposals received by
an agency pursuant to invitations to bid or requests for proposals are exempt from the
provisions of subsection (1) and s. 24(a), Art. I of the State Constitution until such time as the
agency provides notice of a decision or intended decision pursuant to s. 120.57(3)(a) or
within 10 days after bid or proposal opening, whichever is earlier.
26. RECORDS/AUDITS
The Contractor shall maintain during the term of the contract all books, reports and records in
accordance with generally accepted accounting practices and standards for records directly
related to this contract. The form of all records and reports shall be subject to the approval of
the City's Auditor. The Contractor agrees to make available to the City's Auditor, during
normal business hours and in Broward, Dade or Palm Beach Counties, all books of account,
reports and records relating to this contract for the duration of the contract and retain them
for a minimum period of one (1) year beyond the last day or the contract term.
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City of Tarn r ac n Purch.asing & Contraci.s Division
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SPECIAL CONDITIONS
BID N0.03-2913
1. PURPOSE OF BID
The City of Tamarac is hereby requesting Bids, from qualified vendors, to supply Scott brand
self-contained breathing apparatus (SCBA) and accessories. It is the intent of the City to
award this bid to the lowest responsible and responsive bidder.
In order to be considered for this project, the vendor must meet the following conditions:
1. Be an authorized distributor for the equipment being bid.
2. Be able to provide factory authorized service for the equipment being bid.
3. Be able to provide free technical assistance via telephone.
2. CONSIDERATION FOR AWARD
Funds for purchases against this bid are being made available through the FEMA FIRE
ACT GRANT of 2002. It is the intent of the City to purchase these SCBA's with either the
factory installed PASS Devices or as SEMS Devices, but not both. This is reflected in the
organization of the price sheets on the Bid Form. Group 1 lists PASS Devices; Group 2
lists SEMS Devices. The City will purchase either Group 1 in total or Group 2 in total, but
not both Groups. Determination of which Group the City will select will be based solely on
the available grant funds for such equipment at time of award. Purchase quantities for
items in each group are shown on the Bid Form.
3. CONTINGENCY ITEMS
Group 3 lists contingency items. These are items which the City may elect to purchase in
the future but for which the City has no immediate requirement. There are no quantities
shown for these items. Contingency item pricing will not be a factor in determining the
lowest responsive and responsible bidder in either Group 1 or Group 2 for purposes
of bid award. If a contingency item is determined to be needed, it will be effected by
written change order. The City reserves the right not to purchase these items, and is under
no obligation to do so, from the same vendor awarded this bid
4. PRICING
All prices are to be quoted delivered, F.O.B destination. Pricing for contingency items is to
be held firm and fixed for a period of one year from the date of Bid Award. Orders for
contingency items are to be effected only through issuance of a City of Tamarac change
order.
5. DELIVERY DATE
All items ordered shall be delivered to the City of Tamarac no later than 90 days after
the issuance of a Purchase Order.
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City of Tamarac Purchasing & Contracts Division
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COMPANY NAME: (Please Print):
Phone:
Fax:
BEFORE SUBMITTING YOUR BID MAKE SURE YOU...
❑ Carefully read the General Terms & Conditions and Special Conditions.
❑ Fill out and sign the Non -Collusive Affidavit and have it properly
notarized.
❑ Sign the Certification page. Failure to do so will result in your Bid being
deemed non -responsive.
❑ Fill out the Bidder's Qualification Statement.
❑ Fill out the References page.
❑ Sign the Vendor Drug Free Workplace Form.
❑ Fill out and sign the Certified Resolution.
❑ Submit one (1) Original and two (2) copies of your bid, clearly marked
with the Bid number and Bid Name on the outside of the package.
❑ Make sure your Bid is submitted PRIOR to the deadline. Late Bids will
not be accepted.
Failure to provide the requested attachments may result in your bid
being deemed non -responsive.
THIS SHOULD BE THE FIRST PAGE OF YOUR BID.
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( ity of 7 rnarac Purchasing and Contracts Division
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BID FORM
BID NO.03-29B
Submitted by:
THIS BID IS SUBMITTED TO:
City of Tamarac
Purchasing and Contracts Manager
7525 Northwest 88t" Avenue
Tamarac, Florida 33321
Date
1. The undersigned Bidder proposes and agrees, if this bid is accepted, to enter into a
contract with the City to perform and furnish all Work as specified herein for the
Contract Price and within the Contract Period indicated in this bid.
2. This bid will remain subject to acceptance for sixty (60) days after the day of bid
opening.
a) Bidder has familiarized itself with the nature and extent of the contract
documents, locality, and all local conditions and laws and regulations that in
any manner may affect cost, progress, performance, or furnishing of the
Work.
b) Bidder has given the City written notice of all conflicts, errors, or
discrepancies that it has discovered in the contract documents and the
written resolution thereof by the City is acceptable to Bidder.
c) This Bid is genuine and not made in the interest of or on behalf of any
undisclosed person, firm or corporation 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
person, firm or corporation to refrain from bidding; and Bidder has not sought
by collusion to obtain for itself any advantage over any other Bidder or over
the City.
