HomeMy WebLinkAboutCITY OF SUNNY ISLES BEACH. COW
DELIVER To, SECTION 6 OPENING: 2:30 P.M.
City of Sunny Isles Beach BID SUBMITTAL FORMS MARCH 24, 2022
City Clerk
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 Administrator: Date Issued:
GENESIS CUEVAS MARCH 2, 2022
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 22-03-01
GATEWAY PARK RENTAL MANAGEMENT
A Bid Deposit in the amount of 0?/6 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
&M Name;
S7 -i' - Cckr_ rj� , Inc.
RE7ZIgIV ONE ORIGINAL R COPLE5 A ND Offif U5B OFRFP SMM17TA L PA GES AND
AFFIDAVr
FAILURE TO SIGN PAGE 33 OF THE BID SUBMITTAL MAY RENDER YOUR PROPOSAL. NON-
RESPONSIVE
City of Sunny Isles Beach I Request for Proposal No. 22-03-01
cry►"OF s4,:•
SECTION 6
BID SUBMITTAL FOR:
ACKNOWLEDGEMENT OF ADDENDA
INSTRUCTIONS: COMPLETE PART I OR PART 11, WHICHEVER APPLIES
PART 1:
LIST BELOW ARE THE DATES OF ISSUE FOR EACH ADDENDUM RECEIVED IN CONNECTION
WITH THIS BID
PART 11:
Addendum #1, Dated +►�%' i j "" Zv L Z_
Addendum #2, Dated "L u Z z—
Addendum #3, Dated
Addendum #d, Dated
Addendum #5, Dated
Addendum #6, Dated
Addendum #7, Dated
Addendum #8, Dated
❑ NO ADDENDUM WAS RECEIVED IN CONNECTION WITH THIS BID
FIRM NAME: Lt L~GL�ef�Y �1r'1L
AUTHORIZED SIGNATURE: DATE.—
TITLE OF OFFICER: ` es,
City of Sunny Isles Beach I Request for Proposal No. 22-03-01
of Sold r
BID SUBMLITAL FORM
Bid Title: GATEWAY PARK RENTAL MANAGEMENT
The undersigned Proposer proposes and agrees, if this Bid is accepted, to enter into an agreement with
The City of Sunny Isles Beach to perform and furnish all Work as specified or indicated in the Contract
Documents for the Contract Price and within the Contract Time indicated in this Bid and in accordance with
the other terms and conditions of the Contract Documents.
The Proposer accepts all of the terms and conditions of this Request for Proposal, Including without
limitation those dealing with the disposition of Bid Security. This Bid will remain subject to acceptance for
90 days after the day of Bid opening. The Proposer agrees to sign and submit the Agreement with the
Bonds and other documents required by the Bidding Requirements within ten days after the date of the
City's Notice of Award.
In submitting this Bid, the Proposer represents, as more fully set forth in the Agreement, that:
■ The Proposer has familiarized himself/herself with the nature and extent of the
Contract Documents, Work, site, locality, and all local conditions and Law and
Regulations that in any manner may affect cost, progress, performance, or
furnishing of the Work.
• The Proposer has given the City written notice of all conflicts, errors, discrepancies
that it has discovered in the Contract Documents and the written resolution thereof
by City is acceptable to the Proposer.
This Bid is genuine and not made in the interest of or on behalf of any undisclosed
person, fine or corporation and is submitted in conformity with any agreement or
rules of any group, association, organization, or corporation; the Proposer has not
directly or indirectly induced or solicited any other Proposer to submit a false or
sham Bid; the Proposer has not solicited or induced any person, Firm or corporation
to refrain from Bidding; and Proposer has not sought by collusion to obtain for
itself any advantage over any other Proposer or over the City.
City of Sunny Isles Beach (Request for Proposal No. 22-03-01
Firm Dame:
aty LE cm-�erl; V -S, f n C .
Street Address:
--'-'T- "S N 4_I 2SA rec-4
Mailing Address (if different):
3312L -
Telephone No. ' 00 - S (Z - M_ 3 Fax No.
Email Address:SYjQle',k(4 1 bSe�d±J FEIN No. 6 2-JJ-Qj0/ (7
* 'By signing this document the bidder agrees to all Terms
Signature:. ,,,ryt
1.
(Signature of authorized agent)
Pant Name:
Title: �/tSlc�rri i -
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, 22-03-01
'IV of 110 P-
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NON -COLLUSION AFFIDAVIT
y' i
City of Sunny Isles Beach
18070 Cottrns Avenue
• . �. v'`Ya Sumy Wes Beach, :t 33160
Weahnne 305I941-0606 Fox,(3051849-51113
STATE OF FLORIDA )
COUNTY OF Mrriit,r We
The unders fined being first duly sworr as provided by law, deposes. and says
This Affidavit is made with the knowledge and intent thal it rs to be fried with the City o1 Sunny Isles Beach City Commission and tnat i1 w II be
relied upon by said County, in any Consideration which may give to and any action it may take N in respec''o this Bid.
