HomeMy WebLinkAboutCity of Tamarac Resolution (326)Temp. Reso #9961
October 28, 2002
Page 1 of 1
CITY OF TAMARAC, FLORIDA
RESOLUTION NO. R-2002-
A RESOLUTION OF THE CITY COMMISSION OF THE CITY
OF TAMARAC, FLORIDA, AUTHORIZING THE AWARD OF
BID NO, 03-01 B FOR THE PURCHASE OF AQUATIC,
ORNAMENTAL AND TURF HERBICIDES TO HELENA
CHEMICAL COMPANY, AGRO DISTRIBUTION, LLC DBA
PRO SOURCE ONE, AND UAP TIMBERLAND LLC;
AUTHORIZING AN ANNUAL EXPENDITURE OF FUNDS IN
AN AMOUNT NOT TO EXCEED $81,700; PROVIDING FOR
CONFLICTS, PROVIDING FOR SEVERABILITY; AND
PROVIDING FOR AN EFFECTIVE DATE.
WHEREAS, the Public Works Department utilizes a variety of chemicals for weed
control and fertilizing within City maintained canals and rights -of -way; and
WHEREAS, in order to effectively provide these services, it is necessary to
purchase certain quantities of chemicals on an annual basis; and
WHEREAS, the City of Tamarac publicly advertised Bid No, 03-01 B for Landscaping
and Aquatic Chemicals in the Sun -Sentinel on September 151h and 22" d, 2002; and
WHEREAS, on October 2, 2002, seven (7) bids were opened and reviewed in order
to determine cost and responsiveness to the City's technical specifications; and
WHEREAS, three (3) of the seven (7) bidders provided the lowest responsive and
responsible bids for various individual items as per the copy of the Bid and bid tabulation
being hereto attached as Exhibit 1;and
WHEREAS, funding is available in the adopted Public Works operating budget for
said purpose; and
WHEREAS, the Director of Public Works and Purchasing and Contracts Manager
recommend that the City award Bid No. 03-01 B to the three (3) lowest responsive and
Temp. Reso #9961
October 28, 2002
Page 2 of 2
responsible bidders for individual items as listed in the bid tabulation; and
WHEREAS, the City Commission of the City of Tamarac, Florida deems it to be in
the best interest of the citizens and residents of the City of Tamarac to award Bid #03-01 B
to the three (3) lowest responsive responsible bidders, Helena Chemical Company, Agro
Distribution, LLC DBA Pro Source One, and UAP Timberland LLC, for the provision of
landscaping and aquatic chemicals.
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COMMISSION OF THE
71r17;�r�Tt•L�17�[����7:�1�7���� L��
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
upon adoption hereof.
SECTION 2: The award of Bid No. 03--01 B for the purchase of Landscaping
and Aquatic Chemicals to the three (3) lowest responsive responsible bidders, Helena
Chemical Company, Agro Distribution LLC DBA Pro Source One, and UAP Timberland
LLC, for a period of one (1) year with two (2) additional two (2) year renewal options, for an
annual expenditure not to exceed $81,700, is hereby approved.
SECTION 3: There are sufficient funds available in the Public Works
operating budgets for said purpose.
SECTION 4: All resolutions or parts of resolutions in conflict herewith are
hereby repealed to the extent of such conflict.
SECTION 5: 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
application, it shall not affect the validity of the remaining portions or applications of this
1
Resolution.
SECTION 6:
passage and adoption.
Temp. Reso #9961
October 28, 2002
Page 3 of 3
This Resolution shall become effective immediately upon its
PASSED, ADOPTED AND APPROVED this 131h day of November, 2002.
ATTEST:
MARION WENSON, CMC
CITY CLERK
I HEREBY CERTIFY that I
have approved this
RELUTION as to form.
MITCHE A
CITY ATTO E)
JOE SCHREIBER
Mayor
RECORD OF COMMISSION V TE:
MAYOR SCHREIBER
DIST 1: V/M PORTNER
DIST 2: COMM. MISHKIN
DIST 3: COMM. SULTAN 10
DIST 4: COMM. ROBERTS i
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Purchasing
Division
City of Tamarac
"C OrI'llTvttc. (:l to E::xc ellenc-c)...Alwny ,,
INVITATION TO BID
BID NO. 03-01 B
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,
F aniarac, Florida 33321 2401 until Wednesday, October 2, 2002 at 2:00 p.m., at which
time bids will be publicly opened and announced for
Landscaping and Aquatic Chemicals
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
i _andscaping and Aquatic Chemicals, as per the conditions and specifications contained in
this document.
One original and two copies (2) of the bid shall be submitted on an official bid form
furnished with the bid package and those submitted otherwise will not be considered
responsive. The submittal shall be plainly marked Bid No. 03-0113, Landscaping and
Aquatic Chemicals opening on Wednesday, October 2, 2002 at 2:00 p.m, 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 issuers, contact Wes Tipton at (954) 724-2519.
Steven J. Beamsder-fer
Buyer
Publish Sun Sentinel: 9/15/02 & 9/22/02
752.5 NW 88th Avenue ■ Totn(cirac., Honda 33321-2401 • (954) 724-2450 ■ Fax (954) 724-2408 ■ www.tamorac.org
Equol Oppoil roily Frnployei
TABLE OF CONTENTS
Landscaping and Aquatic Chemicals
r � r
Instructions to Bidders ............... ____ ....... ........ __........... ................... ............. ... 3
General Terms and Conditions............................................................................. 3
Special Conditions ................................ 10
Bid Coversheet Checklist ................................
