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Home My WebLink AboutREX Three, Inc. • CITY OF SUNNY ISLES BEACH 18070 Collins Avenue Sunny Isles Beach, Florida 33160 _(oNNIS off,. 305.947.0606 ° e wwv,,.sibfl.ner c =:1 Received C�ry.OF SUNs:? JAN 16 t ,I A. , City of Sunny isles Bush :,.. cA•: Office satin City Ckek DELIVER TO: REQUEST FOR PROPOSAL City of Sunny Isles Beach SECTION 6 .OPENING: 2:30 P.M. City Clerk BID SUBMITTAL FORMS Thursday,January 16, 2020 18070 Collins Avenue Sunny Isles Beach, FL 33160 PLEASE QUOTE PRICES F.O.B. DESTINATION, LESS TAXES, DELIVERED IN CITY OF SUNNY ISLES BEACH, FLORIDA NOTE: City of Sunny Isles Beach is exempt from all taxes (Federal, State, and Local). Bid price should be less all taxes. Tax Exemption Certificate furnished upon request. Issued by: Purchasing Agent Date Issued: This Bid Submittal Consists of 12/20/2019 Pages 31+ Sealed bids are subject to the Terms and Conditions of this Request for Proposal and the accompanying Bid Submittal. Such other contract provisions, specifications, drawings or other data as are attached or incorporated by reference in the Bid Submittal, will be received at the office of the City Clerk at the . address shown above until the above stated time and date, and at that time, publicly opened for furnishing the supplies or services described in the accompanying Bid Submittal Requirement. RFP 19-12-01 Printing &Mailing of SIB Living Magazine&Newsletter A Bid Deposit in the amount of 0%of the total amount of the bid shall accompany all bids A Performance Bond in the amount of 0%of the total amount of the bid will be required upon execution of the contract by the successful bidder and City of Sunny Isles Beach Procurement Agent: Firm Name: Genesis Cuevas `-CI 1` \O t1-esQ- Commodity Code(s): RETURN ONE ORIGINAL AND 71410 COPIES OF BID SUBMITTAL PAGES AND AFFIDAVITS FAILURE TO SIGN PAGE 32 OF SECTION 4 BID SUBMITTAL WILL RENDER YOUR BID NON- RESPONSIVE City of Sunny Isles Beach I Request for Proposal No. 19-12-01 31 • • Rex Three, Inc. Quotation 15431 SW 14 St. • 760023-1 • Sunrise„FL 33326 • Phone(954)452-8301 Fax(954.)452-0569 estimating@rex3.com www.rex3.com • • To: U I Date 1/13/20 Salesperson Steve Hager City of Sunny Isles Beach � ' Estimator JM 18070 Collins Avenue 4th floor Sunny Isles Beach, FL 33160 Phone (305) 792-1764 Fax(305),792-1607 • Email ayeash@sibfl.net Dear City of Sunny Isles Beach We would like to thank you for your time and consideration in regards to this quotation. The quotation is confidential and is intended solely for the use of the addressee(s) named above. Your detailed production specifications for this request are listed below. Description . Magazine Pages • 44 Pages+4 Page Cover Size • Final Size : 8 1/2 x 11 Paper 80.0 lb Endurance Silk Cover 80.0 lb 'Endurance Silk Text Colors • 4/4 Process+OA Satin AQ -Cover 4/4 Process-Text PrePress PDF_Files- Rip,Trap, HP, Epson Color Proofs Finishing Cutting, Folding, Perfect Binding Prices Quantity Prices 7,500 $10, 820 per issue / $43,280 per year / $86,560 per term Shipping Carton Pack, Local Delivery Sincerely, Prices are subject to review upon receipt of art. Upon acceptance please indicate the quantity required • Quoted By: Steve Hager Sign: Date: Accepted By:. Sign: Date: Thank you for giving us the opportunity to submit this quote.As always,quotes am based on receiving fully assembled documents using standard desktop publishing applications.Consult with your sales rep to find out how you can see if your files are within specification.This quote is valid for 30 days unless otherwise specified. • Page 1 of 1 • Rex Three, Inc. Q uotation 15431 SW 14 St. 760023 Sunrise„FL 33326 Phone(954)452-8301 . • Fax.(954.)452-0569 estimating@rex3.com www.rex3.com To: Date 1/8/20 Salesperson Steve Hager • City of Sunny Isles Beach 112 ) Estimator ' JM• 18070 Collins Avenue / 4th floor Sunny Isles Beach, FL 33160 Phone (305) 792-1764 Fax(305),792-1607 Email ayeash@sibfl.net 7'3 .% Dear City of Sunny Isles Beach We would like to thank you for your time and consideration in regards to this quotation. The quotation is confidential and is intended solely for the use of the addressee(s) named above. • Your detailed production specifications for this request are listed below. Description Magazine Pages 48 Pages+4 Page Cover Size . Final.Size : 8 1/2 x 11 Paper 80.0 lb Endurance Silk Cover 80.0 lb Endurance Silk Text Colors 4/4 Process + OA Satin AQ -Cover 4/4 Process-Text PrePress PDF_Files- Rip,Trap, HP, Epson Color Proofs Finishing Cutting, Folding, Perfect Binding Prices Quantity Prices • 7, 500 $10, 995 per issue / $43, 980 per year / $87, 960 per term Shipping Carton Pack, Local Delivery Sincerely', Prices are subject to review upon receipt of art. Upon acceptance please indicate the quantity required Quoted By: Steve Hager Sign: Date: Accepted By: Sign: Date: Thank you for giving us the opportunity to submit this quote.As always,quotes are based on receiving fully assembled documents using standard desktop publishing applications.Consult with your sales rep to find out how you can see if your files are within specification.This quote is valid for 30 days unless otherwise specified. Page 1of1 Rex Three Inc. Q uotation 15431 SW 14'St. 760000 Sunrise, FL 33326 Phone(954)452-8301 Fax(954)452-0569 estimating@rex3.com www.rex3.com To: Date • 1/8/20 Salesperson Steve Hager • City of Sunny Isles Beach ( 7 - 0 ' Estimator JM 18070 Collins Avenue • 4th floor Sunny Isles Beach, FL 33160 Phone (305) 792-1764 Fax(305),792-1607 Email ayeash@sibfl.net . ► �� Dear City of Sunny Isles Beach We would like to thank you for your time and consideration in regards to this quotation. The quotation is confidential and is intended solely for the use of the addressee(s) named above. Your detailed production specifications for this request are listed below. • Description SIB Islander Newsletter Pages 6 Pages Size Final Size : 25.5"x 10.875"folds to 8.5"x 5.5" Paper 100.0 lb Endurance Silk Text Colors 4/4 Process+ OA Satin AQ PrePress PDF_Files- Rip,Trap, Proof Finishing Cutting, Folding, Wafer Seal, Mail 17m, Deliver Balance. Prices Quantity Prices 17, 300 $3, 895 per month/ $46,740 per year / $93,480 per term +POSTAGE ADDITIONAL Shipping NCOA List, File Prep, CASS per list and/or drop, Ink Jet Format 3-1 blocks, Delivery++ (postage not included) Notes Price Does Not Include Mailing List Sincerely, • Prices are subject to review upon receipt of art. Upon acceptance please indicate the quantity required Quoted By: Steve Hager Sign: Date: • Accepted By: Sign: Date: Thank you for giving us the opportunity to submit this quote.As always,quotes am based on receiving fully assembled documents using standard desktop publishing applications.Consult with your sales rep to find out how you can see if your files are within specification.This quote is valid for 30 days unless otherwise specified. Page 1 of 1 Rex Three, Inc. Quotation 15431 SW 14 St. 760028 Sunrise,FL 33326 Phone(954)452-8301 Fax(954.)452-0569 estimating@rex3.com www.rex3.com ) 47 —of To: Date 1/10/20 Salesperson Steve Hager City of Sunny Isles BeachEstimator JM• 18070 Collins Avenue 3k -3. 