The undersigned is authorized to make this Affidavil on behall of,
T LI -`QCk"VV\, }Iii
(Name of Corporation. Partnership. Individual., etc.)
,I-- I � rY„�[ Ci -4C I(c i�- forted under the laws of C L
(Type of Business) (Stale)
sye I
-�
of Which M is 1 r1 C i Cir ;t -k
-
of
Owner: Partner, President etc.)
Neither the undersigned nor any parson, firm., or corporation nanted above nor anyone else to the knowledge of the undersigned. have
themselves solicited or employed anyone etre to soiicrt favorable action for this Bid by the City, also that no head of aly department or
employee therein, or any officer of the City of Sunny Islas Beach. Flonda is directly interested therein,
Ibis Bid is genuine and not collusive or a sham, the person, firm or corporation named above has not colluded, conspired.. connived or agreed
dfrecily or Irxfrrectfy wth any proposers or person, firm or Corporation, to pal in a sham Bid, or that such person, firm or corporation, shall
refrain from &riding, and has not in any manner, directly or mclireetly, sought by agreement or collusion, of Communtcabon or conference w 111
any person, firm or cofporat,on, to fix the prices of said Bd or Bids of any other proposers: and all statements conte neo in the Bid or Bids
described above true. and further; neither the undersigned, nor the person. firm or corporation named above 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_
....)�C�15P
AFFtANT'S NAME
AFFIANT"$ TITLE
TAKEN, S'WCHN AND SUBSCRIBED TO BEFORE MB this day of ( 20 .E
Personally Known or Pro��dd(uced IIddentiftcabon L�
Type of identrfcabon,�i��%fi� }�f��J S L�CCnSC
lAffix seal here)
El
fliTt7 J DEAE[.SORRpTO NO Y PURL are pant or yped)
Public • Site 0f Flondit
miWontHm00810tm Erspiritr Jt l 14, 1014
1 of 8
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PUBLIC ENTITY CRIMES
>t Cily of Sunny Isles Beach
. / 19070 Colirs Ave4vue
Sunny Islea Beech. FL 33160
,£ •' or ,�.'!p`` Tereorlxm 1305194 7-051M FaK, (305) 94"113
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 budding 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.
1. This sworn statement is submitted to �City of Sunny Isles Beach
by �r L0110 � � �11v J `4'_ 1t lc 'rl
bmit rdwlb+ta rine a -s iaw -
for ti �G1!!•.,rc Biu
J:wrvt ham d cnely vut rddny —wn staldnenQ
whose business address is:
fie&, - 33t2-l—
and (If applicable) its Federal Employer Identification number (FEIN) is �Z `� V 0 8 Z c) 0
(If the entity had no FEIN, include the Social Secunty Number of the individual signing this sworn
statement. )
2. 1 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.
3. 1 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.
4. 1 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
2 of 8
market value under an arm's length agreement, shall be a pnme 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 cnme in Florida during the preceding 36 months shall be
considered an affiliate.
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,
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.)
bJ
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 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 OF ANY, CHANGE W THE INFORMATION CONTAINED IN THIS FORM.
By:
9,---
(Signature)
(Printed Name),
(Title)
3r
Sworn to and subscribed before me this 3) day of Mx 20 z-7- , by
L 5, bbIie
(AFFI
fp.,��f ti0R2cRTO J PfREI•BORROTO Signature N utb is —State f Florida
Notary -1ntNlc - State of F;onai p
coff �uion I MH 001101 /yG�Il �ir_ .7 2t Z C�M�? f�
} rr coin, Expire SLI ta, 202• Print or Type Commissioned Name
Personally Known OR Produced Identification
Type of Identification Produced d,4
3of8
vfi)
EQUAL OPPORTUNITYAFFIRMATIVE ACTIc�h
Glty of Sunny Isles Beach
1&I 70 GoIMs Avew°
Su- wv Isles 04wh. Fl- 3.3160
Telephone (30.5) 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:
Title:
Firm: � f � [ ' care rev, Inc
Address: � �s N-0 2.--144'~ 4, S�c !03
DaZ' & S31 Z Z
4of8
C'rj\: L3CT 4F INTEREST
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CW W� ��MS ST/STEWO
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of
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ad fw t�w ezy of srmr I,,a sear',, 3d N,. 2 2 - 03 - 01
�r o €rs • 1 + � �. 2 � r- E r.��rke r f z r,- nas rude Meerd
> X/ 7r /_ 7ssr*• ' . d r ' aY ---s - *A.i Ar daA based upm !Fi a own krowhedge
' i 'r z{ %PO tr* S rj - `r else abryow fad i% - z gibmaned Arid that the above r&w.