Bic. Form.............................................................................................................12
Non -Collusive Affidavit........................................................................................ 13
Certification......................................................................................................... 20
Bidder's Qualification Statement......................................................................... 21
References......................................................................................................... 24
Vendor Drug -Free Workplace ................................ 5
City of Tamarac Prirchw5iiig Divi5i0rr
...... ...... ........ ...........
INSTRUCTIONS TO BIDDERS
131111111i 19KI SV]
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, lurIlf) sure
or individual item basis urilc?ss othc,,rwise 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 lirrnited 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.
The; Bidder is directed to deliver sealed bids to the City's Purchasing Office, City of f amarac,
7525 N_ W. 88th Avenue, Tamarac, Florida 33321, no later than 2:00 PM, Wednesday,
October 2, 2002. At this time the bids will be opened, the names of all Bidders will be
announced and all bids shall be 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 City
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 packet. 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 shall 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 quotations must be typewritten or filled in with pen and ink. Bids
having erasures or corrections must be initialed in ink by the Bidder, 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
(., y or iamarac Purchasing Division
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 fist 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 forthe 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 to be made on the date of the mailing of the check.
..................................................................... .
4
City of Tamarac: i; S,�t Ptifu i iwig Division
... ...... :........... .... ......
nF=i ivFRY
All items shall be delivered F.Q.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' narne, brand name, model number or make is used in these specifications for
the sole purpose of establishing miniMUrn requirements of quality, performance and design_
% SAMPLES AND DEMONSTRATIONS
When requested, samples are to be furnished free of charge to the City. If a sample is
requested it rnrrst be delivered within seven days of the request unless otherwise stated in the
bid. Each sample must he 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 dernonstrations 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 scat forth in the Occupational Safety and Health Act and its amendments to any
industry standards if applicable.
5
City of Tamarac( � Purctiasirrg Division
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 days written notice delivered by certified mail, returr7 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 srrb-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 pr.rrsuant 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 shell at all times be under its sole direction and not an employee or
agent of the City_ ..the Bidden 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.
6
city or -1-arnaox, (l Purrhasing Division
19. TAXES
The City of' Tarrlarac is exempt from all Federal, State, and Local taxes. An exemption
cortificate 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
sr.rpplying 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 rc:spEzct 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 Officer 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 Officer certificates of all insurance required
under this section prior to beginning any work under this Agreement. Bidder shall indemnify
and save the City harmless frorxl 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:
Line of Business/ Coverage
Commercial General Liability
Limits
Occurrence Aggregate
$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
....................... .. ........
C;rly of Tamarac
i,
Automobile Liability
Workers' Compensation & Employer's Liability
f'rrrr Ir nrc7 (JrVr;ltan
$1,000,000 $1,000,000
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 Lander 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 cornply 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 Tarnarac, 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 t arnarac 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 jLidge 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 C',ity employee or its representative.
.....................
� 4q
Gity of Tamarac i Purchasing Division
25. BID TABULATION
Bidders who wish to receive a ropy of the bid tabulation should request it by enclosing a
stamped, self-addressed envelope with their bid, or by requesting a 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 St:ratoto Chapter 119, Section 7(m), sealed bids or proposals received by
ran 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
ragemy provides notice of a decision or intended decision pursuant to s. 1_2-0. _, 5 7(:3)(a) or,
within 10 days after bid or proposal opening, whichever is earlier.
26. RECORDSMUDIT S
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 otaccount,
reports and records relating to this contract for the duration of the contract and retain them for
a minirnum period of one (1) year beyond the last day or the contract term.
............ . ....................... .. .....
9
City of Tamarac, , Purchasing Division
IWOr7kI0Ik11[ 7
1PURPOSE OF BID
The City of Tamarac is hereby requesting Bids, from qualified vendors, to obtain fixed prices
for various Aquatic, Ornamental and Turf herbicides and additives for an initial period
beginning upon date of approval by City of Tamarac Commission through December 31,
2003.
The City reserves the right to extend the contract for two (2) additional two (2) year periods
providing all parties agree to the extension, and all of the terms, conditions, and specifications
remain the same.
2. DELIVERY:
All deliveries by bidder's fleet or common carrier are to be palletized and secured by proper
banding and/or wrap material to prevent shipping, unloading, or handling accidents. Fhe City
reserves the right to refuse any delivery, at no cost to the City or its employees, that does not
meet this requirement. The City is not responsible for any accident or spillage while
chemicals are in transit to their designated receiving points and until actual delivery is
accepted. All deliveries must be made Monday through Friday between the hours of 7.00
A.M. and 3.00 P.M. Deliveries must he scheduled twenty-four (24) hours in advance by
calling the Storrnwater Supervisor at (954) 724-2519 so adequate personnel can unload
trucks and store materials in the storage shed.
3. LABELING:
Two (2) complete sets of specimen labels and any supplemental labeling covering the items
offered must accompany all bids. Each label must carry the appropriate EPA registration
rnurnber(s) for the material specified. Two (2) original copies of Material Data Safety Sheets L,f ,
Must be included with bid raterial.
