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,Vr d.Aty d BEACH <br />Veteran Owned Business. Is Proposer claiming a ve an owned business status? <br />YES NO <br />SUBMITTAL REQUIREMENT: Proposers claiming veteran owned business status <br />firm is certified as a veteran -owned business or a service -disabled veteran owned <br />States federal government, as required pursuant to ordinance 2011-3748. <br />shall submit a documentation proving that <br />business by the State of Florida or United <br />Conflict Of Interest. All Proposers must disclose, in their Proposal, the name(s) of any officer, director, agent, or immediate <br />family member (spouse, parent, sibling, and child) who is also an employee of the City of Miami Beach. Further, all Proposers <br />must disclose the name of any City employee who owns, either directly or indirectly, an interest of ten (10%) percent or more in <br />the Proposer entity or any of its affiliates. <br />1v, t71" r <br />SUBMITTAL REQUIREMENT: Proposers must disclose the name(s) of any officer, director, agent, or immediate family member <br />(spouse, parent, sibling, and child) who is also an employee of the City of Miami Beach. Proposers must also disclose the name <br />of any City employee who owns, either directly or indirectly, an interest of ten (10%) percent or more in the Proposer entity or any <br />of its affiliates <br />References & Past Performance. Proposer shall submit at least three (3) references for whom the Proposer has completed <br />work similar in size and nature as the work referenced in solicitation. ,,, /�Tt�acrf <br />SUBMITTAL REQUIREMENT: For each reference submitted, the following information is required: 1) Firm Name, 2) Contact <br />Individual Name & Title, 3) Address, 4) Telephone, 5) Contact's Email and 6) Narrative on Scope of Services Provided. <br />Suspension, Debarment or Contract Cancellation. Has Proposer ever been debarred, suspended or other legal violation, or <br />had a contract cancelled due to non-performance by any public sector agency? <br />YES [ NO <br />SUBMITTAL REQUIREMENT: If answer to above is "YES," Proposer shall submit a statement detailing the reasons that led to <br />action(s).' <br />Vendor Campaign Contributions. Proposers are expected to be or become familiar with, the City's Campaign Finance Reform <br />laws, as codified in Sections 2487 through 2-490 of the City Code. Proposers shall be solely responsible for ensuring that all <br />applicable provisions of the City's Campaign Finance Reform laws are complied with, and shall be subject to any and all <br />sanctions, as prescribed therein, including disqualification of their Proposals, in the event of such non-compliance. <br />�0-� <br />SUBMITTAL REQUIREMENT: Submit the names of all individuals or entities (includmg your sub -consultants) with a controlling <br />financial interest as defined in solicitation. For each individual or entity with a controlling financial interest indicate whether or not <br />each individual or entity has contributed to the campaign either directly or indirectly, of a candidate who has been elected to the <br />office of Mayor or City Commissioner for the City of Miami Beach. <br />Code of Business Ethics. Pursuant to City Resolution No.2000-23879, each person or entity that seeks to do business with the <br />City shall adopt a Code of Business Ethics ("Code") and submit that Code to the Department of Procurement Management with <br />its proposal/response or within five (5) days upon receipt of request. The Code shall, at a minimum, require the Proposer, to <br />comply with all applicable governmental rules and regulations including, among others, the conflict of interest, lobbying and <br />ethics provision of the City of Miami Beach and Miami Dade County. <br />SUBMITTAL REQUIREMENT: Proposer shall submit firm's Code of Business Ethics. In lieu of submitting Code of Business <br />Ethics, Proposer may submit a statement indicating that it will adopt, as required in the ordinance, the City of Miami Beach Code <br />of Ethics, available at http:/lwww.miamibeachfl.gov/city-halVorocuremenV <br />f_h_tTP.Ctih%D- <br />RFQ 2018 -183 -KB 20 <br />386 <br />