HomeMy WebLinkAboutGOODYEAR TIRE & RUBBER COMPANY BIDInvitation to Bid
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City of Sunny Isles Beach
Office of the City Clerk
FLEET MAINTENANCE & REPAIR SERVICES
INVITATION TO BID NO. 22-08-01
ADVERTISEMENTNDATE E "MONpAY;AUGUST
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AUGUST 23, 2022 AT 11:00 AM
IN-PERSON
SUNNY ISLES BEACH GOVERNMENT CENTER
NON -MANDATORY PRE-BID CONFERENCE:
18070 COLLINS AVENUE, 4T" FLOOR CONFERENCE
SUNNY ISLES BEACH, FLORIDA 33160
" ALL QUESTIONS DUES x
''AUGUST 26,2022 AT 5'00 PM
All questionswill be answeredwia an"''d,dIK
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Posted
SUBMISSION DUE DATE:
SEPTEMBER 1, 2022 AT 11:00 AM
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CITYiOF SUNNY ISLES BEACH GOl/ERNM NT CENTER` x ` ` `
.
'SUBMIT SEALED�BIDS TO
OFFICE OF THE`CITY`CLERK'"
Envelope' lust clearly pro"ide,your�firm's Warne,
18070`COLLINS AVENUE, 4T" FLOOR
phone #and c°o'ntact �ifarmation nod„tt ust be
ISLES BEACH; FLORIDA 33160
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ONLINE SUBMITTALS ARE NOT ACCEPTEDw
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City of Sunny Isles Beach I Invitation to Bid No. 22-08-01
TABLE OF CONTENTS
; = '+I TABLE OF CONTENTS
PAGE NO.
LEGAL ADVERTISEMENT/ NOTICE TO FIRM
3
GENERAL TERMS & CONDITIONS
4
SPECIAL TERMS & CONDITIONS
10
SCOPE OF WORK/ TECHNICAL SPECIFICATIONS
19
BID FORMAT
25
BIDDER'S QUESTIONNAIRE
28
BID PRICE SHEET
30
BID SUBMITTAL FORM
32
AFFIDAVITS
NON -COLLUSIVE AFFIDAVIT
PUBLIC ENTITY CRIMES
EQUAL OPPORTUNITY/ AFFIRMATIVE ACTION STATEMENT
CONFLICT OF INTEREST STATEMENT
DISPUTE DISCLOSURE FORM
ANTI -KICKBACK AFFIDAVIT
ANTI -BOYCOTT CERTIFICATION
E -VERIFY AFFIDAVIT
ATTACHMENT—THE ATTACHMENT MUST BE REVIEWED BY YOUR FIRM
ATTACHMENT A — FLEET LIST 2022
City of Sunny Isles Beach I Invitation to Bid No. 22-08-01
OF SvO rt+
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LEGAL ADVERTISEMENT
NOTICE TO BIDDER
NOTICE IS HEREBY GIVEN that the City of Sunny Isles Beach is seeking sealed Bids for the following work as
specified.
ITB # 22-08-01 FLEET MAINTENANCE & REPAIR SERVICES
The Bid Specifications for this Invitation to Bid are available from DemandStar by calling (800) 711-1712 or by
accessing their website at www.demandstar.com. The Bid Specifications may also be examined at the City of
Sunny Isles Beach — Office of the City Clerk. Vendors who obtain the Bid Specifications from sources other than
DemandStar or the City of Sunny Isles Beach are cautioned that their Bid response package may be incomplete.
Addenda will be posted and disseminated by DemandStar at least five days prior to the submittal date to all
vendors who are listed on the official list.
Bids shall be on a unit price basis; segregated Bids will not be accepted. Sealed Bids will be received by the City
Clerk no later than 11:00 AM. on Tuesday, September 1, 2022 at the Sunny Isles Beach Government Center
located at 18070 Collins Avenue, 41 floor, Sunny Isles Beach, Florida, 33160. Bids received after this time will not
be considered. The City is under no obligation to return Bids. Timely submitted Bids will be opened publicly and
read aloud at this time.
The envelope containing the sealed Bid must be clearly marked:
"FORMAL BID ENCLOSED"
Bid No. 22-08-01 Fleet Maintenance & Repair Services
OPENING DATE AND TIME: SEPTEMBER 1, 2022 AT 11:00 AM
The City reserves the right to reject any or all submittals, with or without cause, to waive technical errors and
informalities, and to accept the submittals, which best serves the interest of, and represents the best value to, the
City in conformity with the criteria set forth in Section 62-8 of the Code of Ordinances of the City of Sunny Isles
Beach.
All questions regarding this solicitation shall be directed in writing to Purchasing by no later than AUGUST 26,
2022 AT 5:00 PM. Questions must be submitted via email to Purchasing@sibfl.net or via regular mail at:
Purchasing, City of Sunny Isles Beach, 18070 Collins Avenue, Sunny Isles Beach, FL 33160.
Pursuant to Florida Statutes 119.071, sealed bids, proposals or replies by an agency pursuant to a competitive
solicitation are exempt from inspection until such time as the agency provides notice of an intended decision or
until thirty (30) days after the opening of the bids, proposals, or final replies, whichever is earlier.
Mauricio Betancur, CMC, City Clerk
City of Sunny Isles Beach
City of Sunny Isles Beach I Invitation to Bid No. 22-08-01
or SUIS �r
SECTION 1
INSTRUCTIONS TO BIDDER / GENERAL TERMS AND CONDITIONS
THESE INSTRUCTIONS ARE STANDARD FOR ALL BID COMMODITIES/SERVICES ISSUED BY THE CITY OF SUNNY ISLES BEACH. THE CITY OF SUNNY ISLES BEACH MAY DELETE, SUPERSEDE OR
MODIFY ANY OF THESE STANDARD INSTRUCTIONS FOR A PARTICULAR CONTRACT BY INDICATING SUCH CHANGE IN SPECIAL INSTRUCTIONS TO BIDDERS OR IN THE BID SHEETS. ANY AND ALL
SPECIAL CONDITIONSTHAT MAY VARY FROM THE GENERAL CONDITIONS SHALL HAVE PRECEDENCE. BIDDER AGREES THATTHE PROVISIONS INCLUDED WITHIN THIS BID OR RFP SHALL PREVAIL
OVER ANY CONFLICTING PROVISION WITHIN ANY STANDARD FORM CONTRACT OF THE CHNBIDDER REGARDLESS OF ANY LANGUAGE IN BIDDER'S CONTRACT TO THE CONTRARY.
1.1 CLARIFICATION/EXPLANATION/QUESTIONS:
Bids must be submitted no later than the time and date shown within this
Any questions concerning this Invitation to Bid or any required need for
document.
clarification must be made to Purchasing at Purchasing@sibfl.net. Such
requests for clarification/explanation or questions must be made in
1.7
SEALED BID:
writing to Maurlcio Betancur, CMC, Deputy City Clerk, at least five (5)
business days prior to the date of the Bid opening. Interpretations or
The entire Bid Response Package shall be placed In an opaque envelope
clarifications considered necessary by the City will be Issued by addenda
(with all items listed on the Bid checklist form and all other Items
and posted/disseminated by DemandStar (www.demandstar.com) to all
required within this Request for Bid must be executed) and submitted in
parties listed on the official plan holders' list as having received the
a sealed envelope.
Request for Bids documents. Only questions answered by written
addenda shall be binding. Oral Interpretations or clarifications shall be
1.8
BID EXECUTION. SIGNATURES. ERASURE/CORRECTION:
without legal effect. No plea of ignorance or delay or required need of
additional Information shall exempt a Respondent from submitting their
All Bids shall be signed In blue ink. All price quotes shall be typewritten
submission on the required date and time as publicly noted.
or printed with Ink. All corrections made by the proposers prior to the
opening must be Initialed and dated by the proposers. No changes or
1.2 PLAN HOLDER'S UST:
corrections will be allowed after Bids are opened. Bids must contain an
original, manual signature of an authorized representative of the
As a convenience to vendors, the City of Sunny Isles Beach has made
company.
available via Internet lists of all plan holders for each Request for
Proposal, Request for Bid, and request for qualifications. The Information
1.9
WITHDRAWAL OF BIDS:
Is available on-line at www.demandstar.com or by calling the Office of
the City Gerk at (30S) 792.1703.
Proposers may withdraw Bids only by written request and shall forward
the withdrawal request via, "Certified U.S. Mail — Return Receipt
1.3 ADDENDATO SPECIFICATIONS:
Requested" prior to the Bid opening time. Negligence on the part of the
Proposers In preparing the Bid confers no right for the withdrawal of the
If any addenda are issued after the Initial specifications are released, the
Bid after it has been opened.