1.0
COMPANY NAME- (Please Print)- _ ` {') '
.-`>�'i �} % I ( C < Fax: `7 Cam( ��— �.:
BEFORE SUBMITTING YOUR BID MAKE SURE YOU...
1. Carefully read the General Terms & Conditions, Special Conditions and the
General Requirements.
❑ 2. Carefully read the Detailed Specifications, and then properly fill out the BID
FORMS.
❑ 3. Fill out and sign the NON -COLLUSIVE AFFIDAVIT and have it properly notarized.
❑ 4. Sign the CERTIFICATION page. Failure to do so will result in your Bid being
deemed non -responsive.
175. Fill out the BIDDERS QUALIFICATION STATEMENT.
❑ 6Fill out the REFERENCES page.
❑ 7. Sign the VENDOR DRUG FREE WORKPLACE FORM.
3. Include proof of insurance.
❑ 9� Submit ONE (1) Original AND TWO (2) Photocopies of your bid, clearly
marked with the BID NUMBER AND BID NAME on the outside of the package.
❑ 1 O) 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.
�M
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Fee 6 •:u
BID NO. 03-01 B
Submitted by:_ r;ti//i :�' �"C'i _ r, Date'
Bidder
THIS BID IS SUBMITTED TO:
City of Tamarac
Purchasing and Contracts Manager
7525 Northwest 881r' Avenue
Tarnarac, Florida 33321
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 riecessary 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 mature and extent of the contract
docur-nents, locality, and all local conditions and laws and regulations that in
any manner may aff(:c:t cost, progress, performance or furnishing of the Work.
b) Bidd(,,r has given the City written notice of all conflicts, errors or discrepancies
that it has discovered in the contract doCUnlents 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 riot submitted in conformity
with any agrc:�ement 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.
__ .-............ ._._._......._
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(continued)
BID NO. 03-01 B
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 firrn 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 prodr.ict 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) drays of
delivery. Return of rejection will be at the expense of the bidder.
.... _.._._ .__
Company Name
J , /\/ , °y7 / T
Address
Authorized Signatu
Typed/Printed arYae:
1 iix
City, State., IP_ Telephone & Fax Number
_ 1 _
Contractor's License Number
?/ oJ" , 9 '7s s
Federal Tax ID#
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w-Y � r'� r rti rti M •
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BID NO. 03-01 B
Bidders Name: L..
TERMS: I 1-t- % Net �mm) nays
Delivery/cornpletiom calendar days after receipt of Purchase Order
To be considered eligible for award, one (1) on final and two (2) c_ot?es of this bid form
MUST be submitted with the Bid.
NOTE: Bid submittals without the manual signature of an authorized agent of the Bidder
shall be deerned non -responsive and ineligible for award.
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.
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BID FORM
(continued)
BID NO. 03-01 B
r
Bidder's Name: t. gler)n C—h er-r) t. cu._�. ;
Variations:
The Bidder shall identify all variations and exceptions taken to the Instructions to Bidders, the
Special Conditions and any Technical Specifications in the space provided below; provided,
however, that such variations are not expressly prohibited in the bid documents. For each
variation listed, reference the applicable section of the bid document. If no variations are listed
here, it is understood that the Bidder's Proposal fully complies with all terms and conditions. It
is further understood that such variations may be cause for determining that the Bid Proposal
is non -responsive and ineligible for award:
Section �, 6 c:: Variance i
Section Lr7 kcQ42 . Variance % , ; e. k",
Sc ction Variance,
Section Variance
Attach additional sheets if necessary.
ry
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. ..... ..... . ....... ......... .... ....... .. .... . . ...
NON -COLLUSIVE AFFIDAVIT
State of
) SS:
County of
deposes and says that:
being first duly sworn,
1. He/she is the _ C, f�f��.'i�d��_��Q {Ouvn�r, Partner,
Officer, Representative o Agent) off%f?�, • �' c� the
Offeror that has submitted the attached Proposal;
. 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, sgaled and delivered in the presence of:
Wit aes� �-_
r�
k UVi�ness
°.�
Printed Name
Title mm
M \
..lf r, Cx �} ri
\ 1r
ACKNOWLEDGMENT
NON -COLLUSIVE AFFIDAVIT
State of Florida
County of
On this the day of _.__L?:)'� 2002 before me the
undersigned Notary Public, of the State of Florida, personally appeared:
f- /`/ 1.Ik'/ and
(Name(s) of individuals) ho 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:
7
l
NOTARY P&BLIC.�TATE OF rLORIDA
(Name of Notary Public: Print,
Stamp, or Type as Commissioned)
JZ Personally known to me, or
❑ Produced identification:
(Type of Identification Produced)
❑ DID take an oath, or
❑ DID NOT take an oath
(r1,..... .... (1 .f
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, Supplernerital 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:
_ utForized' Sigr7<atr.: Name (Printed C r Typed)
-----__._
Title =cdcr%zl Er n'� plo...yc-r"
? .
i.D./Social Security No,
w
Company Name Address
/-c
City/State/Zap Telephone
___.._ 41
Contact Person fax Number
.. . ....... ............... ....... .. . . ... ... . ------ . .. ...... ... ............ . . .... . .