3. Bidder will complete the Work for the prices shown in the "Bid Form".
4. Bidder agrees that the Work will be substantially performed and complete in
accordance with the schedules established herein.
City of Tamarac = Purchasing and Contracts Division
BID FORM
(continued)
BID NO. 03-39B
The City of Tamarac is hereby requesting Bids, from qualified vendors, to supply 47 Scott
brand Air -Pak self-contained breathing apparatus units complete with harness, 30-minute
carbon cylinder, and regulator. Pricing is also being requested for additional accessories
including PASS and SEMS devices. Model numbers are specified in the attached Bid Form.
Alternative model numbers by the same manufacturer that meet or exceed all the same
specifications and requirements as the requested model numbers may be proposed. For
evaluation purposes a complete description of the proposed alternative must be submitted to
and received by the Purchasing Division of the City of Tamarac at least 7 days prior to the
date of the bid opening. Alternative model numbers that do not meet or exceed the
specifications of the requested model numbers will not be considered. Decisions made by
the City of Tamarac concerning equality of specifications of proposed alternatives shall be
final.
Prices for both PASS and SEMS must be indicated in the spaces provided on the bid sheet.
It should be understood by the vendor that the City will select either the PASS or SEMS
equipment for award, but not both.
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City of Tamarac Purchasing and Contracts Division
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We propose to furnish the attached inconformity with the specifications and at the
bid prices indicated on the attached bid sheet. The bid prices quoted have been
checked and certified to be correct. Said prices are fixed and firm and shall be paid
to Bidder for the successful completion of its obligation as specified in the contract
documents.
GROUP 1
PASS Devices
Scott Model
Price
Extended
Item
Number
Quantity Each
Total
Air -Pak Fifty 4.5, 30 min Carbon
804846-06
47 ea.
Cylinder w/EBSS w/o case
PASS device, PAK-Alert SE,
Factory Installed
805796-02
47 ea.
TOTAL BID PRICE:
$
GROUP 2
SEMS DEVICES
Scott Model
Price
Extended
Item
Number
Quantity Each
Total
Air -Pak Fifty 4.5, 30 min Carbon
804846-06
47 ea.
Cylinder w/EBSS w/o case
SEMS PDA Factory installed,
805898-05
47 ea.
4500 psiq
SEMS Base Station
805679-01
1 ea.
SEMS Serial Cable Interface,
10012421
1 ea.
PDR to Computer
SEMS, IR Link for Programming
1
PDA
10012420
ea.
SEMS PC Software
100112422
1 ea.
On -site SEMS training-3 days
On -site SEMS Train -the -trainer
TOTAL BID PRICE
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tCity of Tamarac Purcha..;inc� and Contracts Division
GROUP 3
CONTINGENCY ITEMS
Items in this group will not be a factor in determining the award of this Bid. Vendor agrees
to hold quoted price for period of 12 months from the date of award.
Item
4500 psi 60 minute carbon cylinder
4500 psi 30 minute carbon cylinder
RIT-PAK w/low pressure hose and bag
AV-2000 Voice Amp Assembly
Scott Model Price Each
Number
804723-01
804721-01
805446-01
804564-01
E-Z Radiocom for Motorola MTS 2000
805206-04
PASS device, PAK-Alert SE, Field Kit
805796-01
Face Mask, Kevlar with Silicone seal, size small
804191-11
Face Mask, Kevlar with Silicone seal, size large
804191-12
Face mask, Kevlar with Silicone Seal, size x-Irg.