City will post and disseminate the addenda through DemandStar. For
those projects with separate plans, blue prints, or other materials that
1.10
BID OPENING:
cannot be accessed through the Internet, the Office of the City perk will
make good faith effort to ensure that all registered proposers (those who
Bids will be opened publicly at the time and place stated in the Notice to
have been registered as receiving a Bid package) receive the documents.
Bidder. It Is the responsibility of the proposers to Insure that the Bid
It Is the responsibility of the vendor prior to the submission of any Bid to
reaches the Office of the City Clerk on or before the closing hour and date
check the above website or contact the Office of the City Clerk at (305)
stated on the Request for Bid. After the Bid opening, the contents of the
792-1703 to verify any addenda Issued. The receipt of all addenda must
Bid Form will be made public for the Information of vendors and other
be acknowledged on the Bid Response Sheet.
Interested parties who may be present either In person or by
representative. Bids that are received after the Bid opening time will not
1.4 SPECIAL ACCOMMODATIONS:
be considered and will not be returned.
Any person requiring a special accommodation at a Pre -Bid Conference
1.11
EVALUATION OF BIDS:
or Bid/RFP/RFQ opening because of a disability should call the Office of
the City Gerk at (305) 792-1703 at lease five (5) days prior to the Pre -Bid
The City, at Its sole discretion, reserves the right to inspect any/all
Conference or Bid/RFP/RFQ opening. If you are hearing or speech
Proposers facilities to determine their capability of meeting the
Impaired, please contact the Office of the Clty Clerk by calling the Cityof
requirements for the Contract. Also, price, responsibility, and
Sunny Isles Beach using the Florida Relay Service which can be reached at
responsiveness of the Proposers, the financial position, experience,
1(800) 955-8771 (TDD).
staffing, equipment, materials, references, and past history of service to
the City and/or with other unitsof state, and/or local governments in
1.5 PUBLIC ENTITY CRIMES STATEMENT:
Florida, or comparable private entities, will be taken Into consideration in
the Award of the Contract.
Pursuant to the provisions of paragraph (2) (a) of section 287.133, Florida
statutes "a person or affiliate who has been placed on the convicted
1.11.1 Hold Harmless: All Proposers shall hold the City, It's
vendor list following a conviction for a public entity crime may not submit
officials and employees harmless and covenant not to sue
a Bid on a contract to provide any goods or services to a public entity,
the City, It's officials and employees in reference to their
may not submit a Bid on a contract with a public entity for the
decisions to reject, award, or not award a Bid, as
construction or repair of a public building or public work, may not submit
applicable.
Bids on leases of real property to a public entity, may not be awarded to
1.11.2 Cancellation: . Failure on the part of the Proposers to
perform work as a Contractor, supplier, sub -Contractor, or consultant
comply with the conditions, specifications, requirements,
under a contract with any public entity, and may not transact business
and terms as determined by the City, shall be just cause
with any public entity In excess of the threshold amount provided In
for cancellation ofthe Award.
section 287.107, for category two fora period of 36 months from the
1.11.3 Disputes: If any dispute concerning a question of fact
date of being placed on the convicted vendor list".
arises under the Contract, other than termination for
default or convenience, the Contractor and the City
1.6 BID DEADUNE: department responsible for the administration of the
City of Sunny Isles Beach I Invitation to Bid No. 22-08-01
Contract shall make a good faith effort to resolve the
dispute. If the dispute cannot be resolved by agreement,
then the department with the.advice of the City Attorney
shall resolve the dispute and send a written copy of Its
decision to the Contractor, which shall be binding on both
parties.
1.12 AGREEMENT:
After the Bid award, the City will, at its option, prepare an Agreement
specifying the terms and conditions resulting from the award of this Bid.
The vendor will have ten (10) calendar days after notification of the
award by the City to execute the Agreement and provide the required
Performance Bond.
The Proposers who has the Contract awarded to them and who fails to
execute the Agreement and furnish the Performance Bond and Insurance
Certificates within the specified time shall forfeit the Bid Security that
accompanied their Bid, and the Bid Security shall be retained as
liquidated damages by the City, and It Is agreed that this sum Is a fair
estimate of the amount of damages the City will sustain In case the
Proposers falls to enter Into the Contractand furnish the Bonds as herein
before provided. Bid Security deposited in the form of a cashiers check
drawn on a local bank In good standing shall be subject to the same
requirements as a Bid Bond.
The performance of the City of Sunny Isles Beach of any of Its obligations
under the agreement shall be subject to and contingent upon the
availability of funds lawfully expendable for the purposes of the
agreement for the current and any future periods provided for within the
Bid specifications.
1.13 PAYMENTS:
Payment will be made after commoditles/services have been received,
accepted, and properly Invoiced as Indicated In the contract and/or
purchase order. Invoices must bear the purchase order number.
1.14 BRAND NAMES:
If a brand name, make, of any "or equal' manufacturer trade name, or
vendor catalog Is mentioned whether or not followed by the words
"approved equal" it is for the purpose of establishing a grade or quality of
material only. Vendor may offer equals with appropriate Identification,
samples, and/or specifications on such item(s). The City shall be the sole
judge concerning the merits of items Bid as equals.
1.15 MATERIAL:
Material(s) delivered to the City under this Bid shall remain the property
of the seller until accepted to the satisfaction of the City. In the event
materials supplied to City are found to be defective or do not conform to
specifications, the City reserves the right to return the product(s) to the
seller at the sellers expense.
1.16 SAMPLES:
Samples of Items, when required, must be furnished by the Proposers
free of charge to the City. Each Individual sample must be labeled with
the Proposers name and manufacturers brand name and delivered by
them within ten (30) calendar days of Proposers receipt of the "Notice to
Proceed", unless schedule Indicates a different time. If samples are
requested subsequent to the Bid opening, they should be delivered
within ten (10) calendar days of the request. The City will not be
responsible for returning samples.
1.17 QUANTITY GUARANTY:
No guaranty or warranty is given or Implied by the City as to the total
amount that may or may not be purchased from any resulting Contract or
Award. These quantities are for Bid purposes only and will be used for
tabulation and presentation of the Bid. The City reserves the right to
Increase or decrease quantities as required, even significantly. The prices
offered herein and the percentage rate of discount applies to other
representative items not listed In this Bid.
1.18 GOVERNMENTAL RESTRICTIONS ON MATERIALS:
1.19
1.20
1.21
1.22
1.23
1.24
of S130
In the event any governmental restrictions may be imposed which would
necessitate alteration of the material quality, workmanship, or
performance of the Items offered on this Bid prior to their delivery, it
shall be the responsibility of the successful Proposers to notify the City at
once, Indicating in their letter the specific regulation which required an
alteration. The City of Sunny Isles Beach reserves the right to accept any
such alteration, Including any price adjustments occasioned thereby, or
to cancel at no further expense to the City.
SAFETY STANDARDS:
The. Proposers warmntsdhat the product(s) supplied to the City conforms
In all respects to the standards set forth In the occupational safety and
health act (OSHA) and its amendments. Bids must be accompanied by a
materials data safety sheet (MSDS) when applicable.
WARRANTIES:
Successful Proposers shall act as agent for the City In the follow-up and
compliance of all Items under Warranty/Guaranty and complete all forms
for Warranty/Guarantee coverage under this Contract.
COPYRIGHTS/PATENT RIGHTS:
Proposers warrants that there has been no violation of copyrights or
patent rights In manufacturing, producing or selling of goods shipped or
ordered, as a result of this Bid. The seller agrees to indemnify City from
any and all liability, loss, or expense occasioned by any such violation.
LOCAL BUSINESS TAX (OCCUPATIONAL LICENSE REGISTRATION):
The contractor shall be responsible for obtaining and maintaining
throughout the contract period his or her city and county local business
tax receipts. Each vendor submitting a Bid on this Request for Bid shall
Include a copy of the company's local business tax/occupational license(s)
with the Bid response. For information specific to City of Sunny Isles
Beach local business tax/occupational licenses, please call Code
Enforcement & Licensing at (305) 792-1705. If the contractor is operating
under a fictitious name as defined in Section 865.059, Florida Statutes,
proof of current registration with the Florida Secretary of State shall be
submitted with the Bid. A business formed by an attorney actively
licensed to practice law In this state, by a person actively licensed by the
Department of Business and Professional Regulations or the Department
of Health for the purpose of practicing his or her licensed profession, or
by any corporation, partnership, or other commercial entity that Is
actively organized or registered with the Department of State shall
submit a copy of the current licensing from the appropriate agency
and/or proof of current active status with the Division of Corporations of
the State of Florida.