BIDDER'S
QUALIFICATION STATEMENT
The undersigned certifies under oath the truth and correctness of all statements and of
all answers to questions rnade hereinafter:
SUBMITTED TO: City of Tamarac
Purchasing & Contracts Manager
7525 NW 881h Avenue
Tamarac, Florida 33321-2401
CHECK ONE: FCorporation F1 Partnership F-1 Individual L] Joint Venture E 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 P-7
Principal address of Business
City, State Zip
Z o 2. If Offeror is a corporation, answer the fo wing:
a. Date of Incorporation
b. State of Incorporation
C. President's name �6 C6
d. Vice President's name
e. Secretary's name:
f. Treasurer's name,
9- 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
.... . . .. .... ... ... ..... ---------- . ..... ..
1 s \
'1
State whether general or limited partnership
4. If offer is other than an individual, corporation or partnership, describe the
organization and give the narne and address of principals:
NAME
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?
T 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:
g
State the names, telephone nurnbers 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 (goverrarnont owners are preferred as
references):
NAME DD. •
....._ �?.`(�.�_ 7 r - d ,. _:r'' r, r:r-- — 1 `
"
t l LL1 r 44-jar e4
9M �a
li / r.
... ). .. .......................................... .... _...
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 GIDDFR ACKNOWI...EDGES AND UNDERSTANDS THAT THE INFORMATION CONTAINED IN
FRES PON SL To i I ItS QUALIFICATIONS STATEMENT SHALL BE RELIED UPON 13Y THE OWNER IN
AWARDING THL CONTRACT AND SUCH INFORMATION IS WARRANTED BY 13IDDER 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 ..r.`�; �c �-
On this the / ' day ofCr, 2002, before me, the undersigned Notary Public
of the State of Florida, personally appeared
e�rat i�divic_ u_��nd
Na
(.) a (s) who appeared before notary)
whose, narne(s) is/are Subscribed to within the instrument, and he/she/they
acknowledge that he/she/they exe(;uted it.
WITNESS my hand
and official seal.
NOTARY PUBLIC
SEAL OF OFFICE:
NOTARY STATE OF FLORIDA
Notary PI-iblic: y Print,
Stamp, or Type as Commissioned)
I Personally known to me, or
❑ Produced identification:
(Type of Identification Produced)
DID take an oath, or 0 DID NOT take an oath
� v
REFERENCES
Please: list name of government agency or private firni(s) with whom you have, done business
within the past five years:
Your Company Name
Address
City State Zip
Phone/Fax
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
rig Or (t�>1-:rr �
f�
VENDOR DRUG -FREE WORKPLACE
Preference may be, given to vendors subrnitting 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 prograrn 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 staterfrent 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 erraployce 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.
pit}i rized Signat ur
�e Company Name
V FF,
. . .. ........ ..... ... . .. . . . ...... ... . . . __.._..._ . . ,............. `-`,/i �.� ,:_..r„�, E �'s, X,1. . ....
AGRO DISTRIBUTION. LLC
COMPANY NAME: (Please Print):
Phone- Fax -
BEFORE SUBMITTING YOUR BID, MAKE SURE YOU...
1. Carefully read the General Terms & Conditions, Special Conditions and the
General Requirements,
2. Carefully read the Detailed Specifications, and then L)roperly fill out the BID
FORMS.
03. Fill out and sign the NON -COLLUSIVE AFFIDAVIT and have, it properly notarized.
F 14. Sign the CERTIFICATION pa
ge. Failure to do so will result in your Bid being
doomed non -responsive.
5. Fill out the BIDDERS QUALIFICATION STATEMENT.
E] 6. Fill out the REFERENCES page.
177- Sign the VENDOR DRUG FREE WORKPLACE FORM.
8. include proof of insurance.
q. Submit ONE (1) Original AND TWO (2) Photocopies of your bid, clearly
marked with the BID NUMBER AND BID NAME on the outside of the package.
10. 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 deerned non -responsive.
THIS SHOULD BE THE FIRST PAGE OF YOUR BID.
/lO , �''°i 1
.....------...---......_..... ..... -----._............ ...
0-12MI-A d,l
BID NO. 03-01 B
AGRO DISTRIBUTION, LL.0
Submitted by: D'BA PRO SOURCE ONE
Bidder
THIS BID IS SUBMITTED TO:
City of Tamarac
Purchasing and Contracts Manager
7525 Northwest 331h Avenue
Tamarac, Florida 33321
r l �
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 (CCU) 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 arid 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 riot 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,
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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 Said
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 rneets 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.
AGRO DISTRtBLMON, LLC.
DBA FRO SOURCE OME
Company Name
p
Address
Author�ze d Signature
Typed/rinted Gnie
Telephone
& Fax Number
Cit State, ZIP o e
sC,
Contractor's License Number Federal Tax ID#
,1
Iti r., :r.r r rr
ZE,
BID FORM
(continued)
BID NO. 03-01 B
AGRO DISTRIBUTION. LLC
Bidders Name:
°/} N' TERMS' Net - days
Delivery/cornpletiom calendar days after receipt of Purchase Order
To be considered eligible for award, one (1) original and two (2) codes of this bid form
MUST 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.
n1r) rwnQM
(conrinuea)
BID NO. 03-01 B
AG,RO DIS T RISUTIQN, LL
Bidder's Name: DBA PRO SOURCE ONE
Variations:
The Bidder shall identify all variations and exceptions taken to the Instructions to Bidders, the
Special Conditions and any Technical Specifications in the space provided below; provided,
however, that such variations are not expressly prohibited in the bid documents. For each
variation listed, rc-�Jere;ncc the applicable section of the bid document. If no variations are listed
here, it is understood that the Bidder's Proposal fully cornplies with all terms and conditions. It
is further understood that such variations may be cause for determining that the Bid Proposal
is non -responsive and ineligible for award:
Section
Variance
Section `t i ^; N !
