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Home My WebLink AboutCity of Tamarac Resolution R-2003-233Temporary Resolution 10243 September 24, 2003 First Revision: September 30, 2003 Second Revision: October 2, 2003 Page 1 CITY OF TAMARAC, FLORIDA RESOLUTION NO. R- 2003- a.3_-_ A RESOLUTION OF THE CITY COMMISSION OF THE CITY OF TAMARAC, FLORIDA AUTHORIZING THE AWARD OF BID NO. 03-30B FOR THE PURCHASE OF URBAN SEARCH AND RESCUE GEAR TO FISHER SCIENTIFIC CO., LLC AT A TOTAL COST OF $71,949; 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 Fire Rescue Department is responding to increasing numbers of non-structural emergency calls; and WHEREAS, the City's fire rescue personnel currently respond to non-structural emergency calls in structural turnout gear; and WHEREAS, light -weight personal protective clothing, also known as Urban Search and Rescue (USAR) gear, will provide appropriate protection for technical rescue operations such as extrications, while providing the optimal comfort and mobility for fire rescue personnel; and 1 Temporary Resolution 10243 September 24, 2003 First Revision: September 30, 2003 Second Revision: October 2, 2003 Page 2 WHEREAS, the City was awarded a grant in the amount of $195,230, providing for a City match of $83,670, for a total project cost of $278,900 to support the purchase of additional Self -Contained Breathing Apparatus (SCBA) units and USAR gear; and WHEREAS, the City Commission of the City of Tamarac is committed to enhancing fire rescue personnel safety through the acquisition of USAR gear for all fire rescue personnel; and WHEREAS, the City of Tamarac publicly advertised Bid No. 03-30B for USAR gear, a copy of which is hereto attached as "Exhibit 1 ", in the Sun -Sentinel on August 24, 2003; and WHEREAS, on September 10, 2003 one bid was opened and reviewed in order to determine cost and responsiveness to the City's technical specifications; and WHEREAS, Fisher Scientific Co., LLC provided the only responsive and responsible bid for the USAR gear 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 Federal Emergency Management Agency; and WHEREAS, the City Manager and the Fire Chief recommend that the City award Bid No. 03-30B to Fisher Scientific Co., LLC; and 1 Temporary Resolution 10243 September 24, 2003 First Revision: September 30, 2003 Second Revision: October 2, 2003 Page 3 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. 043- 30B to Fisher Scientific Co., LLC to provide USAR gear for the Tamarac Fire Rescue Department at a total cost of $71,949. 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. 03-30B for the purchase of Urban Search and Rescue gear at a total cost of $71,949 is hereby awarded to Fisher Scientific Co., LLC. 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 portion or applications of this Resolution. J Temporary Resolution 10243 September 24, 2003 First Revision: September 30, 2003 Second Revision: October 2, 2003 Page 4 Section 5: This Resolution shall become effective immediately upon its adoption. PASSED, ADOPTED AND APPROVED this 8�h day of October, 2003. MARION SW NSON, CMC CITY CLERK I HEREBY CERTIFY that I have approved this RESOLUTION cis to form. MITCHELL 9. KRAF/ CITY ATTORNEY t � . ,.JOE SCHREIBER, MAYOR RECORD OF COMMISSION VOTE: %r MAYOR SCHREIBER DIST 1: COMM. PORTNER DIST 2: COMM. FLANSBAUM-TALABISCO DIST 3: COMM. SULTANOF ' DIST 4: V/M ROBERTS /hut 1 r Purchasing and Contracts Division Citv of Tamarac "Committed to Excellence... Always" EXHIBIT 1 /TR # 10243 INVITATION TO BID BID NO. #03-30B 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, September 10, 2003 at 2:00 p.m., at which time bids will be publicly opened and announced for: URBAN SEARCH AND RESCUE GEAR 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 Urban Search and Rescue (USAR) lightweight, non-structural, protective fire gear, as per the conditions and specifications contained in this document. One (1) original must be submitted and two (2) copies should accompany the original; however, copies must be submitted within 3 days of City's request. Bids shall be submitted on the official Bid Form furnished with the bid package and those submitted otherwise will not be considered responsive. The bid submittal shall be plainly marked "Bid No. 03-30B, Urban Search and Rescue Gear" 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 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 Kimberly Perron at (954) 724-2531. A � ILO_� Steven J. Beamsderfer Buyer Publish Sun -Sentinel 8/24, 8/31/2003 7525 NW 88th Avenue ■ Tamarac, Florida 33321-2401 ■ (954) 724-2450 N Fax (954) 724-2408 ■ www.tomarac.org Equal Opportunity Employer tCity of Tamarac. Purchasing 8, Contracts Division INSTRUCTIONS TO BIDDERS BID NO.03-30B 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, Sepetember,10, 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, bid name, time and date of the bid opening 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. Bidders are required to state exactly what they intend to furnish to the City via this solicitation and must indicate any variances to the terms, conditions and specifications of this bid, no matter how slight. If variations are not stated in the bid, it shall be construed that the Bidder's bid fully complies with all conditions identified in this bid. The Bidder must submit one (1) original and two (2) copies of the bid. 