4th floor Sunny Isles Beach, FL 33160 Phone(305) 792-1764 Fax (305) 792-1607 Email ayeash@sibfl.net Dear City,of Sunny Isles Beach We would like to thank you for your time and consideration in regards to this quotation. The quotation is confidential and is intended solely for the use of the addressee(s) named above. Your detailed production specifications for this request are listed below. Description Desk Calendar Pages 16 Leaves + Cover Leaf+ Easel Base Size 6.75"x 6"- 16 Leaves+ Cover Leaf 15"x 6.75"- Easel Base Paper 100.0 lb Endurance Silk Cover- 16 Leaves (Hannoart n/a) 130.0 lb Classic Crest Natural White Stipple Cover-Cover Leaf(Mill Item) 160.0 lb Classic Crest Natural White Stipple Cover- Easel Base (Mill Item) Colors 4/4 Process+ OA Satin AQ - 16 Leaves 0/0 No Printing -Cover Leaf& Easel Base PrePress PDF_Files- Rip,Trap, HP, Epson Color Proofs Finishing Foil Stamp Cover Leaf 3"x 2"Area (Standard Foil Color), Die Cut, Die Score, Cutting,Wire 0 Bind Prices ' Quantity Prices 1, 500 $6,295 year / $12, 590 term Shipping Carton Pack, Local Delivery Sincerely, • Prices are subject to review upon receipt of art. Upon acceptance please indicate the quantity required Quoted By: Steve Hager Sign: Date: Accepted By: Sign: Date: Thank you for giving us the opportunity to submit this quote.As always,quotes are based on receiving fully assembled documents using standard desktop publishing applications.Consult with your sales rep to find out how you can see if your files are within specification.This quote is valid for 30 days unless otherwise specified. Page 1 of 1 7...1.... 3 N , ? � ( 0 O i ..& it NN o vi c u m 11) RI 22` ► V`es. _S e O NO a a o al ° J � - L i :S\': 1; Fs' 4.1 V0 Ql I 30 v -I VVV , ]� 1 '� -ter C L . ( \ .., C( o `9, � 46 .4 y • E NU u H 76 c _ .' `! W Q c0 oo N N • V 0 o 1- .0 a — Q 4 a a y ..;:4, j cs\.L.`1 . u a/ w N y m lc 1 i al p, •,,, E v c y3 a N ' a d L a v O F > > c c o ro >j o c O d c7 2 Q / _, a) Q/ O O M 0O J La r .-i u O ai 113 illt E y 61 la c N o 0 3 v t m10 COco c CO E y 2 v, 'w u, Z N Q o m CO°1OD m v a 0 LL a` > c E c o z J N 00 Sc' N o m c a,v. O Vf > m C O 1- J y a) Li m E ro H Z 6 • SUNNY is(F,.`. t , _ NON- COLLUSION AFFIDAVIT u\ r � City of Sunny Isles Beach T 9t, 18070 Collins Avenue 4'90 ?:!•F.Lo''O01- Sunny Isles Beach,FL 33160 suN.' Telephone:(305)947-0606 Fax:(305)949-3113 STATE OF FLORIDA COUNTY OF CLW 1'D) • The undersigned being first duly sworn as provided by law,deposes,and says: This Affidavit is made with the knowledge and intent that it is to be filed with the City of Sunny Isles Beach City Commission and that it will be relied upon by said County,in any consideration which may give to and any action it may take with respect to this Bid. The undersigned is authorized to make this Affidavit on behalf of, e)c `rkie.e__ (Name of Corporation,Partnersl'p,Individual,etc.) a, i 191- „o, ,formed under the laws of { e�� (Typ of Business) (State) Cti Pr�-11-4 t. B ►�- (cc � of which he is � (Sole Owner,Partner,President,etc.) Neither the undersigned nor any person, firm, or corporation named in above Paragraph 10.2, nor anyone else to the knowledge of the undersigned, have themselves solicited or employed anyone else to solicit favorable action for this Bid by the City, also that no head of any department or employee therein,or any officer of the City of Sunny Isles Beach,Florida is directly interested therein. This Bid is genuine and not collusive or a sham;the person,firm or corporation named above in Paragraph 10.2 has not colluded,conspired, connived or agreed directly or indirectly with any proposers or person,firm or corporation,to put in a sham Bid, or that such person,firm or corporation, shall refrain from Bidding, and has not in any manner,directly or indirectly, sought by agreement or collusion, or communication or conference with any person,firm or corporation,to fix the prices of said Bid or Bids of any other proposers;and all statements contained in the Bid or Bids described above true; and further; neither the undersigned, nor the person, firm or corporation named above in Paragraph 10.2,has directly or indirectly submitted said Bid or the contents thereof,or divulged information or data relative thereto,to any association or to •ny member or agent thereof. iritic - �Z J AFFIANT'S NA. = AFFIANT'S TITLE TAKEN,SWORN AND SUBSCRIBED TO BEFORE ME this `4"'aay of � i{ 20 "i Personally Known x or Produced Identification Type of identification (Affix seal here) k I 1 A NOTA=' • =LIC( ame p nte:o typed) giff Notary Public State of Florida 'Caney Ratteray +� t� My Commission FF 978529 'eta op1F Expires 04/04/2020 ..1 • DECEMBER 28.2010 Sdf4NY'/S,e PUBLIC ENTITY CRIMES ; a ' City of Sunny Isles Beach D9 18070 Collins Avenue yI Loa° -"° Sunny Isles Beach,FL 33160 Telephone:(305)947-0606 Fax:(305)949-3113 SWORN STATEMENT PURSUANT TO SECTION 287.133(3)(a) FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES PUBLIC ENTITY CRIMES Pursuant to the provisions of paragraph (2) (a) of Section 287.133, Florida State Statutes - "A person or affiliate who has been placed on the convicted vendor list following a conviction for a public entity crime may not submit a Bid on a Contract to provide any goods or services to a public entity, may not submit a Bid on a Contract with a public entity for the construction or repair of a public building or public Work, may not submit Bids on leases of real property to a public entity, may not be awarded to perform Work as a Contractor, supplier, Sub-Contractor, or Consultant under a Contract with any public entity, and may not transact business with any public entity in excess of the threshold amount Category Two of Sec. 287.017, FS for thirty six months from the date of being placed on the convicted vendor list". THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICIAL AUTHORIZED TO ADMINISTER OATHS. 11.1. This sworn statement is submitted to City of Sunny Isles Beach by V 4110IW G I GI not individual's name and titles)?i for IctX Ill fe -T-ate pnnt name of entity submitting sworn statement] whose bysinessaddrgss is:� ( L 7+ -r and (if applicable) its Federal Employer Identification number(FEIN) is Cc) —09 1 !S I (If the entity had no FEIN, include the Social Security Number of the individual signing this sworn statement: .) 