Variance
I u�;,
t c..
Section t:katic'.
Variance
Section '
Variance
Attach additional sheets if necessary.
, IT7c3'::C r' ;' a7 5N7C %7iV ior;
_ 1........ - - ----- ........ _ - - --. w.......
ti rl
NON -COLLUSIVE AFFIDAVIT
State of ._ L
SS:
County of l_r
being first duly sworn,
deposes and says that:
1. He/she is the _ . f.... ' . �f `! F ,t�_,\�i . ;- c (Owner, Partner,
Y _' f 'the
Officer, i�eprc7sentative or Agent)'of t.'�4 ^,�.` E �� „",�, �k; ��, N, �,.�_ �'�,
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 circurnstances 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 ele:monts 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;
. 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, re;presentatiw s, owners, employees or parties in
interest, including this affiant.
Signed sea,
W itnd:
�.
7 rU_r
Witness
and delivered in the, presence of;
,,-Printed' Name
Title
ACKNOWLEDGMENT
NON -COLLUSIVE AFFIDAVIT
State of Florida
County of m
On this the _ day of 2002, before me, the
undersigned Notary Public of the State of Florida, personally appeared:
and
(Name(s) ref individuaf(s) who appeared Before notaill)
whose names) 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)
El Personally known to me, or
Cl Produced identification:
(Type of Identification Produced)
❑ DID take an oath, or
Q DID NOT take an oath
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(l) have read the entire document, including the
Specifications, Additional Requirerrlents, 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:
Authorized Sign lure
PARTNERSHIP ❑ CORPORATION, OTHER Q
._, \ v
!
Title
AGRO DISTRt8U*r
DBA PRO SOL1RCL u,.,...
Corripany Name
City/State/Zip t
f -
c..
Cont ct Person
Nam (Printed Or Typed)
Federal Employer il,bl,/Social Security No.
-..
Address
Telephone
Fax Number
..................... i • n, ----------------- :.J (F ------
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 ON rCorporation ❑ Partnership ❑AIvtl�,��ture ❑ Other
SUBMITTED BY (Company Name) DBA PRO S0URCE ONCE
.ADDRESS;
' CITY, STATE ZIP: �-� '4 ` { ❑❑� : , _
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: AGR,C, DISTRIBUTION, LLC
Correct Name of Bidder DSA PRQ SOURCE ONE
Principal address of Business
City, State Zip17
2, If Offeror is a corporation, answer the following:
a. Date of Incorporation
b. State of Incorporation T ❑❑, . �; ❑❑_
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
...... ... _-_
Purc�;as�no Div,,sror�
...... ... ...
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
.. .......... ..... . ........... - - - — -------- - ----- -
. . .......... ........ . . ...
.. ..... ....... . . . ...... ......... .. ... ........ . .. . ......... . . . I----.----,....,.''..-.- . .. . ... ..... . . ...... .
r name, stibm-t evidence of compliance
operating
. . ..... . ......... . . . . .. . .... ............
5. If Offeror i, operatin ag fictitious nai I
with the Florida Fictitio;��a8me Statute,
F. How many years has your organization been in business under its present
name? 3
(3 Under what former names has your organization operated?
V N V,
........... . ..... . . .... . .. . ..
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 narnes, 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
10. List the pertinent experience of the key individuals of your organization
(continue on insert sheet, if necessary).
ff
_. l "'�('. i r`{. �.. �, !a tf ^✓. • ;:� 1 � �'-a °, c ^•., � E e"---. I l ^f�4 ry �0.—..:::1 !�`ai}
11. State the name of the individual who will have personal supervision of the work:
ff � gg
THF=. 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 ` HAT MATERIALLY AFFECTS THE
RIDDER'S OUALIFICATIONS TO PF':.RFORM UNDER THE CONTRAC I SHALL CAUSE THE OWNER TO
REJEC"r THL- PROPOSAL, AND IF AFTER THE AWARD, TO CANCEL AND TERMINATE THE AWARD
AND/OR CONTRACT. %
(Sign< -lure)
ACKNOWLEDGEMENT
1119rl11PYS-1m. oldr l IQM Wilug u I a ► 1
State of Florida
County of`','
On this the day of2002, 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, S"T"ATE 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
REFERENCES
Please list name of governrnent
agency or private firm(s) with whom you have done business
within the past five years:
AGRO, DISTRIBUTION, LLC
Your Company Name
DBA PRO SOURCE 0ME
Address
City State Zip
Agency/Firm Name:
. \I\.
Address
City State Zip
Phone/Fax
Contact Name
_
' �> s,� `
Agency/Firm Name:
Address
` --
City State Zip
r s' L� x
Phone/Fax
Contact Name
r
—
Agency/Firm Name::
Address
_
City State Zip
\ = a
Phone/Fax
�`, C�
Contact Name
Agency/Firm Name:
Address
.......... -_........ ...... ..
City State Zia
Phone/Fax
Contact Name
- l �
........... .
