HomeMy WebLinkAboutCity of Tamarac Resolution R-94-274Temp. Reso.6935
CITY OF TAMARAC
RESOLUTION NO. R-94- 2 71
A RESOLUTION OF THE CITY COMMISSION OF THE CITY
OF TAMARAC, FLORIDA APPROVING THE RENEWAL OF
A ONE YEAR CONTRACT WITH SAV-ON UTILITIES
SUPPLY, INC. TO PURCHASE P.V.C. PIPE, FITTINGS, AND
APPURTENANCES AT AN ESTIMATED COST OF $20,000
APPROVING FUNDING FROM ACCOUNT 425-888-533-67B,
ENTITLED "93-41 GALVANIZED REPLACEMENT
PROGRAM," PROVIDING FOR CONFLICTS; PROVIDING
FOR SEVERABILITY; AND PROVIDING FOR AN EFFECTIVE
DATE.
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 approve the
renewal of Bid No. 92-25 for the purchase of schedule 40 and 80 P.V.C. pipe, fittings,
and appurtenances from Sav-On Utility Supplies, Inc.: and
WHEREAS, Bid No. 92-25 contains an option to renew for a one year period for
three consecutive years; and
WHEREAS, it is the recommendation of the Utilities Director and the Purchasing
Officer that the bid award be renewed as awarded to Sav-On Utility Supplies, Inc.
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COMMISSION OF THE
CITY OF TAMARAC, FLORIDA:
1
Temp. Reso. 6935
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.
-SE—C 4 2: That the renewal of Bid No. 92-25 for the purchase of
schedule 40 and 80 P.V.C. pipe, fittings, and appurtenances from Sav-On Utilities
Supply, Inc. at an estimated cost of $20,000 IS HEREBY APPROVED to be purchased
from Sav-On Utifiies Supply, Inc.
CTION 3-, Funding for the purchase is budgeted under Account 425-
888-533-67B, entitled "93-41 Galvanized Replacement Program."
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hereby repealed to the extent of such conflict.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 of 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 Resolution.
1-1
1
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1
Temp. Reso 6935
SECTION 6: This Resolution shall become effective immediately upon its
passage and adoption.
PASSED, ADOPTED AND APPROVED this a d day of
1994.
ATTEST:
I HEREBY CERTIFY that I have
a ro d this RESOLUTION as
form
t
ITCHED KRAF
CITY ATTORNEY
nb
pipefitting & appurtenances
N7MAN ABRAMOWITZ
MAYOR
RECORD OF COMI
MAYOR
ABRAMOVA
DIST. 1:
V / M KATZ
DIST. 2:
COMM. MISHKIN
DIST. 3:
COMM. SCHREIBER
DIST. 4.
COMM. UAC141=1C
VOTE
Temp. Reso. # 6425
CITY OF TAMARAC, FLORIDA
• RESOLUTION NO. R-93-_�_-
A RESOLUTION AWARDING A BID TO PURCHASE
SCHEDULE 80 PVC PIPE AND FITTINGS FOR
1 GALVANIZED WATER SERVICE LINE REPLACEMENT
PROGRAM AND WATER VALVE REPLACEMENT
PROGRAM, BID NO. 92-25; AND PROVIDING AN
EFFECTIVE DATE.
WHEREAS, bads were advertised in the Fort Lauderdale News/Sun
Sentinel, a newspaper of general circulation in Broward County,
Florida, on Wednesday, December 9, 1992 and Wednesday, December 16,
and
WHEREAS, bids were opened on Tuesday, December 29, 1992; and
WHEREAS, Sav-On Utility Supplies, Inc., 4250 SW 59 Avenue,
Fort Lauderdale, Florida 33314, is the lowest fully responsive and
fesponsible bidder.