xr... � .�. , r• r � z•p � �s-r.• �" �� rxrrt� :J�s�rn = .. _.- __ p►o+�-
r• 9•y •.Y s•.�, %•I. �N
rev oe rra°rt1,d erlusy !.£. i'.. -'es:6V ed into any `greer em
�4"" ' -^> ; a•�!`I��j',� J',: 1.. 'Y 'T'�+g���'IiE taken "acte,, .y3�_� f�TE,.e,,Wy� �lrt1��WL pnlgG,l�'1yg,. p'1�CO•rM♦�1e�'QlOi1
/r ..: • ri r' `-•�� �siR' A R`J• �w �• P/'.�X I lilt .•. �'•�-t• .. •y_,••IrNi.S V*.dzsum kon o prkkg iYY unW the
fr r, .w 's it : ' :ehary a�Fd eaoe�3Xr Oct for tNS proom
",m "a-' r•.� �"'r`r C•rpY ei aff+frx'ye'i, ntX anyprle a"i!€oCJQ-!� rvlth f#'1ClTf, is presl!r1t3y Suspended or CI{flCllMlif
<� y r t•!° (ior'rJsd i,r€ ja 1:DnWo byl"moi, State, (w Fec*W Agency,
s 1W*r. 1, r `•r --f, w its af%%o, not w y'-ww rploom end wA,h tt*m have any potential canfl€if of
a Ir y *ww ;- 0• 1 '11 • s r �Jofit„ cf ntradt, of poop" w4wetts for th s protect.
7 f tarnov •° -e W,, rr OO s+'Inat /s vwrr_rship"nwkVM lerlt is pfesently applying for any employee
V/,'Aft sar 101 �d fXr`.+Wn WY!h tip.; City of 5 n ny lines SCA&
S. I OwVy 1, 9° r , r•°rl°AA+ of tk* KWAVrs oF�°rrsrsV or ffwLWAwwM, Or staff has a vestrd interest in any
y
If 04 €NW -4 :' s' .i 11,00t Q( AM*fre r} 1! witifi6d In tflt p owel +on of sefvices, I, on behalf of the above
s;&r;4 WAAr, ,w,a rr Wgf #W tit/ of Surma h Iel bcath,
fhK . dsrlf Go � 'f,R' , • IOL -11
br)m rn Type Wanir 4n4 Title
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Wxfp 0,0,64,4 WAe.CrdOuf Wom frig tf€ J l ias r i 0 ZZ
VrryM€�E�1 yiN/N11, (�j 1
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N(11"Y 04J$IX STATL OF FWRIDA
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CONFLICT OF INTEREST
City of Sunny isles Beach
F 18070 Collins Avrtue
Sunny Isles each. Fl, 33160
'ter • p • Telephone (345) 947-0606 Fax: (305) 949-3113
y�
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 FLORIDA r, 1
COUNTY OF My
EQ'1tA-_
BEFORE. ME, the undersigned authority, personally appeared
who was duly sworn, deposes, and states:
1. l am the fe . LAerr) of with a local
office in CAL and principal office
in i"� s -S 1(-L-
2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No. 2 Z - 03 - n 1
descnbed as C l_ k. '1-0141 12'AZ k_ 1i�AL- The Affiant has made diligent
inquiry and provldes the information contained in this Affidavit based upon his own knowledge.
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.
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
5. Neither the entity nor its afilhates, nor anyone associated with them, is presently suspended or otherwise
ineligible from participation in contract letting by any local, State, or Federal Agency.
6 Neither the entity, nor its affiliates, nor anyone associated with them have any potential conflict of
interest due to any other clients, contracts, or property interests for this project.
7, 1 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.
8. 1 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.
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.
5
Dated this day of 20L?,_
j7res,i,�c�'t-
AFFIANT Print or Type Name and Title
5�
Sworn to and subscribed before me this _ day of 1'-1 fi rzG 20 ?-77
❑ Personally Known, OR
%L—Produced Identification - Type ofJoentlfication C Lv/t-f d A rb ✓e oag; C'e'?
NOTARY PUBLIC STATE OF FILORIIDA
NORIIIERTO J PEAEZ-SoRROTO
l;, �rl 1"Vary Public - Stato Or F,V$gi
5 B "� d�' COMMinlOnIHHpCdlol
My Cmm- expires Jul 14, 2024
r F' •
DISPUTE DIS('[.()SLJRI;
City of Sunny Isles Beach
s'. I ROTC Lo4na A"n"
Sunny IslosSe A FL 33t6o
Tviopli (306j W -G606 Fax (365) 919-3tt:a
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.