Agency/Firm Name:
Address
City State Zip
Phone/Fax
._._...... i
Contact Name
,}. . . ... . . . ........ ......... .....
(.�i j; }�..
�. a., .....,,,..............-
1
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 carder 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.
13. Give; each employee.' engaged in providing the commodities or contractual services
[fiat are under bid a copy of the statement specified in subsection (1).
. In the staternent 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 89:3
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 t jform complies fully with the above requirements.
r R
Autho ized Signature Company Narr1e
COMPANY NAME: (Please Print)
i F
r _
';. Carefully read th(,Gcii :ral Tf:,a s, & Conditions, Spc;c;ial Conditions arici the
General Requirernerits,
1 12 Carefully read the Dr�t,-Ailed Specifications, wd then troperly till out the BID
F 0 RMS.
.._1 - iflout 4�Sr�c:9 ; ictr� tlic; NUN -CC tJSI�/I i�I t it /�,'v'1T arid have it properly notarized,
_._._ ' : icira the CERTIFICATION Fade. Fa liure to car, ;so will result in your [aid being
d[?r.med rion-responsivF'.
5. Fill out the BIDDER'S OUALIFICATION S li-ATEMENT.
j 16. Fill out the REFERENCES page.
Sign the VENDOR DRIUC, FREE A/0RI/CPLA(;;E FORM,
y ti, include proof of insurance.
Submit ONE (1) Original AND TWO (2) Photocopies of your bid, clearly
marked with the BID NUMBER AND BID NAME on the outside of the package.
f t) fake sure your Bird is submitted PRIOR to the deadline. Irate Bids will not he
accepted.
Failure to provide, the regt.je stod attaac;nin(-- rnts r-nay result in yor"ar' k id
being deerned non -responsive.
THIS SHOULD BE THE FIRST PAGE OF YOUR BID.
D"!
0
0
BIB FORM
BID NO. 03-OIB
`all )rTaEttf.(.t by,1— ` - Y
S '.,_ r l f
Bidder
f H IS BID IS SUBMITTED TO:
e�lt®f cf Tarnarac
Purchasing and Contracts Manager
,..,,,_ Northwest 83"' avenue
t Barraaraac, Florida 33321
The undersigned Bidder proposes and agrees, if this bid accepted, to enter into as
contract with the City to perform and furnish all Work as specified herein for the
f ontract Price and within the Contract Period indicated in this bid.
This bld will rcertaaaira : l.ar;,i( c;t. to =-a(r egnaance for sixty (60) days after the day of bid
("'xn : Wing. Bidder will sign and submit the necessary documents required by the Laity
within fifteen t`I5)) days prior to the date of the City's Award,
aa) Bidder has familiarized itself with the nature and +extent of the contract
docunnents, locality, and all local conditions and laws and regulations that in
any ;Wanner may/ affect cost, progress, perform arac;c; ,)r turnlsfaira(l of the Work.
b) i? idder has given the City written notice of all conflicts, errors or (ti;7c:rr t)anc;iE t>
that it riaas msc overced in the c:oratract documents and the written resolution
ttat.reof by the City is acceptable to Bidder.
This Bid is clerataine and not made in the interest of or on b(,ft3lf of astray
undisclosed person, firm or corporation and is not subruitted in confon-nity
with any agreement or rules of any caror.ap, ;_association, ow.janization or
corporation; Bidder has not directly ()r indirec:fly induced or solicited any other
Bidder to subrnit a false or sham Bice; Biddc r has riot solicited or induced any
person, firm or corporation to refrain from bidding; sand Bidder has not sought
1)v c,c)Illisiora to obtain for itself any advantage over any other Bidder or over
[tie Git.y_
1 3. Bidder will c;ornpiete, the Work for Ihc> prices shown in the "Biel Form".
4. Bidder agrees that the Work will be substantially performed and complete in
accordance with the schedules established hereira-
......................
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DID FORM
(confrna ed)
BID NO. 03-01 B
The City reserves the right to reject any bid, if it deems that a vendor has deliberately provided
efrorrc,.c.ar.as information. The undersigned declare to have specific and legal authorization to
ohiigrate their firma to the terms of this bid, and further, th<,-A they have examined the Invitation to
Bid, they instrr.ictions to Bidders, the S I:aecific ations, and other documents included in this bid
rt:cttwst, and hereby prorralsc s ;=.and ".Igr(,"e ; 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 c; �tjfies the, product rand/or e(jiaiprrac;nt rneets or, exceeds the specification
as in the bid p<:ac k acte; and also <agre es thatI)roducls -Acid/car <>c:tuiprrac::nt to be do Gvc;rc.ct
which fail to nicot bid spo6fications will be rojected by the City within thirty (:30) days of
delivery. return of rejection will be at the expense of the bidder-
y
C;orrapany Name Authorized Signature
address: _ °. u .:ecf/fir':: _ .._... .__....
s yp inted W.irrme
_ [ ...:. a _ _M
City, State, ZIP telet,ahone & Fax Number
a.. I i, n,< r {
.... ........ _.-. -
Contractor's License Number Federal Tax ID#
r,
j
1
I
. ......... . . ..
BID FORM
BID NO. 03-016
Bidders Name: Q,
TERMS: % Net days
Delivery/completion: calendar days after receipt of Purchase Order
To be (,;llylbic';or award, one (1) original and two (2) copies of this bid form
MUST be submitted with the Rid.