NOW, THEREFORE, BE IT RESOLVED BY THE COUNCIL OF THE CITY OF
TAMARAC, FLORIDA:
SECTION 1: That the bid of Sav-On Utility Supplies, Inc.,
4250 SW 59 Avenue, Fort Lauderdale, Florida 33314, in the amount of
;34,498.19 to purchase schedule 80 PVC pipe and fittings for
Galvanized Water Service Line Replacement Program and Water Valve
Replacement Program for three Utility Projects:
Project No. 92-03 - Galvanized Service Line Replacement
Program - $8,146.19 funded from Account No. 425-364-
533--6HK
Project 92-04 - Water Valve Replacement Program - $12,100.00
funded from Account No. 425-364-533-6HK
Project 92-05 - Sewage Valve Replacement Program - $14,252.00
funded from Account No. 425-367-535-6HK
is HEREBY APPROVED.
E
Temp. Reso. $ 6425
SECTION 2: That the appropriate City officials are hereby
authorized to execute any and all contract documents in connection
with the awarding of the bid.
SECTION 3: This Resolution shall become effective immediately
apon adoption.
PASSED, ADOPTED AND APPROVED this a % 'day of ,1993.
ATTEST:
CAROL A. EVANS
CITY CLERK
I HEREBY CERTIFY that I have
approved this Resolution as
to. -form. I�
MMELL S . $IYAI'7
CITY ATTORNE
0
•
•H L. BENDER
MAYOR
AECORb OF COUNCIL vnrm
MAYpii
01STRIC
USTF11C
DiSTf3ic;
aiS7*ntC-
CITY OF TAMARAC MIGINAL COPY
® Fixed price bid
❑ Request for Proposal
• BID ND: 92-25 (This Is not an Order) DATE
(All blanks mutt be tilled In) PAGE N0. I of 15
aTUM[S) REQUIRED: IrD PACKAGE TO PURCHASE SCHEDULE 80 PVC PIPE AMID FITTINGS FOR GALVANIZED
WATER SERVICE LINE REPLACEMEIIT PROGRAM AND WATER VALVE REPLACII•aTTT2 PROGIM
')SING ACTIVITY Public Services/t tLUties Buyer Ven= Hargray phone (305)722.52DO
BIDS MUST BE SUBMITTED ON OR BEFORE 2: 00 p.m., Tuesday, December 29, 1992
Eeatam standard Tane 0, Eulem Bfandard CeTtlphl tavinp' TIYne as applicable. Trr official thane ■half as as teoOnkd on the 081117 W
RestxOinp clod In the City CNrX's Dllrca. ll will be the BON ry'ponstbl)tty of the bidder to eh ate that this propwi haMns the Deltas of the City '
041k City of Tamarac on v befees aioalnp hbw end date ■flown abora.
rho Lep e I Adel rllaettw nt, Imtutlt>t+to-r Id, stoner•) t:ondnbnt, tntiruelbru to lldd.n, tp.aal ow+dnlvna, tp•eNkatl4nt, Adaendumt, ■np a ny
other pertinent eoarfrlanl forth s Pen of IM proposal and by {•latenae are Wade a pan horaol•
ENTI-COLLUSION IFTATEMENT: The blow Stoned bidder Mt not dtYufoed to, elISM60
0
ofbomPerad his bid with other bidders and has not
Doll„ Bed with any other biodar a p+rtMs to a bid whatewr.(NOTL No premiums,febales or oratullies permitted either with, prior to, or aher any
Newry of 1nsbliSls, Any auch vb 00 rill result In the tang4atlon andru eatum of WAIAtials (As applicable) and the removal from aid 41alfs)
rO THE /UPCHAsINQ orPTOER OF THE CITT OFTAMAPAM WO), the below slened hereby apt" to famish the followlhoTefllclws) or •erwicets)
It the prica(s) and leans slated subject to a)) instructions, Condlllons, specifications, and all atl•ehmenla hareto. W(1) Aare clad Sit •IIA6nrnenla
nCluding the apeclhGitlbnt and tuflyundSrslehd what It raqulred (By eubmllano this cloned Plopo►el,we(I) officially accept a contract if spPtoved
by the City end such accepishce Cpwers all the forms, eondltlons, and specifications of this ploposal; and wa(q hereby &ore$ that wa rill t"he
nikbM for audtl a approp+iats cry Aad)twa arty spli kabis bwsa►est or IMunclal r"wds pertinent to a #SSuttlno wrier Of compact.)