11.2. I understand that a "public entity crime" as defined in Paragraph 287.133(1)(g), Florida Statutes, means a violation of any state or federal law by a person with respect to and directly related.to the transaction of business with any public entity or with an agency or political subdivision of any other state or with the United States, including, but not limited to, any Bid or Contract for goods or services to be provided to any public entity or an agency or political subdivision of any other state of the United States and involving antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material misrepresentation. 11.3. I understand that"convicted" or"conviction" as defined in Para. 287.133(1)(b), Florida Statutes, means a finding of guilt or a conviction of a public entity crime, with or without an adjudication of guilt, in any federal or state trail court of record relating to charges brought by indictment or information after July 1, 1989, as a result of a jury verdict, non-jury trial, or entry of a plea of guilty or nolo contendere. 11.4. I understand that an "affiliate" as defined in Para. 287.133(1)(a), Florida Statutes, means: a.) predecessor or successor of a person convicted of a public entity crime; or b.) Any entity under the control of any natural person who is active in the management of the entity and who has been convicted of a public entity crime. The term "affiliate" includes those officers, directors, executors, partners, shareholders, employees, members, and agents who are active in the management of an affiliate. The ownership by one person of shares constituting a controlling interest in another person, or a pooling of equipment or income among persons when not for fair DECEMBER 28,2010 market value under an arm's length agreement, shall be a prime facie case that one person controls another person. A person who knowingly enters into a joint venture with a person who has been convicted of a public entity crime in Florida during the preceding 36 months shall be considered an affiliate. 11.5. I understand that a "person" as defined in Para. 287.133(1)(e), Florida Statutes, means any natural a3 person or entity organized under the laws of any state or of the United States with the legal power to enter into a binding Contract and which Bids or applies to Bid on Contracts for the provision of goods or services let by a public entity, or which otherwise transacts or applies to transact business with a public entity. The term "persons" includes those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in management of any entity. 11.6. Based on information and belief, the statement which I have marked below is true in relation to the entity // submitting this sworn statement. (Indicate which statement applies.) ✓ Neither the entity submitting this sworn statement, nor any of it's officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, nor any affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, or an affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners, shareholders, employees, members, or agents:who are active in the management of the entity, or an • affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. However, there has been a subsequent proceeding before a Hearing Officer of the State of Florida, Division of Administrative Hearings and the Final Order entered by the Hearing Officer of the State of Florida, Division of Administrative Hearings and the Final Order entered by the Hearing Officer determined that it was not in the public interest to place the entity submitting this sworn statement on the convicted vendor list. (Attach a copy of the final order.) I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR THE PUBLIC ENTITY IDENTIFIED IN PARAGRAPH 11.1 (ONE)ABOVE IS FOR THAT PUBLIC ENTITY ONLY AND, THAT THIS FORM IS VALID THROUGH DECEMBER 31 OF THE CALENDAR YEAR IN WHICH IT IS FILED. I ALSO UNDERSTAND THAT I AM REQUIRED TO INFORM THE PUBLIC ENTITY PRIOR TO ENTERING INTO A CONTRACT IN EXCESS OF THE THRESHOLD AMOUNT PROVIDED IN SECTION 287.017, FLORIDA STATUTES, FOR CATEGORY TWO Oc ANY, CHANGE IN THE INFORMATION CONTAINED IN THIS FORM'. By: (/.4/04414: gn �� ( pt}e0Name) C-rf(Title) Sworn to and subscribed Wore me this 114 day of 74444,14444y _, 20 740 , by (AFFIX NOTARY T• • I 1 pit, Notary Public State or Florida Kaney Ratteray Signature: t My Commission FF 978529 `AL LSA 1 v#0,pdF Expires 04/04/2020 Personally Known )6 OR Produced Identification V r 9 ;SUNNY is,� Ie ra EQUAL OPPORTUNITY / I 1 ' ' AFFIRMATIVEACTION 1•''49,•F 0 ,,0%4' City of Sunny Isles Beach ''7,0 ;N.''`� 18070 Collins Avenue Sunny Isles Beach,FL 33160 Telephone:(305)947-0606 Fax (305)949-3113 EQUAL OPPORTUNITY/AFFIRMATIVE ACTION STATEMENT The contractors and all subcontractors hereby agree to a commitment to the principles and practices of equal opportunity in employment and to comply with the letter and spirit of federal, state, and local laws and regulations prohibiting discrimination based on race, color,, religion, national region, sex, age, handicap, marital status, and political affiliation or belief. Signed: A.A/A714r - Title: CPO L Firm: A 44, 1 't/,e.€I i/l.C. Address: t Y1-7) G i � L1 i IA 4k/ems Alred EL- -277, v& I DECEMBER 28,2010 f . . , C VNNYir/s4.ti DISPUTE DISCLOSURE City of Sunny Isles Beach �• 18070 Collins Avenues� ?.,c -a�°'•,°'' Sunny�o Isles Beach,FL 33160 • c'''''o,.'suN''°° Telephone:(305)947-0606 Fax:(305)949-3113 DISPUTE DISCLOSURE FORM Answer the following questions by placing a "X" after "Yes" or "No". If you answer "Yes", please explain in the space provided, or on a separate sheet attached to this form. 19.1. Has your firm or any of its officers, received a reprimand of any nature or been suspended by the Department of Professional Regulations or any other regulatory agency or professional associations within the last five (5) years? YES , NO 19.2. Has your firm, or any member of your firm, been declared in default, terminated or removed from a contract or job related to the services your firm provides in the regular course of business within the last five (5) years? YES NO 19.3. Has your firm had against it or filed any requests for equitable adjustment, contract claims, Bid protests, or litigation in the past five (5) years that is related to the services your firm provides in the regular course of business? YES NO \k If yes, state the nature of the request for equitable adjustment, contract claim, litigation, or protest, and state a brief description of the case, the outcome or status of the suit and the monetary amounts of extended contract time involved. I hereby certify that all statements made are true and agree and understand that any misstatement or misrepresentation of falsification of facts shall be cause for forfeiture of rights for further consideration of this Bid for the City of Sunny Isles Beach. 