NOTE: Bid st.-ibmittals without the manual signature of an -ii.ithorized a(- ent of tho Bidder
simll be deorned 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.
BID NO. 03-01 B
Bldi:] ,r's Name- ILI
Variations:
'i he Bicic;l(;r shall identify all variations ;and exceptions taken to the Instructions to Bidders, the
Special Conditions and any Tec hra➢c: l Specifications in the space provided below; provided,
however, that such variation s are not expressly prohibited in tho bid documents. For each
vmirat➢on listed, reference, the applicable section of the bld doc: urnent. If no variations are listed
here, it is understood that the Bidder's Proposal fully corraplies with all terms and conditions. It
is further understood tta ,at such variations may be cause for cicA(;rrnining that the Bid Proposal
is non -responsive and ineligible for award:
( cyticara Vaan arac e: ,
`,7ectaora
Section Variance
Section Variance 4-- -
,attach additional sheets if necessary.
U
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NON-COLLUSNE AFFIDAVIT
) SS:
being first duly sworn,
1. He/she ii the _.w_ _ ... (Owner, Partner,
Officler, i epi(-:sentative or ,Agent) of the
Offeror t.tuat has submitted the attached
2. 'He/shs; is fully inforrTaed respF:cting the preparation and coriterlts of the attached
Propos,ai and of all pertinent cir(,.ulTISL races respecting sijch Proposal;
Such }-�r'opot al is genuine ,anci i`.,; no t :i c.,ollusive or • ham Proposal;
4, Neither the said Offeror nor any of ii:s officers, partners, owners, agents,
representatives, ernployees or parties in Interest, including this ,:affiant, have in any
way colluded, c_ nn; pared, connived or acdre>>�_ cd, dirc-;rtly or indirectly, with any other
�dfferor, firma, car person to submit a c:;ollusiv(-. of-;->h am Proposal in connection with the
Work for whic: i the attached Proposal ha.; hetl : ubmitted; or to refrain from bidding in
connection with Such Work; or haysa in ;any manner, cdire.ctiy or indirectly, sought by
icr(>c rrlent or collusion, czar c;orraralurlic:ation, or conferc,nc e with any Offeror, firm, car
person to fix the price or prices in '.he rattac;i-led Proposai or of any other Offeror, or to
fix any overhead, profit, or coast elements of the Pmpo s<ai price or the Proposal price of
any othE;r Otforor, or to secure through any collusion c on>,pirracy, connivance, or
unlawful any advantage, against (Recipient), or any person interested in
the proposed Work;
5The price or pric.c s cauoted in the .att<arhed Proposal -aro .t,-sir and proper and are) not
tainted k:1y _any collusion, conspiracy, c orinivance, or i:ral�,)wfd agreement on the,. part of
,t1c; Offeror or any other of its regents. rfWprc. tarn ativs,.,, yawners, ernploye(,-s or parties in
interest. including this affiani-
Signed, sealed rarird caelivered in the preserice of:
t
[3y
r wu ..
n js
i
Witrlc ss, Printed Name;
Title
E
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11
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11
D
. . . ... ............... .... .....
ACKNOWLEDGMENT
NON -COLLUSIVE AFFIDAVIT
State of Florida
I
County of_ `�",Oeo'J'
On this the day of J" 2002, before me, the
undersigned Notary Public of the State of Florida, personally appeared:
and
. ...... ..... . . .. ......... .......
(Narne(s) of individual() who appeared before notary)
whose, narne(s) is/are Sul')scribed to within tho instrurnent, .'Md hc,/she/they acknowledge
th.it he/she,/they executed it,
\[VIT NESS my hand and official seal.
NOTAkY PUBLIC, STATE OF FLORIDA
NOTARY PUBLIC
SEAL OF OFFICE. P
(Name of Notary Public: Print,
Stamp, or Type as Commissioned)
Personally known to me, or
YProduced identification:
(Type of ldeV'ification Produced)
q DID take an oath, or
7 DID NOT take an oath
D
We (1), the undersigned, hereby agree to furnish the. iterra(s)/service(s) described in the
Invitation to Bid. We (1) certify that we(1) have read the entire document, including the
Spocif c ations, Addition,<:al RegUirernents, Supplemental Attachments, instructions to Bidders.
Torms and Conditions, and any -addenda issued. We agree to comply with all of the
rc,,CjUiremE;its c:>f (1w, entire invitation To Bld_
Indicate which type of organization below:
INDIVIDUAL ❑ PARTNERSHIP ❑
CORPORATION
OT-HER L
If "Other', Explain:
w. r _.. ........ ..... ...
-I
__ ._.... M.._.
.......
Authorized Signature
Name (Printed Or Typed)
_
.- ,;..,
Title
Federal Employer LID./Social
............. .
Security No,
d
.. ........................
T.
Company Name
Address
F�
City/State/Zip
Telephone:
-,
.
N ;
.,-�
Contact Persan...�.�.,,
�'
Fax Nr.a
Number
i
. . ........ ........ ........... ... . . . ..... .. .... .... . ...... .... ..