Proposers shall assume the full duty, obligation, and expense of obtaining
all necessary licenses, permits, inspections, and insurance required. The
Proposers shall be liable for any damages or loss to the City occasioned
by negligence of the Proposers (or their agent) or any person the
Proposers has designated in the completion of their contract as a result
of the Bid. Contractor shall be required to furnish a copy of all licenses,
certificates of competency or other licensor requirements necessary to
practice their profession as required by Florida State Statute, Miami -Dade
County, and City of Sunny Isles Beach Code. Contractors shall include
current Miami -Dade County Certificates of Competency. These
documents shall be furnished to the City along with the Bid response.
Failure to furnish these documents or to have required licensor will be
grounds for rejecting the Bid.
CERTIFICATE(S) OF INSURANCE:
Proposers shall furnish to the Office of the City Clerk, City of Sunny Isles
Beach, 18070 Collins Avenue, Sunny Isles Beach, Florida 33160,
certificate(s) of Insurance which Indicate that Insurance coverage has
been obtained from an Insurance company authorized to do business in
the State of Florida or otherwise secured In a manner satisfactory to the
City, for those coverage types and amounts listed In this document, in an
amount equal to 10076 of the requirements and shall be presented to the
City prior to Issuance of any Contract(s) or Award(s) Document(s). The
City of Sunny Isles Beach I Invitation to Bid No. 22-08-01
City of Sunny Isles Beach I Invitation to Bid No. 22-08-01
City. of Sunny Isles Beach shall be named as "additional insured" with
Whereverused in these
General Conditions or In the other Contract
respect to this coverage. The required certificates of Insurance shall not
Documents, the following terms shall have the meaning indicated which
only name the types of policies provided, but shall also refer specifically
shall be applicable to both the singular and plural thereof.
to this Bid and section. At the time of Bid submission the Proposers must
submit certificates of Insurance as outlined In the General Conditions
Acceptance:
Acceptance by the City ofthe Work as being
section. All required insurances shall name the City of Sunny Isles Beach
fully complete in accordance with the
as additional Insured and such Insurance shall be issued by companies
Contract Documents subject to waiver of
authorized to issue insurance In the State of Florida. It shall be the
claims.
responsibility of the Proposers and Insurer to notify the City Manager of
the City of Sunny Isles Beach of cancellation, lapse, or material
Agreement:
The written Agreement between the City
modification of any insurance policies Insuring the Proposers, which
and the Contractor covering the Work to be
relate to the activities of such vendor and the City of Sunny Isles Beach.
performed, which Includes the Contract
Such notification shall be in writing, and shall be submitted to the City
Documents.
finance support service director thirty (30) days prior to cancellation of
such policies. This requirement shall be reflected on the certificate of
Addenda:
Written or graphic Instruments issued prior
insurance. Failure to fully and satisfactorily comply with the city's
to the Bid Opening which modify or
insurance and bonding requirements set forth herein will authorize the
Interpret the Contract Documents,
City Manager to Implement a rescission of the Bid award without further
Drawings and Specifications, by addition,
City Commission action. The Proposers hereby holds the City harmless
deletions, clarifications or corrections.
and agrees to indemnify City and covenants not to sue the City by virtue
of such rescission.
Approved:
Means approved by the City.
1.25
ASSIGNMENT:
Bid:
The offer ofthe Proposers submitted on the
prescribed form setting forth the prices for
The Contractor shall not transfer or assign the performance required by
the Work to be performed.
this Bid without prior written consent of the City Manager. Any award
Issued pursuant to the Request for Proposal and monies which may be
Proposers:
Any person, firm or corporation submitting
due hereunder are not assignable except with prior written approval of
a Bid for Work. The terms "Bidder' and
the City Manager. Further, In the event that the majority ownership or
"vendor" shall have the same meaning.
control of the Contractor changes hands subsequent to the award of this
contract, Contractor shall promptly notify City in writing (via United
Bonds:
Bid, performance bond and other
States Postal Service —Certified Mall, Return Receipt Requested) of such
Instruments of security, furnished by the
change in ownership or control at least thirty (30) days prior to such
Contractor and their surety in accordance
change and City shall have the right to terminate the contract upon sixty
with the Contract Documents and In
(60) days written notice, at City's sole discretion.
accordance with the law of the State of
Florida.
1.26
HOLD HARMLESS/INDEMNIFICATION:
Change Order:
A written order to the Contractor signed by
The Contractor shall indemnify, hold harmless, and defend the City of
the City authorizing an addition, deletion or
Sunny Isles Beach, it's officers, agents and employees from and against
revision In the Work, or an adjustment In
any claims, demands or causes of action of whatsoever kind or nature
the Contract Price or the Contract Time
arising out of error, omission, negligent act, conduct, or misconduct of
issued after execution ofthe Agreement.
the Contractor, their agents, servants or employees in the provision of
goods or the performance of services pursuant to this Bid and / or from
City:
City of Sunny Isles Beach, 18070 Collins
any procurement decision of the City including without limitation,
Avenue, Sunny Isles Beach, Florida 33160.
awarding the Contract to the Contractor.
Contract Documents:
Contract Documents shall Include,
1.27
NON-CONFORMANCE TO CONTRACT:
Instructions to Proposers, Contractor's Bid,
the Bonds, the Notice of Award, the
The City of Sunny Isles Beach may withhold acceptance of, or reject items
Agreement between the City and
which are found upon examination, not to meet the specification
Contractor as well as any addenda thereto,
requirements. Upon written notification of rejection, items shall be
these General Conditions, Special
removed within (5) calendar days by the vendor at their own expense
Conditions, the Technical Specifications,
and redelivered at their expense. Rejected goods left longer than thirty
Drawings and Modifications, Notice to
(30) calendar days will be regarded as abandoned and the City shall have
Proceed, Request for Proposal, Insurance
the right to dispose of them as Its own property. Rejection for non-
Certificates, Change Orders and
conformance or failure to meet delivery schedules may result in the
Acknowledgment of Conformance with the
Contractor being found In default.
City of Sunny Isles Beach.
1.28
DEFAULT PROVISION:
Contract Price:
The total monies payable to the Contractor
under the Contract Documents.
In case of default by the Proposers, the City of Sunny Isles Beach may
procure the articles. or services from other sources and hold the
Contract Time:
The number of calendar days stated in the
Proposers responsible for any excess costs occasioned or incurred
Agreement for the completion of the Work.
thereby.
Contracting Officer:
The individual who is authorized to sign the
1.29
SECONDARY/OTHER VENDORS:
contract documents on behalf of the City's
governing body.
The City reserves the right In the event the primary vendor cannot
provide an item(s) or service(s) in a timely manner as requested, to seek
Contractor:
The person, firm or corporation with whom
other sources without violating the Intent ofthe Contract.
the City has executed this Agreement.
130
DEFINITIONS:
Day:
A calendar day of twenty-four hours
measured from midnight to the next
midnight.
City of Sunny Isles Beach I Invitation to Bid No. 22-08-01
1.31
Field Order: A written order issued by the City which
clarifies or Interprets the Contract
Documents or orders minor changes In the
Work.
Modification: Modification means any one of the
following: (a) a written amendment of the
Contract Documents signed by both parties,
(b) a Change Order, (c) a written
clarification or interpretation If issued by
the City, or (d) a written order for minor
change or alteration in the Work Issued by
the City. A modification may only be Issued
after execution of the Agreement.
Notice of Award: The written notice by City to the apparent
successful Proposers stating that upon
compliance with the conditions precedent
to be fulfilled by him within the time
specified, City will execute and deliver the
Agreement to him.
Samples: Physical examples which Illustrate
materials, equipment or workmanship and
establish standards by which the Work will
bejudged.
Specifications: Those portions of the Contract Documents
consisting of written technical descriptions
of materials, equipment, construction
systems, standards and workmanship as
applied to the Work.
Statement of Services: The form furnished by the City which is to
be used by the Contractor in requesting
progress payments.
Supplier: Any person or organization who supplies
materials or equipment for the Work,
Including that fabricated to a special design,
but who does not perform labor at the site.
Work: Any and all obligations, duties and
responsibilities necessary to the successful
completion of the Project assigned to or
undertaken by 'Contractor under the
Contract Documents, Including all labor,
materials, equipment and other incidentals,
and the furnishing thereof.
Written Notice: The term "Notice" as used herein shall
mean and Include all written notices,
demands, Instructions, claims, approvals
and disapproval's required to obtain
compliance with Contract requirements.
Written notice shall be deemed to have
been duly served if delivered in person to
the individual or to member of the firm or
to an officer of the corporation for whom it
Is Intended, or to an authorized
representative or such Individual, firm, or
corporation, or if delivered at or sent by
registered mail to the last business address
known to them who gives the notice.