1. Has your firm or any of its officeis, received a reprimand of any nature or been suspended by the
Department of Professional Regulations or any other regulatory agency or professional associations with -n the last
five (5) years)
YES NO
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
3. Has your firm had against it or filed any requests for equitable ad)ustment, contract claims, Bid protests,
or libgaton in the past five (5) years that is related to the services your firm provides In the regular course of
business')
YES NO "� If yes, state the nature of the request for equ table ad]ustment, 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.
Firm
0331(22
Date
Authorized Signature print or Type Name and Title
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STATE OF FLORIDA )
COUNTY OF )
ANTI -KICKBACK
City of Sunny Isles Beach
18070 Wkr% AVOW49
Su" Isles Beach, FL 33150
Toleplhone (305) 947-0808 Fax' (305) 94$-3113
ANTI -KICKBACK AFFIDAVIT
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: R SIZjLe Q.-", i, 1r .c
51
The foregoing instrument was acknowledged before me this 1 day of
t't'_",c I'\ . 20 ? L, by S - 6lief2. [name
of person], as - �Ro-„tet.-;L C wr,e— [type of authority], for
_5n I G C'n-I eezinc , _"n}— [name of party on behalf of whom instrument was
executed].
AFFIX NOTARY STAMP HERE:
,�` f6j4f "ORBER70 J PEREMORRpro
y. Nat Sri Pub'lc . State of FIOMA
?o;'r `' Eorrrr scion y Ilii 00810!
Co”" Ef.D"11JUI 14, 2024
Nkali Public — State of Florida
or Type Commissioned Name
Personally Known OR Produced Identification
Type of Identification Produced F4�1 c�t'� PM ,,t'f?-<
7of8
Florida Statute 448.095 directs all public employers, including municipal governments, to verity the
employment eligibility of all new public employees through the U.S. Department of Homeland Security's E-
Venfy System, and further provides that a public employer may not enter into a contract unless each party
to the contract registers with and uses the E -Verify system.
Florida Statute 448.095 further provides that if a contractor enters into a contract with a subcontractor, the
subcontractor must provide the contractor with an affidavit stating that the subcontractor does not employ,
contract with, or subcontract with an unauthorized alien.
In accordance with Florida Statute 448.095, all contractors doing business with the City o1 Sunny Isles
Beach are required to verify employee eligibility using the E -Verify system for all existing and new
employees hired by the contractor during the contract term. Further, the contractor must also require and
maintain the statutorily required affidavit of its subcontractors. It is the responsibility of the awarded vendor to
ensure compliance with E -Verify requirements (as applicable). To enroll in E -Verify, employers should visit
the E -Verify website (httpl:/lwww.e-verify,gov/emptoyers/enrolling-in•e-verify] and follow the
instructions. The contractor must, as usual, retain the 1-9 Forms for inspection.
By affixing your signature below you hereby affirm that you will comply with E -Verify requirements.
��AC tic
Company Name
Offeror Signature
Shcin e, � 5,11 its
Pnnt Name
82 _ %0L"
Federal Employer Identification Number (FEIN)
Date
nae
Notary_Public Information
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Print or S Expiration Datd
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CHASE CP Deposit Account Balance Summary
03/31/2022
Requestor information:
STYLE CATERING, INC
7705 NW 29TH ST UNIT 103
DORAL, FL 33122-1123
Summary of Deposit Account
Account Number Account Type Open Date Current Balance Avg Balance (12 mos)
Chase Piatnwrn BUSOM
281883089 1 Chea" 05/032018 S644,05493 5438.828 00
Customer Information
STYLE CATERING INC. Sole Owner
SHANEIL A SIBBLIES Signer
Deposit Account Balance Summary request completed by:
NORBERTO PEREZ-BORROTO
(305) 256-9013
Cutler Bay
PLEASE NOTE THATTHE INFORMATION PROVIDED IN THIS LETTER WILL BE
THE ONLY INFORMATION RELEASED BY JPMorgan Chase, N.A.
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edpremm
CHASE +r i
03/31/2022
Requester information,
STYLE CATERING, INC.
7705 NW 29TH ST UNIT 103
DORAL, FL 33122-1123
Account Number
631693121
Deposit Account Balance Summary
Summary of Deposit Account
Account Type Open Date Current Balance
Chase PL"w Business
ch`kov 07/23/2020 S349.00000
Customer Intofmation
STYLE CATERING, INC, Sole Owner
SHANEIL A SIBBLIES Y Signer
Deposit Account Balance Summary request completed by-
NORBERTO PEREZ•BORROTO
(305) 256-9013
Cutler Bay
Avg Balance (12 mos)
51169.698 00
PLEASE NOTE THAT THE INFORMATION PROVIDED IN THIS LETTER WILL BE
THE ONLY INFORMATION RELEASED BY JPMorgan Chase, N.A.
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