.II priee'to be quoted F.O.t. BMr& Destination Tamarac, fr crlda (Dallweted at the applicable City ■ddrase Indicated en the Purchase f?rder.)
AILURE TG 0007E: If you go nDl quote, please alum 4VPlattan Sheet, 641 Naasdn thereon and request Thal Your as" be retained on our
1e11in0 list, olhorwlsa, your name may be fembw•d Ilom out bid maulno list.
Bids are firm for acceptance within 60 days after bid opening date —yes —no -other.
7ERM5: NET % Days Or by ofMonth (To applyondate ofdelivery anti
acceptance of material.)
If awarded ALL rTEM,5BID HEREIN (when eppllcable),anadditionalDISCOUNT OF 0
Ib offered In addition to any terms oilered above. ye
DELIVERY 30 calendar days after recefpi 0, purchase Order (Oil reserves the right to consider
Delivery time as A vital conslderatlon when making or recommending award),
VARIANCES: stale any varislIon'to speCl6cslbns.Ierrr4 anaror elYndHlpn{ Inthis Imes wAfroncf Mreln all nrl•neel Cp1111rMtl en ether popes of this
INKPioposilSO FOND rr In shyNL atlASUCH 1. ND VARIATIONS DR EXCEPTIONS IT A BIDDER WILL aL CONSIDIPID OR Will Of DEEMED TD eE A pApiY DP
THE a10 SUBMrTTEp UNLESS SUCH VARIATION Ora IxetrTION IS LtSTEp WITHIN THE BID pOCuMENIS ANb WILL
RENCED L THIS COLUMN NO
SEPARATE OR ACCOMPANYING DOCUMENTS oRLCTTERSWILL aLCONSIDIREDASINCLUDEDWITMINASUNDRDAA'TIED0kINCEDIN CITY OL MNT40
BOUNDINANY MANNERWMATSOEVEILaYANY VARIATION DRfact PTiDNoRLIMr1ATIDNNOTs►ECIPICALLYLr57EDWnMINTHEalbDWLLNOT
Te
.2 PRICES WILL a[ CONSIDERED AS FIRM POR7ME PLRIODINDICAT[DWITMIN7ME eID AOCUM( ItIrN"IS UNLESSAeIDDE RMP41N S►EDIDDFIC EXCLINIS
INE Rt'7D AND LISTS bUCM EXCE PTIDN WITHIN THL alA DOCUMINI$ AND REPERENCEo Ua THIS coLLIMN.IIrrestalerlylU 4 aanla„»pin thiA loses q p
'Araby Ynpliao that y641 &C 6601*1166 with Iris frill •,pee Of LhL1 ea shel,,jawt.
'Urchater Order Payment or Futura bids aro to be mailed to Other than proposrr't Address shown below, please
nplete the following;
it rurcnasr Glair to: Mall Payment to: Mail Bids to:
250 SW 59 Ave. l` SMIE SAME,
t.' Laud., Fl. 33314
'Phone No_ 305-583-2963 w/Arta Code
)POSAL SUBMITTED BY:
dE(Printed): • Jim Di Cola Title: General Manager
Tpany �•palR•pltlWaTnNMFtljy SAV—ON UTILITY SUPPLIES INC.
rest: 4250 SW 59 Ave. Ft. Laud. , •F1. 33314
VATUR>r Telephone Na: 305-583-296 3
. E 12 /? 1/9 2 indicate Which: Corporation: x
tnalxed A04 I'anaes A!plle•bk be prpp•at: P/Rnrrihlp:
enrttetlen to lid — It'll
Moe► 01 asnerst Proralon• euvaes — to Individual:
amoral Provisions — F3 Other,
t Ileleteln one Copy for Tour file')
BIDDERS NOTE: loth sides of this Form raqure slpnalurS.