Unless otherwise stated In writing, any
notice to or demand upon the City under
this Contractshall be delivered to the City.
BID AWARD:
The City reserves the right to reject any and all Bids at its sole discretion.
Bids shall be awarded by the City after the City performs all necessary
searches, inquiries, exploration, and analysis of the Bids. The Bid shall be
awarded to the lowest responsible and responsive proposer whose Bid
best serves the interests of and represents the best value to the City In
conformity with the criteria set forth in Section 62-8 of the City Code. No
��ly OF' SUN �r-
Notice of Award will be given until the City has concluded any
investigations) as they deem necessary to establish the Proposers
capability to perform the Services as described in this RFP, ITB, RFQ or
ITC, as substantiated by the required professional experience, client
references, technical knowledge and qualifications; and sufficient labor
and equipment to comply with. the City's established standards, as well as
the financial capability of the Proposer to perform the Work in
accordance with the Contract Documents to the satisfaction of the City
within the time prescribed. The City reserves the right to reject the Bid of
any Proposers on the basis of these queries and investigations and who
does not meet the City's satisfaction,.even though the firm may be the
lowest dollars and cents Bid. In analyzing Bids, the. City will also take into
consideration client references, past work experience and work product,
proven ability to satisfactorily perform. if the Contract is awarded, the
City will Issue the Notice of Award and give the successful Proposers a
Contract for.execution within ninety (90) days after opening of Bids. The
City specifically reserves the right to award the contract to a proposer
who is not necessarily the lowest dollars and cents proposers on the basis
of the results of these queries and investigation(s).
1.32 EXECUTION OF AGREEMENT:
1.33
1.34
1.35
At least four counterparts of the Agreement, the Performance Bond, the
Certificates of Insurance and such other Documents as required by the
Contract Documents shall.be executed and delivered by Contractor to the
City within ten (10) calendar days of receipt of.the Notice of Award.
LAWS AND REGULATIONS:
The Contractor will give all notices and comply with all laws, ordinances,
rules and regulations applicable to the Work. If the Contractor observes
that the Specifications are at variance therewith, they will give the City
prompt written notice thereof, and any necessary changes shall be
adjusted by an appropriate modification. If the Contractor performs any
Work knowing it to be contrary to such laws,ordinances, rules and
regulations, and without such notice to the City, they will bear all costs
arising wherefrom.
TAXES:
The City of Sunny Isles Beach Is exempt from sales tax Imposed by the
State and/or Federal Government. Florida Sales Tax Exemption No. 23-
00, 477131-54C appears on each purchase order. Exemption certificates
areavailable upon request.
DUTY TO DEFEND, INDEMNIFY AND SAVE HARMLESS:
In consideration of the separate sum of twenty-five dollars ($25.00) and
other valuable consideration, the Contractor shall defend, indemnify and
hold harmless the City, Its officers, agents and employees, from or on
account of any injuries ordamages, received or sustained by any person
or persons during or on account of any operations connected with the
Work described in the Contract Documents, or by or In consequence of
any negligence In connection with the same; or by use of any improper
materials or by or on account of any act or omission of the said
Contractor or his Sub -Contractor, agents, servants or employees. The
Contractor will defend, indemnify and hold harmless the City and their
agents or employees from and against all claims,damages, losses and
expenses including attorneys' fees arising out of or resulting from the
performance of the Work, provided that any such claim damage, loss or
expense (a) Is attributable to bodily injury, sickness, disease or death, or
to Injury to or destruction of tangible property (other than Work itself)
Including the loss of use resulting wherefrom and (b) is caused in whole
or in part by any negligent act or omission of the Contractor, Sub -
Contractor, anyone directly or indirectly employed by any of them or
anyone for whose acts any of them may be liable, regardless of whether
or not It Is caused by a party indemnified hereunder. in the event that a
court of competent jurisdiction determines that Sec. 725.06 (2), F.S. is
applicable to this Work, then in lieu of the above provisions of this
section the parties agree that Contractor shall Indemnify, defend and
hold harmless the City, their officers and employees, to the fullest extent
authorized by Sec. 725.06 (2) F.S., which statutory provisions shall be
deemed to be incorporated herein by reference as if fully set forth
herein. In the event that any action or proceeding is brought against City
by reason of any such claim or demand, Contractor, upon written notice
from City shall defend such action or proceeding by counsel satisfactory
City of Sunny Isles Beach I Invitation to Bid No. 22-08-01
to City. The indemnification provided above shall obligate Contractor to
defend at its own expense or to provide for such defense, at City's 1.38.3 The duties and obligations imposed by these General
option, any and all claims of liability and all suits and actions of every Conditions, Special Conditions and Supplemental
name and description that may be brought against City, excluding only Conditions and the rights and remedies available
those which allege that the Injuries arose out of the sole negligence of hereunder, and, in particular but. without limitation, the
City, which may result from the operations and activities under this warranties, guarantees and obligations imposed upon
Contract whether the Work be performed by Contractor, its Sub- Contractor and those in. the Special Conditions and the
Contractors, or by anyone directly or indirectly employed by either. rights and remedies available to the City, shall be in
addition to, and shall not be construed In any way as a
1.36 DECISIONS ON DISAGREEMENTS: limitation of, any rights and remedies available by law, by,
special guarantee or by other provisions of the Contract
The City will be the initial Interpreter of the Technical Specifications. Documents.
1.37 .CITY MAY TERMINATE:
1.38.4 Should the City or the Contractor suffer Injury or damage
to its person or property because of any error, omission,
If the Contractor is adjudged bankrupt or insolvent, or if they make a
or act of the other or of any of their employees or agents
general assignment for the benefit of their creditors, or if a trustee or
or others for whose acts they are legally liable, claim shall
receiver Is appointed for the Contractor or for any of their property, or if
be made In writing to the other party within a reasonable
they file a petition to take advantage of any debtors act, or to reorganize
time of the first observance of such In jury or damage.
under bankruptcy or similar laws, or If they repeatedly fails to supply
sufficient skilled workmen or suitable materials or equipment, or if they
1.39
WAIVER OF JURY TRIAL:
repeatedly fail to make prompt payments to Sub -Contractors or for labor,
materials or equipment or they disregard laws, ordinances, rules,
City and Contractor knowingly, Irrevocably voluntarily and intentionally
regulations or orders of any publicbody having jurisdiction, or if they
waive any right either may have to a trial byjury in State or Federal Court
disregard the authority of the City, of if they otherwise violate any
proceedings in respect to any action, proceeding, lawsuit or counterclaim
provision of, the Contract Documents, then the City may, without
based upon the Contract Documents or the performance of the Work
prejudice to any other right or remedy and after giving the Contractor
there under.
and the surety ten (10) days written notice, terminate the services of the
Contractor and take possession of the Project and of all materials,
1.40
GOVERNING LAW:
equipment, tools, construction equipment and machinery thereon owned
by the Contractor, and finish the Work by whatever method they may
The Contract shall be construed in accordance with and governed by the
deem expedient. In such case the Contractor shall not be entitled to
law of the State of Florida.
receive any further payment until the Work is finished. If the unpaid
balance of the Contract Price exceeds the direct and Indirect costs of
1.41
VENUE:
completing the Project, including compensation for additional
professional services, such excess shall be paid to the Contractor. If such
Venue of any action to enforce the Contract Documents shall be in
costs exceed such unpaid balance, the Contractor will pay the difference
Miami -Dade County, Florida.
to the City. Such costs Incurred by the City will be determined by the City
and incorporated in a Change Order. if after termination of the
1.42
ARBITRATION:
Contractor under this Section, it is determined by a court of competent
Jurisdiction for any reason that the Contractor was not In default, the
It Is the Intention of the parties that whenever possible, If a dispute or
rights and obligations of the City and the Contractor shall be the same as
controversy arises hereunder then such dispute or controversy shall be
ifthe termination had beenissued pursuant to this document.
settled by arbitration In accordance with the procedures, rules and
regulations of the American Arbitration • Association. The decision
1.37.1 Where the Contractors services have been so terminated
rendered by the Arbitrator shall be final and binding upon the parties and
by the City said termination shall not affect any rights of
judgment upon the award rendered by the arbitrator may be entered in
the City against the Contractor then existing or which may
any court having jurisdiction. Arbitration shall be held In Miami -Dade
thereafter accrue. Any retention or payment of moneys
County, Florida. All costs of arbitration and attorneys' fees incurred by
by the City due the Contractor will not release the
the parties shall be paid by the non -prevailing party or, if neither party
Contractor from liability.
prevails on the whole, each party shall be responsible for a portion of the
costs of arbitration and their respective attorneys' fees as may be
1.37.2 Upon ten (10) days written notice to the Contractor, the
determined by the court on confirmation.