804191-13
Personal Issue Regulator
804370-02
Particulate Cartridge, MPC Plus
805557-01
NBC Canister, NTC-1
045122
NBC Canister Enforcement
045123
NBC Canister, P100
052683
Facepiece adapter, 40mm
805059-01
Multi -gas monitor, 3-gas
096-2561-01
Combustible Gas Leak Detector
0019-7083
On -site qualitative fit testing
14
City of Tamarac t
ADDITIONAL PASS ITEMS
Item
Air -Pak Fifty 4.5, 30 min Carbon Cylinder
w/EBSS w/o case
PASS device, PAK-Alert SE, Factory Installed
Pwchasina and Contracts Division
Scott Model I Price Each
Number
805796-02
ADDITIONAL SEMS DEVICES
Scott Model
price Each
Item
Number
Air -Pak Fifty 4.5, 30 min Carbon Cylinder
804846-06
w/EBSS w/o case
SEMS PDA Factory installed, 4500 prig
805898-05
SEMS Base Station
805679-01
SEMS Serial Cable Interface, PDR to Computer
10012421
SEMS, I Link for Programming PDA
10012420
SEMS PC Software
100112422
SEMS PDA, Field Installed, 4500 psig
805898-02
On -site SEMS training-3 days
On -site SEMS Train -the -trainer
15
F q
City of Tamarac M _ � � Purchasing and Contracts Division
Rin FORM
(continued)
BID NO.03-29B
The City reserves the right to reject any bid, if it deems that a vendor has deliberately
provided erroneous information. The undersigned declare to have specific and legal
authorization to obligate their firm to the terms of this bid, and further, that they have
examined the Invitation to Bid, the instructions to Bidders, the Specifications, and other
documents included in this bid request, and hereby promises and agrees that, if this bid is
accepted, they will faithfully fulfill the terms of this bid together with all guarantees and
warranties thereto. The undersigned bidding firm further certifies the product and/or
equipment meets or exceeds the specification as stated in the bid package; and also agrees
that products and/or equipment to be delivered which fail to meet bid specifications will be
rejected by the City within thirty (30) days of delivery. Return of rejection will be at the
expense of the bidder.
Company Name
Address
City, State, ZIP
Contractor's License Number
Authorized Signature
Typed/Printed Name
Telephone & Fax Number
Federal Tax ID#
16
City of Tamarac,
Bidders Name:
TERMS: % DAYS:
Delivery/completion:
r TAq,
Purchasing and Contracts L)ivision
p
R�
BID FORM
(continued)
BID NO. 03-29B
calendar days after receipt of Purchase Order
To be considered eligible for award, one (1) original must be submitted, and two (2)
copies of this Bid Form should be submitted with the Bid.
NOTE: Bid submittals without the manual signature of an authorized agent of the
Bidder shall be deemed non -responsive and ineligible for award.
IF "NO BID" IS OFFERED, PLEASE PROVIDE THE FOLLOWING INFORMATION:
Please indicate reason(s) why a Bid Proposal is not being submitted at this time.
Return the Bid Form to avoid removal of Bidder from the City of Tamarac's
vendor listing.
17
TqM
City of Tamarac �{ ' � Purchasing and Contracts Division
t p _.
NON -COLLUSIVE AFFIDAVIT
State of
)ss.
County of
deposes and says that:
1. He/she is the
Representative or Agent) of
that has submitted the attached Proposal;
being first duly sworn,
(Owner, Partner, Officer,
, the Offeror
2. He/she is fully informed respecting the preparation and contents of the attached
Proposal and of all pertinent circumstances respecting such Proposal;
3. Such Proposal is genuine and is not a collusive or sham Proposal;
4. Neither the said Offeror nor any of its officers, partners, owners, agents,
representatives, employees or parties in interest, including this affiant, have in any
way colluded, conspired, connived or agreed, directly or indirectly, with any other
Offeror, firm, or person to submit a collusive or sham Proposal in connection with the
Work for which the attached Proposal has been submitted; or to refrain from bidding
in connection with such Work; or have in any manner, directly or indirectly, sought by
agreement or collusion, or communication, or conference with any Offeror, firm, or
person to fix the price or prices in the attached Proposal or of any other Offeror, or to
fix any overhead, profit, or cost elements of the Proposal price or the Proposal price
of any other Offeror, or to secure through any collusion, conspiracy, connivance, or
unlawful agreement any advantage against (Recipient), or any person interested in
the proposed Work;
5. The price or prices quoted in the attached Proposal are fair and proper and are not
tainted by any collusion, conspiracy, connivance, or unlawful agreement on the part of
the Offeror or any other of its agents, representatives, owners, employees or parties
in interest, including this affiant.
Signed, sealed and delivered in the presence of:
By
Witness
Witness Printed Name
Title
18
c{ F Purchasing and Contracts Division
Cityof Tamarac _.__._........__-'._..._..... __...----..._ _--.....__._...-.. __--
< P
ACKNOWLEDGMENT
NON -COLLUSIVE AFFIDAVIT
State of Florida
County of
On this the day of , 20 , before me, the undersigned Notary Public
of the State of Florida, personally appeared
and
(Name(s) of individual(s) who appeared before notary)
whose name(s) is/are Subscribed to within the instrument, and he/she/they
acknowledge that he/she/they executed it.
WITNESS my hand
and official seal.
NOTARY PUBLIC
SEAL OF OFFICE:
NOTARY PUBLIC, STATE OF FLORIDA
(Name of Notary Public: Print,
Stamp, or Type as Commissioned)
❑ Personally known to me, or
❑ Produced identification:
(Type of Identification Produced)
❑ DID take an oath, or ❑ DID NOT take an oath
19
�A
City of Tamarac" Purchasing and Contracts Division
( r _....... ---- - _ .