0
BIDDER'S
QUALIFICATION STATEMENT
under oath thc, truth and coriectness of all staten'lents and ol:
cffl y)W;IAICr;5 to qtw,-tlons made, hercjri.�Ifler,
SUBMITTED T(.): City of Talflarac
Purchasing & Contracts Manager
7525 NW 88'r'Avenue
Tamarac, Florida 33321-2401
CHECK ONE: F]Corporation Fartncrship Individual Joint Venture Other
SUBMITTED BY (Company Name)
ADDRESS:
CITY, STATE ZIP°
1 State thf-,� true:, c,x act, corre—t ind compk,,tc. tirirm- (.)I the partnership, corporation,
aldc, or, 9iflitiol.13 fl<=iflle ur1d(.-!rwh1ch you do bw,�ines.-iand th(.,-,,addreSs of the place of
b t. I i r I IS
Correm. NIElffie of Bidder
Principal address of Business
. .... .. ... . ...
City, State Zip
2. If Offeror is a (-.1orporafion, answer the following -
a, Data of liv-.,orporation
b. Sltaie ol' hworporation
. .... ..... .
G President's riji-ne
d Vice President's name
e. Secretary's narne:
. .... ... .. . . ...... ..
Treasi-trer's ri%UTW'
. . . . ..... . .. ... ............. . ............
g.
Nar-ne and address of Resident Agent,
3- If Offeror is an individual or a Partnership, answerthe following:
Date (,)I Organization
N<,,vue, and ownership units of all pa�rtneis (if nucossary, Ilse separate sheet),
NAME
... . ..... ...
ADDRESS OWNERSHIP UNIT
'State whether c em,,,val or limited partnership ,.I - - --------- -- ----- ---- . ....
4, If offer Is other than an individual, corporation or partnership, describe the
organi7.ation and give the name and address of principals:
. . . . . ....... .. ... ......
ll
renislration' ilcense' numbers or nk.nnb(-,;rs for the busines.,soc; or
professions that are the subject of the Bid. Please atlach, certihcate, of, waipetency
and/or :Mate registration
...... . ....... .................... . ... . .. .. . I....., . . .... ........ .... .. ..... .... ..
Haw-) You (,,wer furled to, any work to vouV If so, state when,
where and why-
10 t.ist the pertinent ti.,xperiencu ot the kt>y wilviduals, of your org ini E-itiort
(c ontim.,Ie on insert ;-;Iaeel it ne c.(,ssary).
r
I State the rr�111ae: of th _, individual who will have personal sup(, rvision of the work:
,
!HE: 1. IDDE ;. lC::`r<NUVV!.!: t )t>I ;; „NC) UNDERSTANDS 7 HAT ! HF INFORMATION CONTAINED IN
RESPONSI'_' TO THIS QUAI 11 !CAT ION: S ! ATFMFNT SI'IAL Bl-,- l IE:ED UPON BY 'THE 0WNFR IN
AVVAR )IN(,' I HE CON 1 I AND SUCI-I INI"ORIVIA r ION IS WANNAN T ED BY BIDDER TO BE TRUE.
i II I:)I ,C C)v[_fZY OF ANY OMISSION OR MISSTATEMENT THAT MATERIALLY AFFECTS THE
B11)DE_ R `, (A)ALIFIC:;AI'iON`, 1() PERFORM UNDER TH17 CONTRACT SHALL CAUSE THE OWNER TO
7I.,1(_C; _ 1 I-{F- f>V:C?(='C,) AL, AND iF AFTER THE AWARD, 1-0 CANCEL AND TERMINATE E_HE AWARD
AND/OR GONTRAC-i
(Si`gnature)
ACKNOWLEDGEMENT
BIDDER'S QUALIFICATION STATEMENT
State of Florida
C,)Lanty of . ..._ _.
..
;�,art thi., the /t.:a y + 2002, before me, the undersigned Notary Public
/ caf < :- , o , w„� -�
of the of f-londa, porvonally appeared
and
(I�larttc;(s) of individuai(:) who appe arc d before notary)
whose names) is/are Si_ibscribed to within the instrl.iment, and he/she/they
acknowledge that he/she/they exo cuted it.
VVIT NESS my hand
and official seal.
NOTARY PUBLIC,
SEAL OF OFFICE
NOT,f,,��Y PUBLIC, STApfE OF FLORIDA
�rSYY F�F��, '.iy �. t. i. ,,� °Rdri /�.�i F, �� ..,v• i �
1l%!rt 911, 0310-1/1 v, ,.. r-=.�
_ _..
(N<arrie of Notary Public: Print,
t amp or Type as CornmissIortod)
[JI Personally known to me, or
�a'"Produced identification:
(Tyt:a(.; of Identification Produced)
0, DID take an oath, or El DID NOT take an oath
......................... ....................... ................... ............
Please list name, of government agency or private firm(s) with, whorn you have done; business
within the past five years:
Your Company Name
Address
City State Zip
Phone/Fax
i 1
Agency/Firm Name
- — -
Address
amity ;late Zip
r
t_;c)rika(:t Name
Ac)cracjv/F ir.w.t.t d,4ams
�cicarr
.... .......
City S- .ate Zia
—
Phone/Fa)(
Clont%tct Narne
Agency/Firrri Name':Address
_.
('.ity State Zip
Phone/Fax
Name
AC) ,ncy/Firm Name.
Ac.1(1re:
t_,iiV i
W
,—
Phone/Fi�x
r
_ M .:_...... . .
Contact Name
/\rtertir.y/Firrri dame:
Address
City .Mate Zp
_.r
Phone/Fax
(Contract Narne
f