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. 3. WITHDRAWAL OF BID Any Bidder may withdraw their bid prior to the indicated opening time. The request for withdrawal must be submitted in writing to the City Purchasing Office. ......... 2 F np. � 9 Y _._......._.._Purchain & C nntracts Division City of Tamarac 91. 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 should complete the Non -Collusive Form and submit the form with the Proposal; however the form must be submitted within 3 days of the City's request. 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. All exceptions shall be noted. Failure to do so may be cause for rejection of the bid. 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. 9. BRAND NAMES Manufacturers' name, brand name, model number, or make is used in these specifications for the sole purpose of establishing minimum requirements of quality, performance, and design. __..._..--..._.__.....--........_..... ...-------- ----- _----------- __.__._.......... -.................... 3 a r Tn�k City of iarrarac Purchasing & Contracts Division 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. 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 day's 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 4 City of Tamarac Purchasing g Purch_asing & Contracts Division 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. 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 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 may be 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 ........ __._..._ 5 F City of Tamaiac Purchasing & Contracts Division 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 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 i 99 City of Tgrn�:arrac Purchasing & Contracts Division � P 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 to the City of Tamarac Purchasing and Contract 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 should request it by enclosing a stamped, self-addressed envelope with their bid or by requesting tabulation be sent to their fax machine. Bid results will not be given out by telephone. The City does not notify unsuccessful bidders of contract awards. 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. r rn City of Tamaracu � Purchasing & Contracts Division SPECIAL CONDITIONS BID NO. 03-30B 1. PURPOSE OF BID The City of Tamarac is hereby requesting Bids, from qualified vendors, to provide the Tamarac Fire Rescue Department with Urban Search and Rescue (USAR) lightweight, non- structural, protective fire gear. 2. CONSIDERATION FOR AWARD. The City will review and consider all offers meeting the requirements contained in this bid. It is the intent of the City to award this bid to the lowest responsible and responsive bidder. Color will not be a consideration in determining the lowest responsible and responsive bid. 3. CONTINGENCY ITEMS Contingency items 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 in the pricing table for these items. Contingency item pricing will not be a factor in determining the lowest responsive and responsible bidder for purposes of bid award. 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. SIZES Small (S), medium (M), large (L), and extra large (X-Large) size must be offered at the same unit cost. 5. PRICING All pices shall be quoted delivered, F.O.B. destination. Pricing for contingency items shall be held firm and fixed for a period of one year from the date of Bid Award. 6. DELIVERY DATE All items ordered shall be delivered to the City of Tamarac no later than 60 days after the issuance of a written Purchase Order. 8 tCity of 7arr�atac. Purchasing & Contracts Division TECHNICAL SPECIFICATIONS BID NO.03-30B SCOPE OF WORK Provide eighty-eight (88) sets of Urban Search and Rescue (USAR) lightweight, non- structural, protective gear. Each set will be made up of one jacket and one separate pair of pants. USAR gear bid must meet the following criteria: a) NFPA 1951 certified for fire and flame resistance. b) NFPA 1999 certified for EMS and blood borne pathogen resistance. c) Liquid penetration resistant, NFPA 1992 certified. d) All pants and jackets to be equipped with Crosstech (or equal) Liners. e) All pants and jackets must be equipped with a bar code system. The bar code must meet industrial laundry labeling standards, be compatible with 2 of 5 symbology, and be compatible with tracking software to comply with NFPA 1851. f) All pants and jackets must include two-tone orange and silver triple stripe reflective trim. M F City of Tamarac Purchasing & Contracts Division COMPANY NAME: (Please Print): Phone: 1 K 9 4. 