City may, without cause and without prejudice to any
other right or remedy, elect to terminate the Agreement.
1.43
PROJECT RECORDS:
In such case, the Contractor shall, be paid for all Work
executed and accepted by the City as of the date of the
City shall have right to Inspect and copy during regular business hours at
termination. No payment shall be made for profit for
Citys expense, the books and records and accounts of Contractor which
Work which has not been performed.
relate In any way to the Project, and to any claim for additional
compensation made by Contractor, and to conduct an audit of the
1.38 MISCELLANEOUS:
financial and accounting records of Contractor which relate to the
Project. Contractor shall retain and make available to City all such books
Proposers acknowledge the following miscellaneous conditions:
and records and accounts, financial or otherwise, which relate to the
Project and to any claim for a period of three years following final
1.38.1 Whenever any provision of the Contract Documents
completion of the Project. During the Project and the three year period
requires the giving of written notice It shall be deemed to
following final completion of the Project, Contractor shall provide City
have been validly given If delivered in person to the
access to its books and records upon five days written notice.
Individual or to a member of the firm or to an officer of
the corporation for whom It Is Intended, or If delivered at
1.44
SEVERABILITY:
or sent by registered or certified mail, postage prepaid, to
the last business address known to them who gives the
If any provision of the Contract or the application thereof to any person
notice.
or situation shall to any extent, be held invalid or unenforceable, the
remainder of the Contract, and the application of such provisions to
1.38.2 The Contract Documents shall remain the property of the
persons or situations other than those as to which it shall have been held
City. The Contractor shall have the right to keep one
invalid or unenforceable shall not be affected thereby, and shall continue
record set of the Contract Documents upon completion of
in full force and effect, and be enforced to the fullest extent permitted by
the Project.
law.
City of Sunny Isles Beach I Invitation to Bid No. 22-08-01
IAS INDEPENDENT CONTRACTOR:
The Contractor Is an Independent Contractor under the Contract.
Services provided by the Contractor shall be by employees of the
Contractor and subject to supervision by the Contractor, and not as
End of Section
"rY of sup
t.4D�
officers, employees, or agents of the City. Personnel policies, tax
responsibilities, social security and health insurance, employee benefits,
purchasing policies and other similar administrative procedures,
applicable to services rendered under the Contract shall be those of the
Contractor.
City of Sunny Isles Beach I Invitation to Bid No. 22-08-01 •
Section 2
Special Terms and Conditions
2.1 PURPOSE OF BID
The City's fleet consists of over 200 cars and light trucks, including hybrid vehicles, see
Attachment A. The goal of the City of Sunny Isles Beach Fleet division is to ensure their safe
operation by having an effective preventative maintenance program, including for general
repairs. Vehicle & equipment repairs, modification, preventive maintenance inspections and/or
other work under this contract shall be performed at the contractor's site. The Bidder is
required to have the capabilities to perform routine, scheduled, unscheduled, and any major
component overhaul, rebuilding, repairing and replacement capabilities. The City may add
vehicles or delete vehicles from the list during the term of the agreement. Any vehicles added
shall be serviced at the same bid prices. The City will not pre -pay for service, repair, or parts.
The City has established minimum specifications, which include special and specific vehicle
maintenance requirements to assure the safe operation of the City's fleet vehicles. The
contractor shall provide industry certified mechanics, shop(s), service trucks, mechanic's tools,
lifts, and any waste disposal for vehicle fluids and/or materials, as well as any vehicle fluid spill
clean-up as needed for all work performed at the shop. The contractor shall furnish all necessary
supervision, labor, tools and parts and supplies necessary to provide the service for the City's
fleet in accordance with Manufacturer's recommendations in order to maintain factory
warranties and any extended warranties.
These services will continue on each City vehicle covered by the contract until it is disposed of
by the City. The City may add vehicles or remove vehicles from its list during the term of the
agreement at the discretion of the City. Any vehicles added to the contract shall be offered the
same bid prices as in the original bid.
2.2 NON -MANDATORY PRE-BID CONFERENCE
A non -mandatory pre-bid meeting will be held on Tuesday, August 23, 2022 at 11:00 AM at
Sunny Isles Beach Government Center located at 18070 Collins Avenue Sunny Isles Beach, FL
33160, Fourth Floor Conference Room, to discuss the special conditions and specifications
included within this solicitation. Proposers are requested to bring this solicitation document to
the conference, as additional copies may not be available
2.3 CONE OF SILENCE
All procurement solicitations once released to the public and until an award recommendation
has been forwarded to the City Commission, by the City manager are under the "Cone of
City of Sunny Isles Beach I Invitation to Bid No. 22-08-01
of 5YSta
Silence." Interested firms must direct any calls, emails, questions, inquiries, etc., to the
Purchasing Division at purchasing@sibfl.net. Violation of the Cone of Silence by a particular
proposer shall render the award to said Proposer voidable by the City Commission.
2.4 ADDENDUMS, AMENDMENTS, CLARIFICATIONS
The City of Sunny Isles beach reserves the right to make changes to the terms and conditions of
this RFP and/or the related Agreement at any time by issuance of written addendum/addenda,
amendment(s), or clarification (s).
2.5 MANDATORY SITE VISIT TO BIDDER'S SITE AFTER SUBMITTAL OF BIDS
The City of Sunny Isles Beach will be conducting a mandatory site visit of each Bidder deemed
responsive. Bidder must be ready for the mandatory site -visit within 24 hours notice from the
City.
2.6 MINIMUM QUALIFICATION REQUIREMENTS (MARS)
1. In order to be considered responsive, Bidder shall, at a minimum, demonstrate compliance
with the requirements listed in this ITB.
2. To be evaluated, all requested documentation and/or information shall be provided in the
bid to confirm that the Bidder has satisfied the criteria outlined below. Proposers failing to
meet these requirements may be deemed non-responsive.
3. The Bidder shall, at the time of the bid submittal, time of award, and throughout the
duration of the Contract, continue to meet the criteria requirements as stated in this
document.
a) The Bidder must -employ, at minimum, one mechanic who is ASE Certified Master
Mechanic in medium / light duty truck repair and automobiles.
Bidder must provide a copy of the applicable license(s) with Bidder's response.
Mechanic(s) shall have the following ASE certifications:
• Al Engine Repair
• A2 Automatic Transmission/Transaxle
• A3 Manual Drive Train & Axles
• A4 Suspension & Steering
• A5 Brakes
City of Sunny Isles Beach I Invitation to Bid No. 22-08-01
• A6 Electrical/Electronic Systems
• A7 Heating and Air Conditioning
• A8 Engine Performance
b) Bidder must have a fully equipped and well-established shop as required in this
solicitation, which may be verified by on-site inspection, preferably within ten (10)
mile radius of the City of Sunny Isles Beach.
c) The Bidder must have been in the business of vehicle maintenance and repairs for a
minimum of five (5) years.
d) Bidder must provide security in the form of a fenced lot, or inside of a secure
building, for no less than four (4) standard sized vehicles simultaneously.
e) Bidder shall provide references for no less than (2) two public or
private/commercial sector references in which Bidder serves as their primary
repair/maintenance shop.
f) Bidder shall submit drug test policy for employees. Bidder shall perform drug test
screening on all employees and provide pass/fail results to the City Manager or
designee, upon request.
2.7 TERM
The initial contract term shall be for two (2) years. This contract will commence upon execution
by both parties which shall be the effective date succeeding approval of the contract by the City
Commission, or designee, unless otherwise stipulated in the Notice of Award letter. The contract
shall be contingent upon the completion and submittal of all required documents. The contract
shall remain in effect until the completion of services, provided that the services rendered by
Contractor during the contract period are satisfactory and that City funding is available as
appropriated on an annual basis. However, in the event funding is not appropriated on an
annual basis during any particular year within the contract period, the contract may be canceled
upon thirty (30) days written notice to Contractor. In such an event, the City shall only be
responsible for the reasonable value of services performed prior to the effective date of
termination.
2.8 OPTIONS TO RENEW
Prior to, or upon completion, of that initial term, the City shall have the option to renew the
contract for an additional three (3) one-year renewals.
City of Sunny Isles Beach I Invitation to Bid No. 22-08-01
OF SUN r -"-
Prior to completion of each exercised contract term, the City may consider an adjustment to the
price based on changes in the following pricing index: Consumer Price Index for Urban Wage
Earners and Clerical Workers (CPI -W): Miami — Fort Lauderdale, FL, and shall not exceed five
percent (5%). It is the Contractor's responsibility to request any pricing adjustment under this
provision. For any adjustment to commence on the first day of any exercised option period, the
vendor's request for adjustment should be submitted 60 days prior to expiration of the then
current contract term. The vendor adjustment request should not be in excess of the relevant
pricing index change. If adjustment request is not received from the vendor,,. the City will
assume the vendor has agreed that the optional term may be exercised without pricing
adjustment. Any adjustment request received after the commencement of a new option period
may not be considered.