0' 114/e/1 0 8 ( 'I4'2020 Fir Date 14)i 0 ,44.oti , i'-L I C.c0 Authorized Sign.ur• Print or Type Name and Title DECEMBER 28,2010 „.SVNtJ.Y'IS ,. •v.. ANTI — KICKBACK a • .. t = _ City of Sunny Isles Beach 18070 Collins Avenue sp 9`'`,Flos''c +` Sunny Isles Beach,FL 33160 Telephone:(305)947-0606 Fax:(305)949-3113 ANTI-KICKBACK AFFIDAVIT STATE OF FLORIDA ) COUNTY OF F6(61)W#08 ) I, the undersigned, hereby duly sworn and deposed say that no portion of this sum herein Bid will be paid to any employees of the City of Sunny Isles Beach or its elected officials as a commission, kickback, reward or gift, directly or indirectly by me or any member of my firm or by an officer of the corporation. • By: Title: C Po The foregoing instrument as cknowled ed .before me this � `-�1 day of 20 l4 , by ( A/410 4iity [name o person], / as C f-D [type of authority], for VGv-J 14,,fee Y-uZ • [name of party on behalf of whom instrument was executed]. AFFIX NOTARY STAMP HERE: i I �. !. Notary Pu c — State of Florida 1r opo Notary Public State of Florida +F �; KaneYU M � My CommassionaFF 978529 ” «J Expires 20 Print or type Commissioned Name Personally Known y OR Produced Identification Type of Identification Produced DECEMBER 28,2010 yJ 1( •.• CONTRACTOR ANTI-BOYCOTT CERTIFICATION [PURSUANT TO FLORIDA STATUTE§215.4725] I; Jt p j 14'4 i , on behalf of te), / C • Print Name Company Name certifies that ti-Ge .Y v1,C C . does not: Company Name 1. Participate in a boycott of Israel; and 2. Is not on the Scrutinized Companies that Boycott Israel list; and 3. Is not on the Scrutinized Companies with Activities in Sudan List; and 4. Is not on the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List; and 5. Has not engaged in business operations in Cuba or Syria. Signature (to Title 0 14-11,00 Date CITY OF SUNNY ISLES BEACH 18070 Collins Avenue r� Sunny Isles Beach, Florida 33160 au"to.' J\ 305.947.0606 ° 01@'\, www.sibfl.net , ., ori Firm Name 1 \‘-Q- Street Address: I 31 S(io fSd-flet-51" Mailing Address (if different): Telephone No.31 Fax OIL/ Fax No. N Email Address: S W-- - Q-tke3• Cool FEIN No.�_.-piS 51I1-± o * By signing this documen*le vendor agrees to all Terms Signature: wordith (Signature of autho ied agent) Print Name: Title: ' (A-(i5 - Me Lr-- THE EXECUTION OF THIS FORM CONSTITUTES THE UNEQUIVOCAL OFFER OF PROPOSER TO BE BOUND BY THE TERMS OF ITS PROPOSAL. FAILURE TO SIGN THIS SOLICITATION WHERE INDICATED ABOVE BY AN AUTHORIZED REPRESENTATIVE SHALL RENDER THE PROPOSAL NON-RESPONSIVE.THE CITY MAY, HOWEVER, IN ITS SOLE DISCRETION, ACCEPT ANY PROPOSAL THAT INCLUDES AN EXECUTED DOCUMENT WHICH UNEQUIVOCALLY BINDS THE PROPOSER TO THE TERMS OF ITS OFFER. City of Sunny Isles Beach I Request for Proposal No. 19-12-01 34 USN NY NSiF .n'._' CONFLICT OF INTEREST City of SunnyIsles Beach -,.�.�z-,•• : j 18070 Collins Avenue• .e. -ijo 2,.,F.LpP, S. Sunny Isles Beach,FL 33160 �''°;ok sv ,"- " Telephone:(305)947-0606 Fax:(305)949-3113 CONFLICT OF INTEREST STATEMENT . The award of any contract hereunder is subject to the provisions of Chapter 112, Florida State Statutes. Proposers must disclose with their Bids, the name of any officer, director, partner, associate or agent who is also an officer or employee of the City of Sunny Isles Beach or its agencies. STATE OF FLARI A . COUNTY OF inicuw OLP ' BEFORE ME, the undersigned authority, personally appeared NO J w Q 1.1/1V , who was duly sworn, deposes,and states: (, 1 .1. 1 a the r Po of 4 nie. with a local office in 1 ?Z� t5 A S�eie'1 and principal office in 11-401-se iFt 18.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No. described as: Printing and mailing. The Affiant has made diligent inquiry and provides the information contained in this Affidavit based upon his own knowledge. 18.3 The Affiant states that only one submittal for the above Bid is being submitted and that the above named entity has no financial interest in other entities submitting Bids for the same project. 18.4 Neither the Affiant nor the above named entity has directly or indirectly entered into any agreement, participated in any collusion, or otherwise taken any action in restraints of free competitive pricing in connection with the entity's submittal for the above Bid. This statement restricts the discussion of pricing data until the completion of negotiations if necessary and execution of the Contract for this project. 18.5 Neither the entity nor its affiliates, nor any one associated with them, is presently suspended or otherwise ineligible from participation in contract letting by any local, State, or Federal Agency. • 18.6 Neither the entity, nor its affiliates, nor any one associated with them have any potential conflict of interest due to any other clients, contracts, or property interests for this project. 18.71 certify that no member of the entity's ownership or management is presently applying for any employee position or actively seeking an elected position with the City of Sunny Isles Beach. 18.8 I,certify that no member of the entity's ownership or management, or staff has a vested interest in any aspect of the City of Sunny Isles Beach. 18.9 In the event that a conflict of interest is identified in the provision of services, I, on behalf of the above named entity, will immediately notify theCity of Sunny Isles Beach. Da d this ( t.it6 day of ' .L,A16. 20. b it i . -..t" Y,, GeV ANI<I1A441 Print o Type Name and Title S o.rn to and•subscribed before me this ((44day of ',.., A ,2020. Personally Known OR O Produced Identification ; Type of h= tification ' i i . NOTARY PUBLIC STATE OF FLORIDA III duoxes, Notary Public State of Florida Kaney Ratteray +a t` My Commission FF 978529 ' O1 Expires 04/04/2020 DECEMBER 28,2010 CITY OF SUNNY ISLES BEACH 18070 Collins Avenue Sunny Isles Beach, Florida 33160 ,,,,,,p4 1st 1s es, 305.947.0606 i..9.4:1"- '90: t r www.sibfl.net t - F'6:,,OF3tlµ= , SECTION 6 BID SUBMITTAL FOR: ACKNOWLEDGEMENT OF ADDENDA ' INSTRUCTIONS: COMPLETE PART I OR PART II, WHICHEVER APPLIES PART I: LIST BELOW ARE THE DATES OF ISSUE FOR EACH ADDENDUM RECEIVED IN CONNECTION WITH THIS BID Addendum #1, Dated Addendum #2, Dated Addendum #3, Dated Addendum #4, Dated Addendum#5, Dated Addendum #6, Dated Addendum #7, Dated Addendum#8, Dated PART II: O ADDENDUM WAS RECEIVED IN CONNECTION WITH THIS BID r, ,..... FIRM NAME: IZ_Ibec-ILAnt,e_ ( 1 �-C" 41101 AUTHORIZED SIGNATURE: Ar (---• DATE: I-- I� TITLE OF OFFICER: Mflc.1,l.t. 04 `e•C 1 City of Sunny Isles Beach I Request for Proposal No. 19-12-01 32 1 • • • • • CITY.OF StUNNY•ISLES BEACH • • • 1807.0 Collins'Avenue • Sunny Isles Beach,Florida 33160 �ilT`yY'si\ • 305_ 47.0606 wwi,.sihil net , Jpt � Received 1-0509 JAN C> Milips-ovwci)boF sUN:p�Vy€31+14� 1yat Wes Beach Office ofthe Clay Clogs DELIVER TO: REQUEST FOR PROPOSAL City of Sunny Isles Beach SECTION 6 City Clerk BID SUBMITTAL FORMSOPENING: 216,30 2020 P.M.2 Thursday, 18070 Collins Avenue January 16, Sunny Isles Beach, FL 33160 PLEASE QUOTE PRICES F.O.B. DESTINATION, LESS TAXES, DELIVERED IN • CITY OF SUNNY ISLES BEACH, FLORIDA NOTE: City of Sunny Isles Beach is exempt from all taxes (Federal, State, and Local). Bid price should be less all taxes. Tax Exemption Certificate furnished upon request. Issued by: Purchasing Agent Date Issued: This Bid Submittal Consists of 12/20/2019 Pages 31+ Sealed bids are subject to the Terms and Conditions of this Request for Proposal and the accompanying Bid Submittal. Such other contract provisions, specifications, drawings or other data as are attached or incorporated by reference in the Bid Submittal, will be received at the office of the City Clerk at the address shown above until the above stated time and date, and at that time, publicly opened for furnishing the supplies or services described in the accompanying Bid Submittal Requirement. RFP 19-12-01 Printing &Mailing of SIB Living Magazine&Newsletter A Bid Deposit in the amount of 0%of the total amount of the bid shall accompany all bids A Performance Bond in the amount of 0%of the total amount of the bid will be required upon execution of the contract by the successful bidder and City of Sunny Isles Beach ProcurementAcent: firm Name: Genesis Cuevas i2�YD —�. f V� Commodity Code(s): RETURN ONE ORIGINAL AND TWO COPIES OF BID SUBMITTAL PAGES AND AFFIDAVITS FAILURE TO SIGN PAGE 32 OF SECTION 4 BID SUBMITTAL WILL RENDER YOUR BID NON- RESPONSIVE City of Sunny Isles Beach I Request for Proposal No. 19-12-01 31,. " Rex Three, Inc. Quotation 15431 SW 14 St. 760023-1 , Sunrise, FL 33326 • Phone(954)452-8301 Fax(954.)452-0569 estimating@rex3.com • www.rex3.com To: U / Date 1/13/20 Salesperson • Steve Hager City of Sunny Isles Beach Estimator JM 18070 Collins Avenue �J 4th floor .-4, 4 Sunny Isles Beach, FL 33160 • Phone(305) 792-1764 --__--- -_- --Fax(3051792-'1607 • Email ayeash@sibfl.net • Dear City of Sunny Isles Beach • We would like to thank you for your time and consideration in regards to this quotation. The quotation is confidential and is intended solely for the use of the addressee(s) named above. r Your detailed production specifications for this request are listed below. Description Magazine Pages 44 Pages+4 Page Cover Size Final Size : 8 1/2 x 11 Paper 80.0 lb Endurance Silk Cover 80.0 lb Endurance Silk Text Colors 4/4 Process+OA Satin AQ-Cover 4/4 Process-Text PrePress PDF_Files-Rip,Trap, HP, Epson Color Proofs Finishing Cutting, Folding, Perfect Binding Prices Quantity Prices 7,500 $10,820 per issue / $43,280 per year / $86,560 per term Shipping Carton Pack, Local Delivery Sincerely, • Prices are subject to review upon receipt of art. Upon acceptance please indicate the quantity required • • Quoted By: Steve Hager Sign: Date: Accepted By: Sign: Date: Thank you for giving us the opportunity to submit this quote.As always,quotes are based on receiving fully assembled documents using standard desktop publishing applications.Consult with your sales rep to find out how you can see if your files are within specification.This quote is valid for 30 days unless otherwise specified. • • Page 1 of 1 • • Rex Three, Inc. Quotation 15431 SW 14 St. 760023 Sunrise,,FL 33326 Phone(954)452-8301 Fax(954)452-0569 estimating@tex3.com www.rex3.com To: • Date • 1/8/20 Salesperson Steve Hager City of Sunny Isles Beach r� I ) - ) Estimator JM• 18070 Collins Avenue 4th floor Sunny Isles Beach, FL 33160 Phone(305) 792-1764 Fax(305);792=1607 •Email ayeash@sibfl.net . 3 2- • Dear City of Sunny Isles Beach We would like to thank you for your time and consideration in regards to this quotation. The quotation is confidential and is intended solely for the use of the addressee(s) named above. Your detailed production specifications for this request are listed below. • Description Magazine Pages 48 Pages+4 Page Cover Size • Final.Size : 8 1/2 x 11 Paper 80.0 lb Endurance Silk Cover 80.0 lb Endurance Silk Text • Colors • 4/4 Process+ OA Satin AQ-Cover 4/4 Process-Text PrePress PDF_Files-Rip,Trap, HP, Epson Color Proofs Finishing Cutting, Folding, Perfect Binding Prices Quantity Prices • 7,500 $10, 995 per issue / $43, 980 per year / $87, 960 per term Shipping Carton Pack, Local Delivery Sincerely, • Prices are subject to review upon receipt of art. Upon acceptance please indicate the quantity required Quoted • • Steve Hager By: Sign: Date: t ' Accepted By: Sign: Date: Thank you for giving us the opportunity to submit this quote.As always,quotes are based on receiving billy assembled documents using standard desktop publishing applications.Consult with your sales rep to find out how you can see if your files am within specification.This quote is valid for 30 days unless otherwise specified. Page 1of1 • Rex Three, Inc. Quotation • 15431 SW 14 St. 760000 Sunrise,,FL 33326 Phone(954)452-8301 Fax(954)452-0569 • estimating@rex3.com www.rex3.com To: Date 1/8/20 Salesperson Steve Hager City of Sunny Isles Beach 'j ( 7 - ® ( Estimator JM 18070 Collins Avenue ll 4th floor Sunny Isles Beach, FL 33160• Phone(305) 792-1764 ----- -- — Fax(305),792-1607 Email ayeash@sibfl.net. ► 1 Dear City of Sunny Isles Beach We would like to thank you for your time and consideration in regards to this quotation. The quotation is confidential and is intended solely for the use of the addressee(s) named above. Your detailed production specifications for this request are listed below. • • Description SIB Islander Newsletter Pages • 6 Pages Size Final Size : 25.5"x 10.875"folds to 8.5"x 5.5" Paper 100.0 lb Endurance Silk Text Colors 4/4 Process+OA Satin AQ PrePress PDF_Files- Rip,Trap, Proof Finishing Cutting, Folding, Wafer Seal, Mail 17m, Deliver Balance. Prices Quantity Prices 17, 300 $3, 895 per month/ $46,740 per year / $93,480 per term +POSTAGE ADDITIONAL Shipping • NCOA List, File Prep, CASS per list and/or drop, Ink Jet Format 3-1 blocks, Delivery++(postage not included) Notes Price Does Not Include Mailing List Sincerely, Prices are subject to review upon receipt of art. Upon acceptance please indicate the quantity required • Quoted By: Steve Hager Sign: _ Date: • Accepted By: Sign: Date: Thank you for giving us the opportunity to submit this quote.As always,quotes are based on receiving fully assembled documents using standard desktop publishing applications.Consult with your sales rep to find out how you can see if your files are within specification.This quote is valid for 30 days