0
11
Cr7Y OF TA.N RAC
7525 N.W. 88 Avenue
Tamarac. Florida 33321.2401
Bid No, 92-25
Date
Pagel et -15__ -
6PECrFIC,l1TION6 AND BID 6CIED=
invitation To Bid
A11 pritxs quoud F.b 9.7urtarac,Firzida Dclirettd and nnloadrd a applicable dry desainatitn at lcdicatrd below. Tbc e'
hollowing special eandidons (it checked) apply to this bid.
BIDDERS REQUIREMENT FOR CERTIFIED CHECK OR BID BOND: 7tu City aha11 sequin tram all Bidders, a
certified check or bid band in the amount of five (5) penuu of the bid, which &hall be forfeited to the City in the event the Bidder
X to whom the business is awarded, &W1 fall or refuse to comply with the speciCtcadon of the bid. Cheett wiB ntuined promptly
to the uasntxusfW Bidden afar award of bid. Failure to submit ih)s bid bocd with the bid gold cam rejection of the bid.
PERFORMANCE BONDS: TVt City shall prior to the txecutiaa Of the txetOWk n quire tbt: Bidder to fwn6h bonds covering
the faithful performance of the ooanl+ct and the payment of all obligations arising thereunder In such Haan and amount as the
City may prrscnbe and "b '=des aesuand tluough the Bidder'& UAW +purees as may be ageeable to the panics. U such
. bards are sdpulatr4 the premiums shall be paid by she Bidder, ibe
Of eX=Lioo d du txmeraet Biddy SW deliver bonds to the City do inter than {he date
DESCRUMON
Open end annual contract with
option to renew each year, for
three (3) consecutive years, pro-
vided that the City agrees to
award this contract and to extend
renewal options annually and the
selected material supplier pro-
vides a Letter of Confirmation
annually, agreeing to extend the
unit prices of the original bid.
livtrTo* City of Tamarac
7525 N. W. 88th Avenue
Tamarac, Florida 33321
rol Ebans City Clerk
EXTENDED PRJCE
iddees Si at p�1e 12/21/92
Title General Manager
COMpu+yName Sav-On UTILITY SUPPLIES INC.
Address 4250 SW 59 Ave.
Ft. Laud., F1. 33314
BIDDERS NOTE: Both Sides of this form require signature
0
KI
CITY OF TkIJU C
5811 N. W. 88th Avenue
Bid No. 92-25
Date Deomber 9, 1992
Page No. 3 0f 15
sated Quanit DESCRIPTION JUNIT PRICE 1EXTENDED PRIG
ADO L. F.
00 L. F.
184 EACH
.92 EACH
.56 EACH
.86 EACH
.90 EACH
W EACH
00 EACH
70 EACH
45 EACH
83 EACH
85 EACH
00 L.F.
PUBLIC SERVICES PROJECT No. 92-03
GALVANIZED SERVICE LINE
REPLACEMENT PROGRAM
1" PVC PIPE SCH. 80
3/4" PVC PIPE SCH. 80
1" ELBOW SXS 900, SCH. 80 PVC
ADAPTER C14-44 COUPLING 1" F.P.T. X 1" POLY
ADAPTER C84-44 1" POLY 1" M.P.T.
STOP, CORPORATIONS F-1700-4 1" M.P.T. X 1" F.P.T.