The City reserves the right to negotiate lower pricing for the additional term(s) based on market
research information or other factors that influence price. The City reserves the right to apply
any reduction in pricing for the additional term(s) based on the downward movement of the
applicable index.
The City reserves the right to reject any price adjustments submitted by the vendor and/or to
not exercise any otherwise available option period based on such price adjustments.
Continuation of the contract beyond the initial period, and any option subsequently exercised, is
a City prerogative, and not a right of the vendor. This prerogative will be exercised only when
such continuation is clearly in the best interest of the City.
Should the vendor decline the City's right to exercise the option period, the City may consider
the vendor in default which may affect the vendor's eligibility for future contracts.
2.9 METHOD OF AWARD
Award of this contract will be made to the lowest responsive, responsible vendor. If a vendor
fails to submit an offer for;all items within the group, its offer for that specific group will be
rejected. The City reserves the right to award to multiple bidders. Award to multiple vendors
may be considered for the convenience of the City and does not exempt the primary vendor
from fulfilling its contractual obligations. Failure to perform as noted may result in the vendor
being deemed in breach of contract. The City may terminate the contract for default. The
geographical location of the proposers facility will be taken into consideration during the
evaluation process.
2.10 PRICE
If the vendor is awarded a contract under this solicitation, the prices proposed by the vendor
shall remain fixed and firm during the term of contract.
City of Sunny Isles Beach I Invitation to Bid No. 22-08-01
2.11 DELIVERY
All Bidders shall quote prices based on F.O.B. Destination and shall hold title to the goods until
such time as they are delivered to, and accepted by, an authorized City representative.
2.12 INSURANCE
Primary Comprehensive General Liability with minimum limits of $1,000,000 per claim and
$2,000,000 in the aggregate with the following coverage details:
o Premises and Operation
o Independent Contractors
o Broad Form Property Damages
o Broad Form Contractual Coverage applicable to this specific Contract, including any hold
harmless and/or indemnification agreement.
o Personal Injury Coverage with Employee and Contractual Exclusions removed, with
minimum limits of coverage equal to those required for Bodily Injury Liability and
Property Damage Liability.
o Waiver of Subrogation on behalf of the city.
o The City of Sunny Isles Beach named as Additional Insured
o Coverage to be provided on a Non-contributory and Primary format
Primary Business Automobile Liability with a minimum limit of Liability of $1,000,000 with the
following coverage details:
o Owned Vehicles.
o Hired and Non -Owned Vehicles.
o Employers Non -Ownership
o Waiver of Subrogation on Behalf of the city.
o The City of Sunny Isles Beach named as Additional Insured.
o Coverage to be provided on a Non-contributory and Primary format.
Before starting the Work, the vendor will file and make sure that all certificates of insurance
required by this document and by the Contract are in the City's possession. These certificates
shall contain a provision that the coverage afforded under the policies will not be canceled or
materially changed until at least thirty (30) days prior written notice has been given to the City
by certified mail. The City shall be named as an additional insured on the above -referenced
policies.
City of Sunny Isles Beach I Invitation to Bid No. 22-08-01
,7vor Soo
C'! . MP l
The vendor agrees that if any part of the Work under the Contract is sublet, they will require
the Sub-vendor(s) to carry insurance as required, and that they will require the Sub- vendor(s)
to furnish to them insurance certificates similar to those required by the City in this section.
2.1.1 Cancellation and Re -Insurance:
If any insurance should be canceled or changed by the insurance company or should any
insurance expire during the period of this contract, the Contractor shall be responsible
for securing other acceptable insurance for the coverage specified in this section in
order to maintain coverage during the life of this Contract. All deductibles must be
declared by the Contractor and must be approved by the City. At the option of the City,
either the Contractor shall eliminate or reduce such deductible or the Contractor shall
procure a Bond, in a form satisfactory to the City, covering the same.
2.11.2 Garage Liability coverage for Garage Operations with minimum limits of not less than
One Million Dollars ($1,000,000) per occurrence. Garage keeper's Legal Liability with
minimum limits of not less than One Million Dollars ($1,000,000) per occurrence.
• Waiver of Subrogation on behalf of the city.
• The City of Sunny Isles Beach named as Additional Insured.
• Coverage to be provided on a Non-contributory and Primary format.
Workers' Compensation in accordance with Florida Statute, including $1,000,000 Employers'
Liability form.
Waiver of Subrogation on behalf of the City of Sunny Isles Beach.
A $5,000,000 Umbrella/Excess Liability policy over and above all of the coverage forms
mentioned above.
2.12 MONTHLY INVOICES PAYMENTS
Cut-off date is the close of the last business day of the month. Contractor shall submit by the
10th day of the following month Contractor's completed Statement of Services/Invoice. Should
the 10th fall on a weekend or holiday, Contractor shall submit his application on the next
workday.
Contractor is advised that processing of invoices must follow this schedule, as the City has
funding requirements and other payment obligations which may prevent payment of late
Statement of Services for that month's billing cycle. A late Statement of Services with a
recommendation for payment will be paid in the next month's billing cycle.
City of Sunny Isles Beach I Invitation to Bid No. 22-08-01
yr �
2.13 WARRANTY
A. Type of Warranty Coverage Required
In addition to all other warranties that may be supplied by the Bidder, the Bidder shall
warrant its products and/or service against faulty labor and/or defective material, for a
minimum period of one (1) year after the date of acceptance of the labor, materials
and/or equipment by the City. This warranty requirement shall remain in force for the
full one (1) year period; regardless of whether the Bidder is under contract with the City
at the time of defect. Any payment by the City on behalf of the goods or services
received from the Bidder does not constitute a waiver of these warranty provisions.
B. Correcting Defects Covered Under Warranty
The Bidder shall be responsible for promptly correcting any deficiency, at no cost to the
City, within seventy-two (72) hours after the City notifies the Bidder of such deficiency in
writing. If the Bidder fails to honor the warranty and/or fails to correct or replace the
defective work or items within the period specified, the City may, at its discretion, notify
the Bidder, in writing, that the Bidder may be debarred as a City Bidder and/or subject
to contractual default if the corrections or replacements are not completed to the
satisfaction of the City within this timeframe from receipt.of the notice. If the Bidder
fails to satisfy the warranty within the period specified in the notice, the City may (a)
place the Bidder in default of its contract, and/or (b) procure the products or services
from another vendor and charge the Bidder for any additional costs that are incurred by
the City for this work or items; either through a credit memorandum or through
invoicing.
New vehicles still under manufacturer's warranty shall be taken to the local dealership by the
City for such warranty work.
2.14 DEFICIENCIES IN WORK TO BE CORRECTED BY THE VENDOR (NOT UNDER WARRANTY)
The vendor shall promptly correct any and all apparent or latent deficiencies and/or defects in
work and/or any work that fails to conform to the contract documents, regardless of the
fabrication, installation or completion status of the overall task. All corrections shall be made
within three (3) .calendar days after such rejected defects, deficiencies, and/or non -
conformances are verbally reported to the vendor by the City's project administrator, who may
confirm all such verbal reports in writing. The vendor shall bear all costs of correcting such
rejected work. If the vendor fails to correct the work within the period specified, the City may at
its discretion, notify the vendor in writing, that the vendor is subject to contractual default
provisions if the corrections are not completed to the satisfaction of the City within five (5)
City of Sunny Isles Beach I Invitation to Bid No. 22-08-01
calendar days of receipt of the notice. If the vendor fails to correct the work within the period
specified in the notice; the -City shall place the vendor on default, obtain the services of another
vendor to correct the deficiencies, and charge the incumbent vendor for these costs; either
through a deduction from the final. payment owed to the vendor or through invoicing. If the
vendor fails to honor this invoice or credit memo, the City may terminate the contract for
default.
2.15 LABOR, MATERIALS, AND EQUIPMENT SHALL BE SUPPLIED BY THE VENDOR
Unless otherwise provided in Section 3 (entitled "Technical Specifications") of this solicitation,
the vendor shall furnish all labor, material and equipment necessary for satisfactory contract
performance. When not specifically identified in the technical specifications, such materials and
equipment shall be of a suitable type and grade for the purpose of the warranty or Work. All
material, workmanship, and equipment shall be subject to the inspection and approval of the
City's Project Manager.