unless otherwise specified. Page 1 of 1 • • Rex Three, Inc. Quotation 15431 SW 14 St. • 760028 Sunrise,.FL 33326 Phone(954)452-8301 • Fax(954)452-0569 estimating@rex3.com www.rex3.com 7., Li I To: • Date 1/10/20 Salesperson Steve Hager City of Sunny Isles Beach 3Estimator JM 18070 Collins Avenue 3: 5. • 4th floor Sunny Isles Beach, FL 33160 Phone(305) 792-1764 __- -. _. . ._. fax(305)'792-1607 • Email ayeash@sibfl.net • Dear City of Sunny Isles Beach We would like to thank you for your time and consideration in regards to this quotation. The quotation is confidential and is intended solely for the use of the addressee(s) named above. Your detailed production specifications for this request are listed below. Description Desk Calendar Pages 16 Leaves+Cover Leaf+ Easel Base Size 6.75"x 6"- 16 Leaves+ Cover Leaf 15"x 6.75"- Easel Base Paper 100.0 lb Endurance Silk Cover- 16 Leaves(Hannoart n/a) 130.0 lb Classic Crest Natural White Stipple Cover-Cover Leaf(Mill Item) • 160.0 lb Classic Crest Natural White Stipple Cover- Easel Base(Mill Item) Colors 4/4 Process+OA Satin AQ- 16 Leaves • 0/0 No Printing-Cover Leaf& Easel Base PrePress PDF_Files-Rip,Trap, HP, Epson Color Proofs Finishing Foil Stamp Cover Leaf 3"x 2"Area (Standard Foil Color), Die Cut, Die Score, Cutting, Wire 0 Bind Prices ' Quantity Prices 1, 500 $6,295 year / $12,590 term Shipping Carton Pack, Local Delivery Sincerely, Prices are subject to review upon receipt of art. • Upon acceptance please indicate the quantity required Quoted By: Steve Hager Sign: Date: Accepted By: Sign: Date: • Thank you for giving us the opportunity to submit this quote.As always,quotes are based on receiving fully assembled documents using standard desktop publishing applications.Consult with your sales rep to find out how you can see if your files are within specification.This quote is valid for 30 days unless otherwise specified. • Page 1 of 1 N . II :14 • r '\\/. O E �0 0r o ... , �• p ... „....., 0 O ,_ u 0 r 2,) gf u • "*" ,::$ / zo � •a n -.1--. 7 C � V 0au - !"''' ...., {J a (\—� 00 VV e o `9, 49 Ca .S4 N• E u F- To e ,_ F �. y• 3 (0 Q 00 00 N N u Li 0 O F • 3 au 9 aa0,.. 0, j a V y� w oC _ _ ✓ a• E. -o c w a N v 0 0u yr a o d T T - T ^Cv7, A ..+ ` 0) OJ L ro O y t+ t+ • CU ~ V 7 7 0 Cf Cf 2 Q / v OJ rJ p `\TV a V O Q! Y ' ^` M V _ _d m c • •N a Q 0 n 0 0 Of w 3 . Oa 0 d NN N z rO Q o 00 00 CO 60 N VO. 0 0- U- t1.- a` c (13• a (0 a o 73 c cc -) N bp 4 N SL 173 mc "" -. U Fo N 2 m 0 H N a CO co i ii Z 6 � �- •L NON- COLLUSION AFFIDAVIT City of Sunny Isles Beach 18070 Collins Avenue yP 9?*f 40 O, '• Sunny Isles Beach,FL 33160 'of susus" Telephone:(305)947-0606 Fax:(305)949-3113 STATE OF FLORIDA COUNTY OF `AtO) The undersigned being first duly sworn as provided by law,deposes,and says: • This Affidavit is made with the knowledge and intent that it is to be filed with the City of Sunny Isles Beach City Commission and that it will be relied upon by said County,in any consideration which may give to and any action it may take with respect to this Bid. The undersigned is authorized_to_make_this Affidavit-on behalf-of; (Name of Corporation,Partnersll'p,Individual,etc.) a, Ce,, sT i OIJ ,formed under the laws of F1.49 it:b 1:1- (Typelof Business) (State) of which he isl�I[til ' r"4'0-4G.1,41V B AP► (C.F4 2 (Sole Owner,Partner,President,etc.) Neither the undersigned nor any person, firm, or corporation named in above Paragraph 10.2, nor anyone else to the knowledge of the undersigned, have themselves solicited or employed anyone else to solicit favorable action for this Bid by the City, also that no head of any department or employee therein,or any officer of the City of Sunny Isles Beach,Florida is directly interested therein. This Bid is genuine and not collusive or a sham;the person,firm or corporation named above in Paragraph 10.2 has not colluded,conspired, connived or agreed directly or indirectly with any proposers or person,firm or corporation,to put in a sham Bid,or that such person,firm or corporation,shall refrain from Bidding, and has not in any manner,directly or indirectly,sought by agreement or collusion,or communication or conference with any person,firm or corporation,to fix the prices of said Bid or Bids of any other proposers;and all statements contained in the Bid or Bids described above true; and further; neither the undersigned, nor the person, firm or corporation named above in Paragraph 10.2,has directly or indirectly submitted said Bid or the contents thereof,or divulged information or data relative thereto,to any association or to any member or agent thereof. % • ► t Z) G�%J AFFIANT'S NA,' = AFFIANT'S TITLE TAKEN,SWORN AND SUBSCRIBED TO BEFORE ME this 14 ay of4 7 ,2� Personally Known X or Produced Identification • Type of identification (Affix seal here) �aV• i NOTA- • BLIC(,ame printer o'typed) .ocrsvpw, Notary Public State of Florida Kaney Ratteray My Commission FF 978529 'tor aF Expires 04/04/2020 • DECEMBER 28,2010 . PUBLIC ENTITY CRIMES ti K .... City of Sunny Isles Beach 18070 Collins Avenue .. Sunny Isles Beach,FL 3316 0 f6*O:,SUN'" Telephone:(305)947-0606 Fax:(305)949-3113 SWORN STATEMENT PURSUANT TO SECTION 287.133(3)(a) FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES PUBLIC ENTITY CRIMES Pursuant to the provisions of paragraph (2) (a) of Section 287.133, Florida State Statutes -"A person or affiliate who has been placed on the convicted vendor list following a conviction for a public entity crime may not submit a Bid on a Contract to provide any goods or services to a public entity, may not submit a Bid on a Contract with a public entity for the construction or repair of a public building or public Work, may not submit Bids on leases of real-property-to-a-public-entity,—may-note awarded10-pefform Work as a Contractor, supplier, Sub-Contractor, or Consultant under a Contract with any public entity, and may not transact business with any public entity in excess of the threshold amount Category Two of Sec. 287.017, FS for thirty six months from the date of being placed on the convicted vendor list". THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICIAL AUTHORIZED TO ADMINISTER OATHS. 11.1. This sworn/statement is submitted to City of Sunny Isles Beach by D jl�V iO QM I�?i GT o l�nnt individual's name and title for f t ✓'ieatC - pnn name of entity submitting sworn statement] whose bys-ins addresJ 1 441 +5e. and (if applicable) its Federal Employer Identification number(FEIN) is J c —09 c l l5 I . (If the entity had no FEIN, include the Social Security Number of the individual signing this sworn • statement: • .) 