ADAPTER, FEMALE 1" SCH. 80 FVC
COUFLING SXS 1" SCH. 80 PVC
ELBOW SXS 1" 900 5CH. 80 FVC
ADAPTER C84-33 3/4" POLY X 3/4"
3/4" ADAPTER - FEMALE SXF.P.T. SCH. 80 PVC
3/4" ELBOW SXS 900 SCH. 80 PVC
3/4" COUPLING SXS SCH. 80 PVC
1-1/4" PVC PIPE SCH. 80
PUBLIC SERVICES PROJECT 92-03
TOTAL GROSS SUM BID (All items)
5.40
4.45
12.35
1.55
1.40
1.10
3.75
1.35
.6R
1.30
.41
465.00
126.00
422.40
1,036.80
1,139.20
2,297.10
449.50
539.00
110.00
262.50
195.75
192.44
500.50
41Q.00
IR,146.19
10
10
CITY CF TA"'1ARAC
5611 N. W. 88th Avenue
Tanarac,Florida 33321
Hated DESCRIPTION
PUBLIC SERVICES PROJECT No. 92-04
WATER VALVE REPLACE AND REPAIR PROGRAM
EACH
EACH
EACH
EACH
ME
Bid Do. 92-25
Date Decker 9, 1992
Page No. 4 of 15
U171T PP.ICE XTENDED PRIC
GATE VALVES WM S'f RT) ACCESSQEv SFTq
12" GATE VALVE RESILIENT SEAT® EPDXY COATED
NON -RISING STEM AS IN M-H C509 ORIGINAL MJ
8" GATE VALVE RESILIENT SEAIED EPDXY COATED
NON -RISING STEM MJ MH C509
6" GATE VALVE RESILIENT SEATED EPDXY COATED NR5
MH C509 MJ
4" GATE VALVE RESILIENT SEATED EPDXY COATED NRS
MH C509 MJ
BOLTED COUPLINGS
12" JCM //210 DUCTILE IRON COUPLINGS AC TO CI
8" JCM 11210 DUCTILE IRON COUPLINGS Cl CI
6" JCM 1/210 DUCTILE IRON COUPLINGS AC To Cl
PVC-05, Cl
4" JCM #210 DUCTILE IRON COUPLINGS AC TO CI, PVC Cl
SOLID SLEEVES WITH RETAINER GLAND ACCESSORIES
12" SOLID SLEEVE -LONG BODY G'153 MJ 82IO5
PUBLIC SERVICE PROJECT 92-04
TOTAL GROSS SUM BID (A11 items)
584.00
297.00
191.00
147.00
1,168.00
594.00
4,202.00
2,352.00
83.00 332.00
50.00 200.00
39.00 1,716.00
29.00 928.00
152.00 608.00
12,100.00
CITY cF TANw=
SELL N:,W. 88th Aveme
e=aLc Florida 33321
kima[ed DESCRIPTION
PUBLIC SERVICES PROJ= No. 92-05
SEWAGE VALVE pyllACEMEN, AND REPAIR PROGRAM
8
2
2
1
16
16
4
4
2
4
4
5
4
.2
.2
6"
8"
10"
12" ,
16"
D.I. LONG PATMRN WITH RkTA.M GLOM
6" M.J. C153 L/P SLEEVES
8" M.J. C153 L/P SLEEVES
10" M.J. C153 L/P SLEEVES
12" M.J. C153 L/P SLEEVES
16" M.J. C153 L/P SLEEVES
BOLTED COUPLINGS
12" JCM 6210 D.I. COUPLINGS AC TO DI
10" JCM #210 D.I. COUPLINGS AC TO DI
8" JCM 11210 D.I. COUPLINGS AC TO DI
6" JCM 0210 D.I. COUPLINGS AC TO DI
4" JCM #210 D.I. COUPLINGS AC TO DI
4" JCM #210 COUPLINGS SCH. 80 TO D.I.