2.16 LABOR AND MATERIAL CHARGES
The vendor shall provide the City with labor and materials in strict accordance with all
solicitation requirements on an asneeded, when needed basis. Accordingly, the vendor shall
indicate the cost of this labor and materials on the submittal form included within this
solicitation. The vendor shall not offer an overtime hourly labor rate that exceeds 11/2 times
the value of the regular hourly labor rate. If non-compliance in either regard is evident either
from the offer itself or from subsequent evaluation proceedings, the offer shall be considered
non-responsive and ineligible -for award. No parts, accessories, or supplies shall be used which
might void the vehicle manufacturer's warranty.
2.17 MATERIALS SHALL BE NEW AND WARRANTED AGAINST DEFECTS
The vendor hereby acknowledges and agrees that all materials, except where recycled content is
specifically requested, supplied by the vendor in conjunction with this solicitation and resultant
contract shall be new, warranted for their merchantability, and fit for a particular purpose. In
the event any of the materials supplied to the City by the vendor are found tor be defective or do
not conform to specifications: (1) the materials may be returned to the vendor at the vendor's
expense and the contract cancelled or (2) the City may require the vendor to replace the
materials at the vendor's expense.
2.18 PURCHASE OF OTHER ITEMS NOT LISTED WITHIN THIS SOLICITATION BASED ON PRICE
QUOTES:
City of Sunny Isles Beach I Invitation to Bid No. 22-08-01
While the City has listed all major items within this solicitation which are utilized by City
departments in conjunction with their operations, there may be similar items that must be
purchased by the City during the term of this contract. Under these circumstances, a City
representative will contact the primary vendor to obtain a price quote for the similar items. If
there are multiple vendors on the contract, the City representative may also obtain price quotes
from these vendors. The City reserves the right to award these similar items to the primary
contract vendor, another contract vendor based on the lowest price quoted, or to acquire the
items through a separate solicitation.
2.19 WORK ACCEPTANCE
Any Work will be inspected by an authorized representative of the City. This inspection shall be
performed to determine acceptance of work, appropriate invoicing, and warranty conditions.
2.20 DRUG AND ALCOHOL TESTING
The Contractor's employees must not possess, distribute, consume, use.or cause to be used, any
controlled substance or alcohol on the Work sites. Any Contractor employee under the influence
of alcohol or a controlled substance must not be permitted to perform any Work under the
Contract. Any Contractor or Contractor employee found to be in violation of this requirement
will be permanently prohibited from performing any Work under this Contract. Actions taken
under this provision must not relieve the Contractor of the obligation to provide sufficient
personnel to perform adequate and timely Service as required in this Contract.
END OF SECTION
City of Sunny Isles Beach I Invitation to Bid No. 22-08-01
Section 3
Scope of Services / Technical Specifications
3.0 BACKGROUND
"""'OF SUS'
The goal of the City of Sunny Isles Beach Fleet Department is to ensure the safe and economical
operation of the City's fleet vehicles by having an effective preventative maintenance program
in place and providing for general repairs.
The City has established minimum specifications which include special and specific vehicle
maintenance requirements to assure the safe and economical operation of City fleet vehicles.
The successful repair facility shall possess appropriate facility, equipment, and professional staff
with the skills and experience needed to maintain the City's fleet in accord with Manufacturer's
recommended specifications. The facility shall have the ability to perform quality work, as solely
determined by the City of Sunny Isles Beach, qualifying it to maintain the City's fleet as specified.
The selected repair facility will, from the onset, be held to a very high level of performance
and efficiency in maintaining the City's fleet. The Contractor shall furnish all necessary
supervision, labor, tools and parts and supplies necessary to provide the service for the City's
fleet in accordance with Manufacturer's recommendations in order to maintain factory
warranties and any extended warranties.
The approximate number of City of Sunny Isles Beach vehicles in Fleet by year Make and Model,
is attached hereto as Attachment A.
3.1 SCOPE OF SERVICES
The Contractor shall provide a written checklist for each vehicle of the items checked. The
checks shall include all fluids, brakes, tires, belts and hoses, filters, wiper blades, batteries, oil
checks and oil changes.
Preventative Maintenance (PM) - Scheduled inspection of the vehicle based on either time or
mileage. PM's are scheduled for either 3 months or 5,000 miles, whichever comes first. Select
vehicles due to their unique service are performed more frequently. Preventative Maintenance
consists of a visual inspection of the vehicle for damage or missing parts, functional testing of
components, lubrication, tire rotation, and servicing as needed. The City averages 1,200 PM's a
year.
City of Sunny Isles Beach I Invitation to Bid No. 22-08-01 •
1, fat Z1k $ <
The following must be performed during a scheduled preventative maintenance routine:
Component
Action *reflects additional charge over
PM rate
Visually inspect vehicle for damage or
Advise accordingly
missing parts
Verify function of dash board warning
Advise accordingly
indicators during prove out (key in crank
mode) and advise if any warning indicators
are continuously on. Record idle hours for
Police units.
Check horn & lights for operation.
*Repair as needed
Tires - Inspect for unusual wear or tread at
*Replace as needed.
or below 4/32nd of an inch
Brake Inspection
*Repair as needed
Rotate tires (if spare is new, rotate into
Part of PM
service) and inflate to manufacturer's
recommendations
Parking and service brake
Inspect for proper operation and advise
accordingly
Inspect coolant, brake, power steering,
Top off fluids and advise of any concerns.
transmission, rear axle, and washer fluid.
*Any Level 3 leak, fluid leaking on the ground
must be repaired
Engine oil
Check oil level and condition prior to
changing it. Advise of any concerns. Next
change oil and filter. Fill to top of full line on
dipstick
Check and Adjust Drive Belts
Advise accordingly
Inspect & replace wiper blade and washer
*Replace as needed
pump every three (3) months
Air Filter
*Replace as needed
Battery terminals
Service (part of PM)
Transmission fluid and fuel filter
*Replace at 30,000 mile intervals
Check Engine Cooling System, Hoses And
*Replace as needed
Clamps
Check Exhaust System I
Advise accordingly
City of Sunny Isles Beach I Invitation to Bid No. 22-08-01
OF SUV4
Check Air Condition. System, Freon Level I Advise accordingly
3.2 TECHNICAL REQUIREMENTS
Replacement Parts — Replacement parts should be New Original Equipment (OE) unless noted
otherwise or agreed upon for a specific repair or authorized by the Fleet Manager or designee.
Where an Original Equipment has multiple lines, the premium line should be used (Example:
Motorcraft use Super Duty, AC Delco use OE Service).
Exceptions:
1. Motor Oil must be of premium grade and meet Ford Motor and/or Manufacturer's
specifications for 5W-20 or 5W-30 Synthetic Blend for gasoline engines and 15W 40
Super Duty for diesel engines. Going forward, manufacturers may switch to a full
synthetic. Provision for price adjustments will be noted below.
2. Brakes on Ford Motor Company vehicles should be Motorcraft Super Duty when
available or Motorcraft. For marked patrol units use Ford Original Equipment pads, not
Motorcraft. Brakes on non -Ford vehicles shall meet manufacturer's specifications.
3. Transmission / Rear Axle Fluid / Refrigerant / Brake Fluid — Must be of high quality and
meet 0E manufacturer's specifications.
4. Wiper Blades — High quality refill .(Anco or Trico is acceptable), for GM AC Delco
Advantage line is preferred, or exit fit from NAPA.
5. Misc. supplies— hose clamps, wire connectors, etc. must be of high quality.
Shop Equipment — The facility shall have sufficient high quality tools and equipment to service
late model vehicles (brake lathe, tire changer, tire balancer, alignment, tire pressure monitor
tools, and OBDII diagnostic equipment).
Repairs - Before providing repair work, cost estimates shall be provided to Fleet Management
detailing parts and labor required for the repair. No additional repairs will be allowed unless first
authorized by Fleet Management.
• If a cost estimate for repair appears unreasonable in view of prior cost experience and other
prevailing estimates, the City reserves the right to obtain services from another source.
• In no case shall the charge for labor exceed the bid price per hour times the numbers of hours
quoted at such time repairs were performed.
City of Sunny Isles Beach I Invitation to Bid No. 22-08-01
4�h''Of'SO4y.Pt. .
3.3 HOURS OF OPERATION
Contractor shall at a minimum, provide for the operation of the facility five (5) days per week,
from 7:30 a.m. to 6:00 p.m. Monday through Friday, 7:30 a.m to 4:00 p.m Friday.
Contractor shall operate the facility a minimum of 56 hours per week except for a holiday as
authorized by the City (New Year's Day, Thanksgiving, Christmas). The City shall be notified in
advance of any changes in hours of service (other than those dictated by emergency).
Successful contractor shall have access to check and respond to emails, at least 3 times a day,
morning, afternoon and late PM.