CERTIFICATION
THIS DOCUMENT MUST BE SUBMITTED WITH THE BID
We (1), the undersigned, hereby agree to furnish the item(s)/service(s) described in the
Invitation to Bid. We (1) certify that we(I) have read the entire document, including the
Specifications, Additional Requirements, Supplemental Attachments, Instructions to Bidders,
Terms and Conditions, and any addenda issued. We agree to comply with all of the
requirements of the entire Invitation To Bid.
Indicate which type of organization below:
INDIVIDUAL ❑
If "Other", Explain:
PARTNERSHIP ❑ CORPORATION ❑ OTHER ❑
Authorized Signature Name (Printed Or Typed)
Title Federal Employer I,D./Social Security No.
Company Name Address
City/State/Zip Telephone
Fax Number Contact Person
20
rqM
City of Tamarac ..... .......... ..-....._1...,_------ -..-.-_........ - ----�.�._..--..-..-.------ _.._, cts Division
Purchasin and Contra _.....—n
t al
BIDDER'S
QUALIFICATION STATEMENT
The undersigned certifies under oath the truth and correctness of all statements and of
all answers to questions made hereinafter:
SUBMITTED TO: City of Tamarac
Purchasing & Contracts Manager
7525 NW 88" Avenue
Tamarac, Florida 33321-2401
CHECK ONE: ❑Corporation ❑ Partnership ❑ Individual ❑ Joint Venture ❑ Other
SUBMITTED BY (Company Name)
ADDRESS:
CITY, STATE ZIP:
1. State the true, exact, correct and complete name of the partnership, corporation,
trade or fictitious name under which you do business and the address of the place
of business:
Correct Name of Bidder
Principal address of Business
City, State Zip
2. If Offeror is a corporation, answer the following:
a. Date of Incorporation
b. State of Incorporation
C. President's name
d. Vice President's name
e. Secretary's name:
f. Treasurer's name
g. Name and address of Resident Agent
3. If Offeror is an Individual or a Partnership, answer the following:
Date of Organization
Name, address and ownership units of all partners (if necessary, use separate sheet):
NAME ADDRESS OWNERSHIP UNIT
_ ------- ----- _...... ............. .......................-
21
City of Tamarac
F 9
{
Purchasing and Contracts Division
< P
State whether general or limited partnership
4. If offer is other than an individual, corporation or partnership, describe the
organization and give the name and address of principals:
NAME ADDRESS
5. If Offeror is operating under a fictitious name, submit evidence of compliance
with the Florida Fictitious Name Statute.
6. How many years has your organization been in business under its present
name?
a. Under what former names has your organization operated?
7. Indicate registration, license numbers or certificate numbers for the businesses or
professions that are the subject of the Bid. Please attach certificate of competency
and/or state registration.
8. Have you ever failed to complete any work awarded to you? If so, state when,
where and why:
9. State the names, telephone numbers and last known addresses of three (3) owners,
individuals or representatives of owners with the most knowledge of work that you
have performed or goods you have provided (government owners are preferred as
references):
NAME ADDRESS PHONE
22
,rqq
City of Tamarac �{ - - Porch asiny.end Contracts Division
._........... _..... ........_.. --.......
10. List the pertinent experience of the key individuals of your organization
(continue on insert sheet, if necessary).
11. State the name of the individual who will have personal supervision of the work:
THE BIDDER ACKNOWLEDGES AND UNDERSTANDS THAT THE INFORMATION CONTAINED IN
RESPONSE TO THIS QUALIFICATIONS STATEMENT SHALL BE RELIED UPON BY THE OWNER IN
AWARDING THE CONTRACT AND SUCH INFORMATION IS WARRANTED BY BIDDER TO BE TRUE.
THE DISCOVERY OF ANY OMISSION OR MISSTATEMENT THAT MATERIALLY AFFECTS THE BIDDER'S
QUALIFICATIONS TO PERFORM UNDER THE CONTRACT SHALL CAUSE THE OWNER TO REJECT
THE PROPOSAL, AND IF AFTER THE AWARD, TO CANCEL AND TERMINATE THE AWARD AND/OR
CONTRACT.
(Signature)
ACKNOWLEDGEMENT
BIDDER'S (QUALIFICATION STATEMENT
State of Florida
County of
On this the day of , 20, before me, the undersigned Notary Public
of the State of Florida, personally appeared
and
(Name(s) of individual(s) who appeared before notary)
whose name(s) is/are Subscribed to within the instrument, and he/she/they
acknowledge that he/she/they executed it.
WITNESS my hand
and official seal.