11.2.. I understand that a"public entity crime"as defined in Paragraph 287.133(1)(g), Florida Statutes, means a violation of any state or federal law by a person with respect to and directly related to the transaction Of business with any public entity or with an agency or political subdivision of any other state or With the United States, including, but not limited to, any Bid or Contract for goods or services to be provided to any public entity or an agency or political subdivision of any other state of the United States and involving antitrust,fraud, theft, bribery, collusion, racketeering, conspiracy, or material misrepresentation. 11.3. I understand that"convicted" or"conviction" as defined in Para. 287.133(1)(b), Florida Statutes, means a finding of guilt or a conviction of a public entity crime, with or without an adjudication of guilt, in any federal or state trail court of record relating to charges brought by indictment or information after July 1, 1989, as a result of a jury verdict, non jury trial, or entry of a plea of guilty or nolo contendere. • 11.4. I understand that an "affiliate"as defined in Para. 287.133(1)(a), Florida Statutes, means: a.) predecessor or successor of a person convicted of a public entity crime; or b.) Any entity under the control of any natural person who is active in the management of the entity and who has been convicted of a public entity crime. The term "affiliate" includes those officers, directors, executors, partners, shareholders, employees, members, and agents who are active in the management of an affiliate. The ownership by one person of shares constituting a controlling interest in another person, or a pooling of equipment or income among persons when not for fair DECEMBER 28,2010 . market value under an arm's length agreement, shall be a prime facie case that one person controls another person. _A person who knowingly enters into a joint venture with a person who .has been convicted of a public entity crime in Florida during the preceding 36 months shall be considered an affiliate. 11.5. I understand that a "person" as defined in Para. 287.133(1)(e), Florida Statutes, means any natural person or entity organized under the laws of any state or of the United States with the legal power to enter into a binding Contract and which Bids or applies to Bid on Contracts for the provision of goods or services let by a public entity, or which otherwise transacts or applies to transact business with a public entity.. The term "persons" includes those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in management of any entity.. 11.6. Based on information and belief, the statement which I have marked below is true in relation to the entity / submitting this sworn statement. (Indicate which statement applies.) `' Neither the entity submitting this sworn statement, nor any of it's officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, nor any affiliate-of-the-entity-has-been-charged with and convicted of a public entity crime subsequent-tb-July-1, 1989. The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, or an affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners, • shareholders, employees, members, or agent: who are active in the management of the entity, or an • affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. However, there has been a subsequent proceeding before a Hearing Officer of the State of Florida, Division of Administrative Hearings and the Final Order entered by the Hearing Officer of the State of Florida, Division of Administrative Hearings and the Final Order entered by the Hearing Officer determined that it was not in the public interest to place the entity submitting this sworn statement on the convicted vendor list. (Attach a copy of the final order.) I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR THE PUBLIC ENTITY IDENTIFIED IN PARAGRAPH 11.1 (ONE)ABOVE IS FOR THAT PUBLIC ENTITY ONLY AND, THAT THIS FORM IS VALID THROUGH DECEMBER 31 OF THE CALENDAR YEAR IN WHICH IT IS FILED. I ALSO UNDERSTAND THAT I AM REQUIRED TO INFORM THE PUBLIC ENTITY PRIOR TO ENTERING INTO A CONTRACT IN EXCESS OF THE THRESHOLD AMOUNT PROVIDED IN SECTION 287.017, FLORIDA STATUTES, FOR CATEGORY TWO O ANY,. CHANGE IN THE INFORMATION CONTAINED IN THIS FORM. By: it/ ( ign lui-ib -r1/ Name) (Title) / Sworn to and subscribed before.me this ill day of -J _, 20 /4 , by (AFFIX NOTARY...T• i. - 7 _ 4 do"f4i Notary Public State of Florida r 4; Signature: : I Kaney Ratteray 9• lf My Commission FF 9713529 . 1�a 1 �l'p or Expires 04/04/2020 • Personally Known ' OR Produced Identification i r V 11 SUNNY ,t "0` EQUAL OPPORTUNITY / c+. - Aar ' ' AFFIRMATIVE ACTION .:a,; ° Beach .,.,., ..,,.,��oa s City of Sunny Isles r ' sue 18070 Collins Avenue oe . Sunny Isles Beach,FL 33160 Telephone:(305)947-0606 Fax (305)949-3113 EQUAL OPPORTUNITY/AFFIRMATIVE ACTION STATEMENT The contractors and all subcontractors hereby agree to a commitment to the principles and practices of equal opportunity in employment and to comply with the letter and spirit of federal, state, and local laws and regulations prohibiting discrimination based on race, color, religion, national region, sex, age, handicap, marital status, and political affiliation or belief. Signed: The: CPO Firm: Er14-ty- eeI Address: I Yki 1 71A, ( LI I vl �`k/ems ill/Vie:Se., Ft- 77. ) & DECEMBER 28,2010 uate+' ..`;Y0 DISPUTE DISCLOSURE -:.'•� ' "� City of Sunny Isles Beach 18070 Collins Avenue .rises ; 9 ;,FLp1° :.4: Sunny Isles Beach,FL 33160 r > ` . (305)947-0606 Fax:(305)949-3113 oF,`s�N Telephone: DISPUTE DISCLOSURE FORM Answer the following questions by placing a "X" after "Yes" or"No". If you answer "Yes", please explain in the space provided,or on a separate sheet attached to this form. 19.1. Has your firm or any of its officers, received a reprimand of any nature or been suspended by the Department of Professional Regulations or any other regulatory agency or professional associations within the last five(5)years? YES NO • 19.2. •Has your firm, or any member of your firm, been declared in default, terminated or removed from a •contract or job related to the services your firm provides in the regular course of business within the last five (5) years? YES NO 19.3. Has your firm had against it or filed any requests for equitable adjustment, contract claims, Bid protests, or litigation in the past five (5) years that is related to the services your firm provides in the regular course of business? YES NO \A If yes, state the nature of the request for equitable adjustment, contract claim, litigation, or protest, and state a brief description of the case, the outcome or status of the suit and the monetary amounts of extended contract time involved. I hereby certify that all statements made are true and agree and understand that any misstatement or misrepresentation of falsification of facts shall be cause for forfeiture of rights for further consideration of this Bid for the City of Sunny Isles Beach. I 114/&& 8H4-7,oW Fir fiDate ( cJ Authorized Sign. urs• Print or Type Name and Title DECEMBER28,2010 :s%) N ANTI - KICKBACK x City of Sunny Isles Beach ? 