PUBLIC SERVICES PROJECT 92-05
TOTAL GROSS SEIM BID (All items)
_,;2�
Bid Na. 2-2
Date Deowber 9, 1992
Page No. 5 of 15
❑NIT PRICE XTENDED PRIG
i
191.00
297.00
462.00
584.00
2,222.00
69.00
90.00
121.00
152.00
344.00
83.00
69.00
50.00
39.00,
2'9.00 i 29.00
1,528.00
2,376.00'
924.00
1,168.00
2,222.00
1,104.00
1,440.00
484.00
608.00
688.00
332.00
276.00
250.00
156.00
348.00
348.00
,e- 5.3, �
0
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LJ
Bid No. 92-25
CITY CF T.AKUW. Date
5SU N. W. 68th Ave=e
-q 3 - 9'
i�� /(/
0
Bid No 92-25
Date .r9' '1992
Page 7�eL�
28. SWORN STATEMENT ON pUIUC FUM CRIMES; A Copy of the required SWORN STATEMENT Is bViuded as a
POI Of these bld documents. Thb sworn statement thoukd be completed. SIGNED and NOTARIZED and
subMHed wtth the bid. Any bid that does not include this required sworn rlatment may not be evaluated
and may not be Considered for award, A s►gnature k required on both the sworn statement and where
required on the tnvffatlon to bid to= facture to complete and sign both documents raqulrtrp signature may
result In re}ecflon of bid submMed. ,
t Bid Of («G(1T!'OCt IJa. 9 2- 2 5
BWORN NTkTZm=gT IpURSIIANTTO SEMON il7.137A)U),
ON rtrlxuC YNTTIY atn sus
'Ms FORM MVST Its KILN= AND MORN To IN TM PRLY8I1Ci Or A NOTARY P=11C OR
O'17�1t OFTI MAT. AVT8os:127 TO AOh9NJS= a2MU
7- +� adutetaeatyaubagooQlo City of Tamarac, Florida
by Jim Di Cola/General Ma a rA'a' rn t7
br 5AV_D=1 rr*eiq' lr"%py4US INC.
t soma .natr MMIMMILM.. .....
who" baulesi s a0dtsau is 4250 SW 59 Ave.
Ft. Laud.Y Fl. 33314
Cad Of dppUwbte) In Federal Employer ldeatl6s;Uoa Nsmbet (PRIM') L ,5 9 — 7
N the 16
emtltr b" so F£W, lnduds 9, Sod,,1 lSOCUrf[y Namber of the 1adlvidtul nlralat�thu Alicia
sukmeao
= J andemsaad that a •Dahlia tatlry pie• u pN
memos a viotauon 01 Aar $rats of laden] law b ?b7.133
the MA"Cli0a of bwlaey with ap� ppubtlC eal�fr Ot oneWith � respii or pgo7 "d Surr u{y�l L o
other Bute or of the Lr 10 Ag Suter, Iaeludlap but Cot limped So,�sar bld or mUUWatrsa for goods
of at
e U pled SLd to amr public sadrr or am Cleary er poLlucal subdivulos of any Other suss
Co of the or sod States Cad Isv*lvlar aaUtrwt, tbsud, theft, bribery. etvAwloa, Aactateerins.
aoasptraq, or tssats:rW tsslareprsseptadoa
]• I anderauad that •e+o tevfaeC• of bosvtalan w de8asd !as rarsRapy SJfr.731(t)(b),Ly.
U.rmiswains is Ladnr of lulls or a oosvtotl*a of s pabUc aaUry tea, wiry or wRhout as aaJudioauon of
��vvu� !a Car federal or $Late aw court of record reLUol to eharaos brouslit by ladlrcmeat or
suoo arter July 1,1989, as a roust of a Juryrerdtc; AosJury trial, or eatrr alit plea or tinily
or solo aoatsadan.
A J aadont$md that as %Z114te• as deftest Ispardpdpb Zi7.1]](l)(a�
L A predecag&Or or suaaasor of a bit
2. 'tin "Ury atuier the control of a, r$O*drt tea" of a pubUe eauz
dad rho has bseo coavic ed of A public UUty mR b7U � .M `la �t�sICju4mat of tLhoothe saUty
afIIJ{ai The trraerah! o—picrne asinban, and A eau who w aglw 1, �
Dena, or a pooUnr of equipment Ponca
inncome a�ao pezigo utwl m ao (Or gat .