NOTARY PUBLIC
SEAL OF OFFICE:
NOTARY PUBLIC, STATE OF FLORIDA
(Name of Notary Public: Print,
Stamp, or Type as Commissioned)
❑ Personally known to me, or
❑ Produced identification:
(Type of Identification Produced)
❑ DID take an oath, or ❑ DID NOT take an oath
23
A
City of Tamarac Purchasing and Contracts Division
REFERENCES
Please list name of government agency or private firm(s) with whom you have done business
within the past five years:
Agency/Firm Name:
Address
City State Zip
Phone/Fax
Contact Name
Agency/Firm Name:
Address
City State Zip
Phone/Fax
Contact Name
Agency/Firm Name:
Address
City State Zip
Phone/Fax
Contact Name
Agency/Firm Name:
Address
City State Zip
Phone/Fax
Contact Name
Agency/Firm Name:
Address
City State Zip
Phone/Fax
Contact Name
24
City of Tamarac .... -....---.............----_........._._.._--__....-_9....�.._...........I...'....................... Division...
' 4 Purchasing and Contracts _.
p
P
VENDOR DRUG -FREE WORKPLACE
Preference may be given to vendors submitting a certification with their bid/proposal certifying
they have a drug -free workplace in accordance with Section 287.087, Florida Statutes. This
requirement affects all public entities of the State and becomes effective January 1, 1991.
The special condition is as follows:
IDENTICAL TIE BIDS - Preference may be given to businesses with drug -free workplace
programs. Whenever two or more bids that are equal with respect to price, quality, and
service are received by the State or by any political subdivision for the procurement of
commodities or contractual services, a bid received from a business that certifies that it has
implemented a drug -free workplace program shall be given preference in the award process.
Established procedures for processing tie bids will be followed if none of the tied vendors
have a drug -free workplace program. In order to have a drug -free workplace program, a
business shall:
1. Publish a statement notifying employees that the unlawful manufacture, distribution,
dispensing, possession, or use of a controlled substance is prohibited in the
workplace and specifying the actions that will be taken against employees for
violations of such prohibition.
2. Inform employees about the dangers of drug abuse in the workplace, the business's
policy of maintaining a drug -free workplace, any available drug counseling,
rehabilitation, and employee assistance programs, and the penalties that may be
imposed upon employees for drug abuse violations.
3. Give each employee engaged in providing the commodities or contractual services
that are under bid a copy of the statement specified in subsection (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 contendere to, any violation of chapter
893 or of any controlled substance law of the United States or any state, for a
violation occurring in the workplace no later that five (5) days after each conviction.
5. Impose a section 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 form complies fully with the above requirements.
Authorized Signature Company Name
25
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City of Tamarac g is Division
Purchasing and Contrac
We propose to furnish the attached in conformity with the specifications and at the
bid prices indicated on the attached bid sheet. The bid prices quoted have been
checked and certified to be correct. Said prices are fixed and firm and shall be paid
to Bidder for the successful completion of its obligation as specified in the contract
documents.
GROUP 1
PASS Devices
Scott Model
Price
Extended
Item
Number
Quantity
Each
Total
Air -Pak Fifty 4.5. 30 min Carbon
804846-06
47 ea.
$aL3b°O
$ 1�3g °°
U.—
Cylinder w/EBSS w/o case
PASS device, PAK-Alert SE,
$05796-02
47 ea.
4t -
QSj b
Factory Installed
TOTAL BID PRICE:
$ 143" 115
GR� OUP 2
SEMS DEVICES
Scott Model
Price
Extended
Item
Number
Quantity
Each
Total
Air -Pak Fifty 4.5, 30 min Carbon
Cylinder w/EBSS w/o case
804846-06
47 ea.
tro
a%36 --
l �38qI eg
SEMS PDA Factory installed,
805898-05
47 ea.
10%-j 5_0
s l I I Z- , so
4500 esU,
SEMS Base Station
805679-01
1 ea.
i45$6°°
9.686.00
SEMS Serial Cable Interface,
10012421
1 ea.
No G E
PDR to Computer
SEMS, IR Link for Programming
PDA
10012420
1 ea.
No C-b>}
SEMS PC Software
100112422
1 ea.
IW C4+k��
On -site SEMS training-3 days
On -site SEMS Train -the -trainer
NQ WAR.LiE
TOTAL BID PRICE
$ «J 5q0.9,")
FLU]
City of Tamarac_
,moo
Purch..asing and Contracts Division
_
GROUP 3
CONTINGENCY ITEMS
Items in this group will not be a factor in determining
to hold quoted price for period of 12 months from the
the award of this
date
Bid. Vendor agrees
of award.
Item
Scott Model
Number
Price Each
4500 psi 60 minute carbon cylinder
804723-01
4500 psi 30 minute carbon cylinder
804721-01
626.�0
RIT-PAK w/low pressure hose and bag
805446-01
74a.�s
AV-2000 Voice Amp Assembly
$04564-01
E-Z Radiocom for Motorola MTS 2000
805206-04
PASS device, PAK-Alert SE, Field Kit
$05796-01
d31. 1?0
Face Mask, Kevlar with Silicone seal, size small
804191-11
Face Mask, Kevlar with Silicone seal, size large
804191-12
50
Face mask, Kevlar with Silicone Seal, size x-Irg.