18070 Collins Avenue 'c. ,` SunnyIsles Beach,FL 33160 C' _. {ORNo 1';' uN' Telephone:(305)947-0606 Fax:(305)949-3113 ANTI-KICKBACK AFFIDAVIT STATE OF FLORIDA ) COUNTY OF M W&2 ) I—the-undersigned,—hereby-duly-sworn and-deposed say that no portion of-this sum herein Bid — will be paid to any employees of the City of Sunny Isles Beach or its elected officials as a commission, kickback, reward or gift, directly or indirectly by me or any member of my firm or by an officer of the•corporation. I I By: Title: C Po The foregoing instrument as cknowle/dgJLe ed fore me this 14� day of 40 , 20 , by �410 'iJv [name o.fi person], / as _ Cto [type of authority], for Y',C -J vu'ee ..4 .t Z . [name of party on behalf of whom instrument was executed]. 1 AFFIX NOTARY STAMP HERE: Notary Publ c — State of Florida mer we Notary Public State of Florida I igir Ratteray �•, M ( ct* ;�i � My Commission FF 978529 lit ?o, / p;res04f0412o2o - Print or ype Commissioned Name Personally Known y OR Produced Identification Type of Identification Produced DECEMBER 28,2010 i SUNNY ISf,' . esu, `gam/ CONTRACTOR ANTI-BOYCOTT CERTIFICATION [PURSUANT TO FLORIDA STATUTE§215.4725] I,TV 11 .iLLQ1t,4 , on behalf of lief T -C • Print Name Company Name certifies that Qu- . 11�1,v-L�C fvt.,C • does not: Company Name 1. Participate in a boycott of Israel; and 2. Is not on the Scrutinized Companies that Boycott Israel list; and 3. Is not on the Scrutinized Companies with Activities in Sudan List; and 4. Is not on the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List; and 5. Has not engaged in business operations in Cuba or Syria. Signature (/12 Title Date ' CITY:OF SUNNY ISLES BEACH ` 18070 Collins Avenue SunnyIsles Beach, Florida 33160sr>,r3Y iso 305.947 0606 4c.4. � \ T �4 ww, si .ne1. t . _ -- nam.-,�Jt _A ')i Pc? ��er ioF3U Firm Name l 1 \�- 1 �t Street Address: 4,,,,_. I Cq 3 1 5(n) / Mailing Address-(if-different):-----_.- - . S C.-Q-LUkiS-31/4-C_ ---P t.--kYLO 14 -T55 t(e; CL{ Telephone No.J `—3�0 — O7 l7 Fax No. N tePr P Email Address: 5 e- Q.- 12-0P3. ( V'`i FEIN No. 1_-_0_/ S JI._[J1 Q *"By signing this documenlAa vendor agrees to all Terms Signature: 411 ftIllk 1.J --‘41 _.Air,' (Signature of authoe d agent) Print Name: 56.A.§k..t'U .``—t--- Title: /A-C..,C6 U cit' 84.6 THE EXECUTION OF THIS FORM CONSTITUTES THE UNEQUIVOCAL OFFER OF PROPOSER TO BE BOUND BY THE TERMS OF ITS PROPOSAL. FAILURE TO SIGN THIS SOLICITATION WHERE INDICATED ABOVE BY AN AUTHORIZED REPRESENTATIVE SHALL RENDER THE PROPOSAL NON-RESPONSIVE.THE CITY MAY, HOWEVER, IN ITS SOLE DISCRETION, ACCEPT ANY PROPOSAL THAT INCLUDES AN EXECUTED DOCUMENT WHICH UNEQUIVOCALLY BINDS THE PROPOSER TO THE TERMS OF ITS OFFER. City of Sunny Isles Beach 'Request for Proposal No. 19-12-01 34 • • CONFLICT OF INTEREST sb.y+.moi z City of Sunny Isles Beach t S, 18070 Collins Avenue 4e'9?,p r 210 " Sunny Isles Beach,FL 33160 Telephone:(305)947-0606 Fax:(305)949-3113 CONFLICT OF INTEREST STATEMENT • The award of any contract hereunder is subject to the provisions of Chapter 112, Florida State Statutes. Proposers must disclose with their Bids, the name of any officer, director, partner, associate or agent who is also an officer or employee of the City of Sunny Isles Beach or its agencies. STATE OFF . RI A COUNTY OF w 2.9 BEFORE ME, the undersigned authority, personally appeared1)1 ✓ f4----- , who was dulysworn, deposes,—and-states: _ a�}� the (,P0 of Pic `�' eAt with a local office in ( G1 5/4) 101 S�✓hand principal office in �-1i Se F(- *3i' 18.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No. described as: Printing and mailing. The Affiant has made diligent inquiry and provides the information contained in this Affidavit based upon his own knowledge. 18.3 The Affiant states that only one submittal for the above Bid is being submitted and that the above named entity has no financial interest in other entities submitting Bids for the same project. 18.4 Neither the Affiant nor the above named entity has directly or indirectly entered into any agreement, participated in any collusion, or otherwise taken any action in restraints of free competitive pricing in connection with the entity's submittal for the above Bid. This statement restricts the discussion of pricing data until the completion of negotiations if necessary and execution of the Contract for this project. 18.5 Neither the entity nor its affiliates, nor any one associated with them, is presently suspended or otherwise ineligible from participation in contract letting by any local, State, or Federal Agency. • '18.6 Neither the entity, nor its affiliates, nor any one associated with them have any potential conflict of interest due to any other clients,contracts, or property interests for this project. 18.71 certify that no member of the entity's ownership or management is presently applying for any employee position or actively seeking an elected position with the City of Sunny Isles Beach. 18.8 I:certify that no member of the entity's ownership or management, or staff has a vested interest in any aspect of the City of Sunny Isles Beach.. 18.9 In the event that a conflict of interest is identified in the provision of services, I, on behalf of the above named entity, will immediately notify the City of Sunny Isles Beach. Da d t is l -`1 t1 day of 141i1 , +D A �� p • Y�I.Q r�qy A A717-- Print or Type Name and Title Sworn to and subscribed before me this ( 4 day of ' ' ' ♦ ,2020. • Personally Known OR • ' O Produced Identification ;Type of I�- tification t a EIIL_ NOTARY PUBLIC STATE OF FLORIDA • doso Pool Notary Public State of Florida Kaney Ratteray �+e My Commission FF 978529 14,0,or Expires 04/04(2020 DECEMBER 28,2010 • . CITY .F SUNNY ISLES BEACH 18070 Collins Avenue � Sunny Isles Beach, Florida 33160u� Y ss�-, 305.947.0606 d4.<vr wnvv sibfl,net t 14. O ,47., h �! ;o ;3tliip #yd. 5 v= • r - SECTION 6 BID SUBMITTAL FOR: ACKNOWLEDGEMENT OF ADDENDA INSTRUCTIONS: COMPLETE PART I OR PART II, WHICHEVER APPLIES - PART I: LIST BELOW ARE THE DATES OF ISSUE FOR EACH ADDENDUM RECEIVED IN CONNECTION WITH THIS BID Addendum#1, Dated Addendum#2, Dated Addendum#3, Dated Addendum#4, Dated Addendum#5, Dated Addendum#6, Dated Addendum#7, Dated Addendum#8, Dated PART II: 0 ADDENDUM WAS RECEIVED IN CONNECTION WITH THIS BID FIRM NAME: TZA-k°410 .�l"e� 1 WC—, ► �,J C- - 20 AUTHORIZED SIGNATURE: .1` 4 DATE: /—' '� TITLE OF OFFICER: k Ouws mu" Mx-- City of Sunny Isles Beach I Request for Proposal No. 19-12-01 32