aauket value under an arm'$ Ito fth $peemeat, ahaU be a prima Oq�$ ptyep l y ea sot for >
another Dena, A Ponca who kaowially sitters fat* a pint VoUturs with a Ponca controls
been An of s public aaUty Brims 1a Mr(ds aurimj the prrxdiaj i6 soo*a &L" j h4 mi �a
• as ar5llat� es>,aaldetsd
3• I aaderauad
that a ffiPcmae as dafted in psunZmpb y97.�(1)(t)
aarunl Ponca or tau ry orlank" Bader the L.y of Car stau .or of too I,rdt states gow m
parer to sorer Into a blaatal contact dad which bids hich ores pUa a% bid oa eOatruv for the prar4lan witfh a ppublic satltyet yspterm • opuarypn rla4udp togs OMCe r APPua w traasder bualoaa shareholders, employe, member$• tad aleau Who errs aCtb %angle oM ga o Uo pas'tsea
F� 1
L i
v '93�: `?
� -; 4-, i
9
'
Bid No ' .92-25
�
Daj* 22M ra 9, 1992
PapeyLot 15
d Based on fnfvrmados and belle] tba autemeat whkb is 1 havo ta►arkod below it eras seladon to
Chs entity aubmitdnt this ewon autemeat. (tadkate whkh atalaaaat aPPUga•I
WIN
eltber the entity submlldat shy sworn sutetacnl. nor spy, of inDT=n, dlreclork esaeouves, Prue , sha.rebolders, employers, numbers, or a feats who are active in the maaatement of the
eattty, not say LMUAte of the eadty hu been charted wtdt and eotrviaod of a public =nl crime
aubtequent to July 1.1989.
� The entity aubmltTtat this sworn sulepteal, or one or more of W ofsoas, directors, ==llvr s,
thareboldea, employees, members, or ateau rho are atxlve to the entity, or snaaatemeat of the
• as aa714te of the eadry Ass bees chatted With sad ounvigcd of a pu S entity crime
sw"uenl to Jaly 1. mg,
T%e aadry subntlttint shy swore sutemeay or one or more of 10 0,5 pacts, shueholdets, employee:, membul, or a gnu Who are ' won' �Uvu'
entity, or as &X'Ute of the entity bu bees ehu ed With and Convtaed Lheof pLllc zagatitryo�e
suEscquoft to July o, IM.Flori However, there hal beep a atthsequest prooeedlat before a };coin=
Otdcer of the Sate of Fonda, plvwos of Adtrilaltun-Ov% µesrtaD and the Fraal Order entered by
the Hearin= Dtficer determined that 11.wzs sot In the public !oust to plaoc the entity submltdaj
LW sworn statement On the eoovtapd vendor lilt. (apack a copy of the final orderj
1 P��AND TEAT TT7T 5UDMISSION OF T1aS FORK{ TO THE 'Co
NTT;ACT�lC OFFICER FOR
IiTF PUIiLiC ! 1QIII1' 1D1 NTJTiT� W PARA.GRAPIa t (ONE) AIIOVB IS FOR 7ZiAf PL'eIJC ENTITY
ONLY IT s I ►T TEiZS FORl,I IS VALm THROUGR DECEM1iF� Jl OF TILE
F-NTI'H IT LS i'u.ID. I AISO UNDERSTAND THAT f AM Rf:QUIf1 O TOM 7 E pAR jC
Di
EhTT7Y AR1gR TO ENTERWG "'O A CONTRA PROVmED IN SECTION 287.07, Cr IN EXCESS CtF TTTE TDR.ESEULO AMOUNT
T7� ORhSATION COhTAJNED JN THIS FORM. FOR CATEGORY •iIVO OF ANY CHANGE IN
alt;aatuts
December 21, 1992
STATE 01= FLORIDA
date
COUNTY OF Broward
PEJC'NALLY APPEARED BEFORE ME, the aadentped aaWotity,
Jim Di Cola
(name of ladlrtduaT sli�il •'bo. agar flrsl "i sworo by me, anted his/her iljnttettre
fn the space Primed 0a a on this 21 Dec:
day of `� >�9 92
My mmmiulos upkes: NOTARY PLmL1C
ALICIA WEITZEL
DtPIpF9
3iCi ram',AL Oftbsr POTARr "Et
mm• 00194400
Form PLR 700 (Rey. 00Q91)
i