804191-13
,sv
4.
Personal Issue Regulator
$04370-02
Particulate Cartridge, MPC Plus
$05557-01
NBC Canister, NTC-1
045122
27$4;
NBC Canister Enforcement
045123
22,11
NBC Canister, P100
0526$3
Facepiece adapter, 40mm
805059-01
Multi -gas monitor, 3-gas
096-2561-01
o3, 65
Combustible Gas Leak Detector
001 s-7os3
� � 3.°O
On -site qualitative fit testing
No CUAA, 1c
14
City of Tamarac
ADDITIONAL PASS ITEMS
Purchasing and Contracts Division
Item
Scott Model
Number
price Each
Air -Pak Fifty 4.5, 30 min Carbon Cylinder
804846-06
�3�I
w/EBSS w/o case
,S0
PASS device, PAK-Alert SE, Factory Installed
805796-02
46 so
ADDITIONAL SEMS DEVICES
Item
Scott Model
Number
Price Each
Air -Pak Fifty 4.5, 30 min Carbon Cylinder
w/EBSS w/o case
804846-06
33*r� SO
SEMS PDA Factory installed, 4500 psig
805898-05
SEMS Base Station
805679-01
aa9
SEMS Serial Cable Interface, PDR to Computer
10012421
SEMS, IR Link for Programming PDA
10012420
4((6.60
SEMS PC Software
100112422
SEMS PDA, Field Installed, 4500 psig
805898-02
13rrs�
On -site SEMS training-3 days
NO CIR.
On site SEMS Train -the -trainer
ho COARA
15
( 5T
U h'
City of Tamarac
BID FORM
(continued)
BID NO. 03-29B
Purchasing and Contracts Division
The City reserves the right to reject any bid, if it deems that a vendor has deliberate)
erroneous information. The undersigned declare to have specific and legal authorization to
obligate their firm to the terms of this bid, and further, that the have y provided
Bid, the instructions to Bidders, the Specifications, and other documents included in Invitation to
request, and hereby promises and agrees that, if this bid is accepted, they will faithfued
lly fubf I
the terms of this bid together with all guarantees and warranties thereto. The undersi
bidding firm further certifies the product and/or equipment meets or exceeds the s ecifican n
as stated in the bid package; and also agrees that products and/or equipment to be delivered
which fail to meet bid specifications will be rejected by the City within p tion
delivery. Return of rejection will be at the expense of the bidder. thirty (30) days of
Company Name
Address
IRPQA FL33b (D
City, State, ZIP
Contractor's License Number
Authorized ig atur
CAF. obmis
Typed nted Na e
$$-?.h3�-�3t9 �66-1oQ-362. TelephoneS8, Fax Number
a� �.73
Federal Tax ID#
16
City of Tamarac
7
BID FORM
(continued)
BID NO. 03-29B
Bidders Name: 15# SuLmnr-tG (% uc
Purchasing and Contracts Division
TERMS: -� % DAYS: 30
Delivery/completion: -9 4 calendar days after receipt of Purchase Order
To be considered eligible for award, one (1) original must be submitted, and two (2)
copies of this Bid Form should be submitted with the Bid.
NOTE: Bid submittals without the manual signature of an authorized agent of the Bidder
shall be deemed non -responsive and ineligible for award.
IF "NO BID" IS OFFERED, PLEASE PROVIDE THE FOLLOWING INFORMATION:
Please indicate reason(s) why a Bid Proposal is not being submitted at this time.
Return the Bid Form to avoid removal of Bidder from the City of Tamarac's
vendor listing.
17
City (.).fI Tamarac
.. _ Purchasing and Contracts Division
NON -COLLUSIVE AFFIDAVIT
State of F(oaLi b A )
County of A (j.5PaoXcrk4 N ) )ss.
deposes and says that: being first duly sworn,
1. He/she is the AE`44'5I0rN7)Vr , (Owner, Partner, Officer,
Representative or Agent) of / --X, 4 Ox/r7 Fri co. WL ,the Offeror
that has submitted the attached Proposal;
2. He/she is fully informed respecting the preparation and contents of the attached
Proposal and of all pertinent circumstances respecting such Proposal;
I Such Proposal is genuine and is not a collusive or sham Proposal;
4. Neither the said Offeror nor any of its officers, partners, owners, agents,
representatives, employees or parties in interest, including this affiant, have in any
way colluded, conspired, connived or agreed, directly or indirectly, with any other
Offeror, firm, or person to submit a collusive or sham Proposal in connection with the
Work for which the attached Proposal has been submitted; or to refrain from bidding in
connection with such Work; or have in any manner, directly or indirectly, sought by
agreement or collusion, or communication, or conference with any Offeror, firm, or
person to fix the price or prices in the attached Proposal or of any other Offeror, or to
fix any overhead, profit, or cost elements of the Proposal price or the Proposal price of
any other Offeror, or to secure through any collusion, conspiracy, connivance, or
unlawful agreement any advantage against (Recipient), or any person interested in
the proposed Work;
5. The price or prices quoted in the attached Proposal are fair and proper and are not
tainted by any collusion, conspiracy, connivance, or unlawful agreement on the part of
the Offeror or any other of its agents, representatives, owners, employees or parties in
interest, including this affiant.