5. 6. 7. 8. Fax: BEFORE SUBMITTING YOUR BID, MAKE SURE YOU... ❑ Carefully read the General Terms & Conditions, Special Conditions and Technical Specifications. ❑ 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. ❑ Include proof of insurance. Failure to provide the requested attachments may result in your bid being deemed non -responsive. THIS SHOULD BE THE FIRST PAGE OF YOUR BID. 10 tCity of Tamarac Purchasing and Contracts Division 1��Im BID NO. 03-30B 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. Bidder will sign and submit the necessary documents required by the City within fifteen (15) days prior to the date of the City's Award. 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. ...---_ _ ........................_ 11 eCity of Tamarac Purchasing and Contracts Division BID FORM (continued) BID NO. 03-30B We propose to furnish the following eighty-eight (88) sets of Urban Search and Rescue (USAR) gear in conformity with the technical specifications and at the below bid prices. 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. All prices quoted are FOB delivered to the City of Tamarac. Item Ouantity Cost per set Extended Cost USAR Gear, W/Crosstech (or equal) Liner. Jacket and pants combination. 88 S,M, L, X-Large (at same unit cost)_ Total Bid Cost $ List all color options available for proposed USAR gear at same bid price: CONTINGENCY ITEMS Item Cost/unit USAR Gear. Jacket and pants combination. Size XX-Large $ USAR Gear. Jacket and pants combination. Size XXX-Large $ Storage bag for gear $ Pocket for pants $ Pocket for jacket $ Radio pocket $ ......" ......... -----------........... -.............. 12 City of Tamarac M P Purchasing and Contracts Division 13 City of Tamarac � � Purchasing and Contracts Division BID FORM (continued) BID NO. 03-30B 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 Authorized Signature Typed/Printed Name Telephone & Fax Number Contractor's license Number Federal Tax ID# 14 F A,� City of Tamarac � Purr hnsinrl and Contracts Division < p. Bidders Name: TERMS % DAYS: BID FORM (continued) BID NO. 03-30B To be considered eligible for award, one (1) original must be submitted, and 2 (two) copies should be submitted; however, bid copies must be submitted within 3 business days of the City's request. 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. 15 F Tq q A Y City of Tamarac Purchasing Division ( P NON -COLLUSIVE AFFIDAVIT State of )ss. County of being first duly sworn, deposes and says that: 1. He/she is the , (Owner, Partner, Officer, Representative or Agent) of , 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; 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 16 oe� City of Tamarac Purchasing Division 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 17 City of Tamarac c ,< Purchasing Division P F1 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 ❑ PARTNERSHIP ❑ CORPORATION ❑ OTHER ❑ If "Other", Explain: Authorized Signature Title Company Name City/State/Zip Fax Number Name (Printed Or Typed) Federal Employer I.D./Social Security No. Address Telephone Contact Person 18 F Tq w � 9 Laity of Tamarac Purchasing 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 881h 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 19 : TAM 1A City of Tamarac. � � Purchasing 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 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 20 i a City of Tamarac Purchasing Division A 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 .......... ....... _...... _........ ......... .. . 21 of Tamarac � Purchasing Division A, 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 22 City of Tamarac Purchasing Division t F 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 23 City of Tamarac Purchasing and Contracts Division BID FORM (continued) BID NO. 03-30B EXHIBIT 2 - TR #10243 We propose to furnish the following eighty-eight (88) sets of Urban Search and Rescue (USAR) gear in conformity with the technical specifications and at the below bid prices. 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. All prices quoted are FOB delivered to the City of Tamarac. Item Quantit Cost er set Extended Cost USAR Gear, W/Crosstech (or equal) Liner. Jacket and pants combination. $8 /�3�. `,/� p $D S,M, L, X-Large (at same unit cost)_ 4 � b Total Bid Cost 1, / Y. V68 $b List all color options available for proposed USAR gear at same bid price: CONTINGENCY ITEMS Item USAR Gear. Jacket and pants combination. Size XX-Lar e USAR Gear. Jacket and pants combination, Size XXX-Large Storage baq for qear Pocket for pants Pocket for jacket Radio pocket Cost/unit 60 $ �60 $ 4�5-'46 � 33,3 sS, 60 12 City of Tamarac Purchasing and Contracts Division Cro�l r,Aj Cz6AUC i USAk 6r" e. Ur 4RAD F & ' P86 -r Ult-fRAbe poceEr -lg& pO-%'tS + 3 /"/, �& F4 UNGP-CA-bt POCKE.r- �O'Q CMIs 4 /a,45- ft, UPCaeA0e 'RAbto Rc ie-sr + S-,L° Ea_ 13 is Cit of Tamarac Y .:\ Purchasing and Contracts Division BID FORM (continued) 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. FisHoA— SGcu-n Company Name Address -rA,A.tPA roc. 336 (v City, State, ZIP Authooriized ignat re- ' Typed/Pri ted Name $92-263--6-3 ti Telephone & Fax Number a3-Z94z13r1 Contractor's License Number Federal Tax ID# 14 City of Tamarac Purchasing and Contracts Division BID FORM (continued) BID NO. 03-30B Bidders Name: - E15ff SC1EN77FIL �--0- Lam- - TERMS: m r % DAYS: 36 To be considered eligible for award, one (1) original must be submitted, and 2 (two) copies should be submitted; however, bid copies must be submitted within 3 business days of the City's request. 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. 15 City o/ Tamarac State of POA4 NON -COLLUSIVE AFFIDAVIT I/ County of IT41kkVXzUhq ) )ss. Purchasing Division being first duly sworn, deposes and says that: 1. He/she is the A "A*StNrAn✓t , (Owner, Partner, Officer, Representative or Agent) of �lS/f�ie Sci6Nn�yc Leo ... , 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; 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: l By ��U Witn k 1potAlfCA, F'. bEALrS Witness Printed Name Title 16 City of Tamarac j..„ Purchasing Division ACKNOWLEDGMENT NON -COLLUSIVE AFFIDAVIT State of Florida County of On this theg day of , 201B, before me, the undersigned Notary Public of the State of Florida, persona ly appeared Wei (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: . •"".'0k, BRENDA J. STOCKTON * MY COMMISSION N DD 229746 EXPIRES: August 1. 2001 + : t hawed Thro lueget Notary WPM � pF Fly NOTARY PUB IC, STATE O�FFLO�RIDA @tom Pr C?d. 1.1� rJ (Name of Notary Public: Print, Stamp, or Type as Commissioned) V' ersonally known to me, or ❑ Produced identification: (Type of Identification Produced) ❑ DID take an oath, or ❑ DID NOT take an oath 17 '` •tip\ City of TamaracPurchasing Division 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 ❑ PARTNERSHIP ❑ CORPORATION ❑ OTHERX If "Other", Explain: _JM r7n L1"IL.In &sLP0 a-&'rt*1+•1 f„_ AuthorizeA Signat re ��b'�j4. SA►u�'S Title f�tS !ID SG ,ram t Co . UG Company Name City/State/Zip T Fax Number l.�f o�E.R-r5 Name (Printed Or Typed) 23-214xl3 Federal Employer I.D./Social Security No. 6So k) , Add ress 9$8 -W-S311 Telephone OA W _ I _ Contact P rson _ W 18 City of Tamarac ~r' Purchasing 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 88th Avenue Tamarac, Florida 33321-2401 CHECK ONE: ❑Corporation ❑ Partnership ❑ Individual ❑ Joint Venture [Other SUBMITTED BY (Company Name) F15 56Esjr► 4� ic. Co L Lz- ADDRESS: &01 1 6 CITY, STATE ZIP: TO�..+�AC� �� _3�jt.1 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 19 City of Tamarac Purchasing Division State whether general or limited partnership N A 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. & 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. & 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 20 City of Tamarac ' Purchasing Division Y i. ':i 9 ---- 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 a�a X— On this the = day of , 20_U, before me, the undersigned Notary Public of the State of Florida, perso ally 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: t BRENDA J. STOCCON ' MY COMMISSION 100 229746 t nEXPIRES: Auguyst 1, 2007 Si�OF Fl ` Pad TV,BA4I Net" served NOTARY PUBLIgjSTATE OF FLORIDA \ \ O C�� ``G U (Name of Notary Public: Print, Stamp, or Type as Commissioned) 215ersonally known to me, or ❑ Produced identification: (Type of Identification Produced) ❑ DID take an oath, or ❑ DID NOT take an oath 21 City of Tamarac j,-;,'.;. .? Purchasing 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: YL ad,] IC/R-T 7�PT Address 340 C Y,5"&M ,- City State Zip �/ccc�t�.,��. Fl- _ _ 336L( _ Phone/Fax Contact Name Agency/Firm Name: F7. thixAf-4M-t_ F1 Address 800 SW (st- Sm-ti4l City State Zip Er (AKb . rL MOO. Phone/Fax Contact Name Agency/Firm Name: 4 /4::/Aw _ PT Address g3 5�T City State Zip L. 330 (D 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 22 City of Tamarac r= ti. `1 Purchasing 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. Y Stttt ! SC.,6W77F7C_ Authoriz Signa ure Company Name 23 1 GC a w c� w U cn w ir 2 W M N M z �a m a� D W 0 J h- N J Y U W 0 m CD R CA W LLU CD 4a 0 m O W > W W � J z 0 w j a ' z m � 4 J � O � I 0 ' (a I I I J a m I1 I1 a z 0 Fn rn 0 U 0 6-