Sign d, sealed and de "vered in the presence of:
+K1Z. By r
fitness
CA
Witness Printed ame
�►sIbE Sic.
Title
City of Tamarac Purchasing and Contracts Division
L+`
ACKNOWLEDGMENT
NON -COLLUSIVE AFFIDAVIT
State of Flgnda
County of
On this the J�L_ day of ,20 , before me, the undersigned Notary Public
of the State of Florida, personal appeare
and
(Name(s) of individual(s) who appeared before notary)
whose name(s) is/are Subscribed to within the instrument, and he/she/they
acknowledge that he/she/they executed it.
WITNESS my hand
and official seal. y
NOTARY PUBLI , TATE OF FLORIDA
NOTARY PUBLIC
SEAL OF OFFICE:
(Name of Notary Public: Print,
""�•'�Bd BRENDAJ.STOCK ON Stamp, or Type as Commissioned)
#*gan,e9 ThN Budget Notary Servius MY COMMISSION I DO 229746
."-eo*
EXPIRES. August 1, 2007
s�
��y
onall known to me, or
❑ Produced identification:
(Type of Identification Produced)
❑ DID take an oath, or ❑ DID NOT take an oath
19
City of Tamarac _ T Purchasing and Contracts Division
CERTIFICATION
THIS DOCUMENT MUST BE SUBMITTED WITH THE BID
We (1), the undersigned, hereby agree to furnish the items)/service(s) described in the
Invitation to Bid. We (1) certify that we(I) have read the entire document, including the
Specifications, Additional Requirements, Supplemental Attachments, Instructions to Bidders,
Terms and Conditions, and any addenda issued. We agree to comply with all of the
requirements of the entire Invitation To Bid.
Indicate which type of organization below:
INDIVIDUAL ❑ PARTNERSHIP ❑
If "Other", Explain:_ bA41Tn (,tq 4tL_r
AuthorizQJ Signature
Title
L/5#vx Sue-A"7r-1C. e 4w—
Company Name
co* re- 33LI o
City/State/Zip
0464oic - 3621
Fax Number
20
CORPORATION ❑ OTHER FA
Cm•,uP
�, owbws
Name (Printed Or Typed)
23;Z� � 3
Federal Employer I.D./Social Security No.
Address
991?- 263- 5��5
Telephone
Po kA-113
Contact Person
City of Tamarac ,' Purchasing and Contracts Division
BIDDER'S
QUALIFICATION STATEMENT
The undersigned certifies under oath the truth and correctness of all statements and of
all answers to questions made hereinafter:
SUBMITTED TO: City of Tamarac
Purchasing & Contracts Manager
7525 NW 88�' Avenue
Tamarac, Florida 33321-2401
CHECK ONE: ❑Corporation ❑ Partnership ❑ Individual ❑ Joint Venture ® Other
SUBMITTED BY (Company Name) /SN Z 5Cf�,ynFjc GAO LLC—
ADDRESS: 001 M , �M&6 cr RD
CITY, STATE ZIP: %, ,#wP q Fe- � 36 t O
1. State the true, exact, correct and complete name of the partnership, corporation,
trade or fictitious name under which you do business and the address of the place of
business: //
Correct Name of Bidder l5 Sxi « (26 . CC.G
Principal address of Business (,S-03 A), tMPIA) M R�>
City, State Zip M P,4 _ 1 33L ICU
2. If Offeror is a corporation, answer the following:
a. Date of Incorporation
b. State of Incorporation
C. President's name
d. Vice President's name
e. Secretary's name:
f. Treasurer's name
g. Name and address of Resident Agent
3. If Offeror is an Individual or a Partnership, answer the following:
Date of Organization
Name, address and ownership units of all partners (if necessary, use separate sheet):
NAME ADDRESS OWNERSHIP UNIT
21
City of Tamarac Purchasing and Contracts Division
State whether general or limited partnership
4. If offer is other than an individual, corporation or partnership, describe the
organization and give the name and address of principals:
NAME ADDRESS
5. If Offeror is operating under a fictitious name, submit evidence of compliance
with the Florida Fictitious Name Statute.
6. How many years has your organization been in business under its present
name?
a. Under what former names has your organization operated?
7. Indicate registration, license numbers or certificate numbers for the businesses or
professions that are the subject of the Bid. Please attach certificate of competency
and/or ttate registration.
8. Have you ever failed to complete any work awarded to you? If so, state when,
where and why:
9. State the names, telephone numbers and last known addresses of three (3) owners,
individuals or representatives of owners with the most knowledge of work that you
have performed or goods you have provided (government owners are preferred as
references):
NAME ADDRESS PHONE
City of Tamarac T s Division
Purchasing and n Contracts
10. List the pertinent experience of the key individuals of your organization
(continue on insert sheet, if necessary).
11. State the name of the individual who will have personal supervision of the work:
THE BIDDER ACKNOWLEDGES AND UNDERSTANDS THAT THE INFORMATION CONTAINED IN
RESPONSE TO THIS QUALIFICATIONS STATEMENT SHALL BE RELIED UPON BY THE OWNER IN
AWARDING THE CONTRACT AND SUCH INFORMATION IS WARRANTED BY BIDDER TO BE TRUE.
THE DISCOVERY OF ANY OMISSION OR MISSTATEMENT THAT MATERIALLY AFFECTS THE BIDDER'S
QUALIFICATIONS TO PERFORM UNDER THE CONTRACT SHALL CAUSE THE OWNER TO REJECT
THE PROPOSAL, AND IF AFTER THE AWARD, TO CANCEL AND TERMINATE THE AWARD AND/OR
CON CT.
(Signatu )
ACKNOWLEDGEMENT
BIDDER'S QUALIFICATION STATEMENT
State of Florida
County of •�1--
On this the `)0o day of &, , 2W 3, before me, the undersigned Notary Public
of the State of Florida, personalq appeared
and
(Name(s) of inividual(s) who appeared before notary)
whose name(s) is/are Subscribed to within the instrument, and he/she/they
acknowledge that he/she/they executed it.
WITNESS my hand
and official seal.
NOTARY PU L , STATE OF FLORIDA
NOTARY PUBLIC �\-
SEAL OF OFFICE:
(Name of Notary Public: Print,
BRENDAJ.STWC)" Stamp, or Type as Commissioned)
* MY WMMWION I DD 229746
* �. EVIRES: August 1, 2W7
"T TW BAd% s„,w� sonally known to me, or
❑ Produced identification,
(Type of Identification Produced)
❑ DID take an oath, or ❑ DID NOT take an oath
23
City of Tamarac _ Purchasing and Contracts Division
REFERENCES
Please list name of government agency or private firm(s) with whom you have done business
within the past five years:
Agency/Firm Name:
ao FlJ2»F UVr
Address
_o- 18 o-l[ Z7.4 t)4S
City State Zip
)Cc 33612,
Phone/Fax
Contact Name
Agency/Firm Name:
P-r. p
Address
3 IF . 5 ft LIE
City State Zip
—
0 33,0(0
Phone/Fax
Contact Name
Agency/Firm Name:
Address
City State Zip
T
Phone/Fax
Contact Name
Agency/Firm Name:
Address
City State Zip
Phone/Fax
Contact Name
Agency/Firm Name:
Address
City State Zip
Phone/Fax
Contact Name
24
City of Tamarac Purchasing and Contracts Division
VENDOR DRUG -FREE WORKPLACE
Preference may be given to vendors submitting a certification with their bid/proposal certifying
they have a drug -free workplace in accordance with Section 287.087, Florida Statutes. This
requirement affects all public entities of the State and becomes effective January 1, 1991. The
special condition is as follows:
IDENTICAL TIE BIDS - Preference may be given to businesses with drug -free workplace
programs. Whenever two or more bids that are equal with respect to price, quality, and service
are received by the State or by any political subdivision for the procurement of commodities or
contractual services, a bid received from a business that certifies that it has implemented a
drug -free workplace program shall be given preference in the award process. Established
procedures for processing tie bids will be followed if none of the tied vendors have a drug -free
workplace program. In order to have a drug -free workplace program, a business shall:
1. Publish a statement notifying employees that the unlawful manufacture, distribution,
dispensing, possession, or use of a controlled substance is prohibited in the
workplace and specifying the actions that will be taken against employees for
violations of such prohibition.
2. Inform employees about the dangers of drug abuse in the workplace, the business's
policy of maintaining a drug -free workplace, any available drug counseling,
rehabilitation, and employee assistance programs, and the penalties that may be
imposed upon employees for drug abuse violations.
3. Give each employee engaged in providing the commodities or contractual services
that are under bid a copy of the statement specified in subsection (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 contendere to, any violation of chapter 893
or of any controlled substance law of the United States or any state, for a violation
occurring in the workplace no later that five (5) days after each conviction.
5. Impose a section 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 form complies fully with the above requirements.
Aj-
r
Authoriz Signa Ure
25
f 1_50?n 5C4 ewnAc eo
Company Name