3.4 PROTECTION
3.4.1 The Contractor shall be solely responsible for City vehicles and equipment while in their
possession for maintenance and/or repairs.
3.4.2 Vehicles left at Contractor's facility during non -business hours to complete service must
be stored in a secure area.
3.4.3 The Contractor must take all necessary precautions for the safety of employees in the
performance of the Work on, about or adjacent to the premises, and must comply with
all applicable provisions of Federal, State, and local laws, including, but not limited to
the requirements of the Occupational Safety and Health Act of 1970 (OSHA), and
amendments thereto, to prevent accidents or injury to persons on, about or adjacent to
the premises where the Work is being performed.
3.5 ESTIMATES
Bidder shall provide written "not to exceed" estimates on any repair. The estimate will include
the estimated number of hours, hourly rate, estimated material cost and completion date. It will
be the Bidder's responsibility to ensure they have all the equipment and materials to provide
accurate estimates. No work shall be performed by the Contractor before authorization is
provided by the City's Fleet Manager or designee via a Purchase Order.
3.6 HOURLY RATE
The hourly rates submitted with your bid response shall include full compensation for labor,
equipment use, and any other cost to the Bidder.
City of Sunny Isles Beach I Invitation to Bid No. 22-08-01
or SUS► I+e+-
3.7 PARTS SUPPLY
The Proposer shall furnish all parts and supplies necessary to maintain and repair vehicles and
equipment at the fleet facility. Parts installed by the Proposer shall meet OEM specifications,
and shall be warranted accordingly. Parts installed on vehicles and equipment shall be identified
by part number and cost on the work order for the appropriate assignment. The Proposer shall
have available to the City an audit report showing part costs and a pricing comparison of at least
three local suppliers.
3.8 INVENTORY
The Proposer shall maintain an adequate parts inventory as part of the Proposer's target costs.
A management information system shall be used to monitor the parts inventory and track parts
usage on the City's fleet. At a minimum, the electronic system shall be capable of generating a
complete inventory by part number and part cost, and a usage rate history for each part
normally stocked. Respondents shall describe their program for inventory control, ability to
provide volume purchasing programs, and plans to utilize local vendors and suppliers, as
appropriate, in their Proposals to the City.
3.9 PERFORMANCE STANDARDS
The Contractor needs to be fully aware of the fact that City departments that rely on vehicles to
perform their functions operate in a highly competitive environment and time for maintenance
and repair work is of the essence. With this in mind, the Contractor will meet the performance
standards noted below during the term of this agreement.
The Contractor will be expected to maintain these performance standards at all times. Labor
disputes, strikes, and other events, except those beyond the Contactors' control will not relieve
the Contractor of meeting these standards.
3.10 VEHICLE TURNAROUND TIME STANDARDS
The following percentages of all maintenance and repair work must be completed within 24
hours of the vehicles delivery to the garage or within 24 hours of notification of maintenance
requirements (excluding weekends and non -working holidays):
General Fleet Vehicles 85% of the time
One -Ton or Smaller Vehicles 80% of the time
Larger than One -Ton Vehicles 75% of the time
City of Sunny Isles Beach I Invitation to Bid No. 22-08-01
1011
(Includes Construction Equipment
& other specialty equipment)
The Contractor is responsible for notifying the representative of user departments by telephone,
email or in person when any vehicle will be out -of -service for maintenance or repair for more
than 24 hours.
3.11 RE -WORK
The Proposer shall track and identify multiple repairs for the same deficiency on the same
vehicle (re -work) and shall not include in the statement costs for re -work occurring after the
original repair. Such re -work labor costs will be calculated and .reimbursed to the City. All rework
must be performed within 24 hours after City notification of corrective action.
3.12 REPORTING
Upon prior notice to the Contract Project Manager, the Proposer shall provide the City's
authorized representative(s) access at all reasonable times to all electronic and hard data, Fleet
Management Information System, books, records, correspondence, instructions, plans,
drawings, receipts, vouchers, and memoranda of every description related to the Proposer's
fleet management and maintenance services for the City, and shall provide to the authorized
representative (s) cost verification for work.
3.13 POST AWARD SITE -INSPECTION
The City may require the on-site pre -service inspection be performed in the presence of or by
City's project manager or designee prior to September 25th of each calendar year. The
inspection will include all mechanical, hardware, software, labor, and quality of vehicle fleet and
associated technology to be used for this service.
3.14 TIRES, TUBES AND SERVICES
The City purchases Goodyear tires using the NASPO contract RFP1118005083 pricing. The
repairing facility shall either be able to provide tires accordingly or agree to stock and inventory
City supplied tires at no additional charges. All tires must be logged in and out electronically. The
City will pay for the mounting, balance, tire valves, and disposal of old tires upon usage at State
of Florida rate. The City will not be responsible for any other fees or charges.
END OF SECTON
City of Sunny Isles Beach I Invitation to Bid No. 22-08-01
SECTION 4
BID FORMAT
4.0 FORMAT
V/� Of S ��-
Bidders must submit (1) original and four (4) copies of the bid. The original Bid must contain an original
signature. Be sure that the individual signing the Proposal is authorized to commit the Proposer's
organization to the Proposal as submitted. Each page of the Proposal should state the name of the
Proposer, the Bid number, and the page number. The City reserves the right to request additional data
or material to support Proposals. All material submitted in response to the Bid will become the property
of the City.
LABEL EACH SECTION AS NUMBERED
The bid must be in the following format. Failure to submit all documentation in response to items #1
through #7 of this section may result in the proposal being deemed non-responsive and may result in
the proposer's bid not being considered, in the City's sole discretion.
COMPANY INFORMATION:
• In response to this,Proposal, all Proposers must provide the following:
• Name of Agency/Company (including any "Doing Business As" names)
• Company Locations.
• Internet Web Site Address (if any).
• Details of Entity Business Structure (Corporation, Partnership, LLC).
• Date Founded.
• Home office address, telephone number, and local address -and phone number.
• List of any outstanding litigation that would threaten the viability of the firm or the
performance of this contract.
• Proof of insurance.
• Indication of how long it would take to implement service after authorized to begin.
• Hours of operation
• The Contractor shall provide an example of a written checklist for that reflects, oil
changes, fluids, brakes, tires, belts and hoses, filters, wiper blades, and batteries.
2. MINIMUM QUALIFICATION REQUIREMENTS:
a) The Bidder must employ, at minimum, one mechanic who is ASE Certified Master
Mechanic in medium / light duty truck repair and automobiles.
Bidder must provide a copy of the applicable license(s) with Bidder's response.
City of Sunny Isles Beach I Invitation to Bid No. 22-08-01 ��E M
Mechanic(s) shall have the following ASE certifications:
• Al Engine Repair
• A2 Automatic Transmission/Transaxle
• A3 Manual Drive Train & Axles
• A4 Suspension & Steering
• AS Brakes
• A6 Electrical/Electronic Systems
• A7 Heating and Air Conditioning
• A8 Engine Performance
b) Bidder must have a fully equipped and well-established shop as required in this
solicitation, which may be verified by on-site inspection, preferably within ten (10)
mile radius of the City of Sunny Isles Beach.
c) The -Bidder must have been in the business of vehicle maintenance and repairs for a
minimum of five (5) years.
d) Bidder must provide security in the form of a fenced lot, or inside of a secure
building, for no less than four (4) standard sized vehicles simultaneously.
e) Bidder shall provide references for no less than (2) two public or
private/commercial sector references in which Bidder serves as their primary
repair/maintenance shop.
f) Bidder shall submit drug test policy for employees. Bidder shall perform drug test
screening on all employees and provide pass/fail results to the City Manager or
designee, upon request.
3. QUALIFICATIONS:
• Include licenses and certificates such as the ASE Certified Master Mechanic.
• A schedule of proposed services. The schedule should include the Proposer's
understanding of the issues and tasks of the project at hand.
4. STAFFING:
Relevant experience and qualifications of key personnel, including key personnel of
subcontractors, that will be assigned to this project as well as experience and qualifications. The
City of Sunny Isles Beach I Invitation to Bid No. 22-08-01
CA �Nq �
size and experience of the company staff pool from which staff assigned to the contract can be
drawn. The composition of the staff team should include:
• The names of the employees in the area responsible for the contract;
• Their function in the company; and
• The name of the person who will be responsible for the coordination of Work.
5. APPROACH / METHODOLOGY:
Proposer's approach methodology to providing the services requested in this solicitation
• Suitability of the methodologies and approaches used in achieving tasks
• Overall organization to completing the project
• Ability to meet desired timelines and deadlines
6. COST PROPOSAL: See Bid Price sheet on page 30 below for your firm to complete.
7. EXCEPTIONS:
Firm must list any exceptions taken to the terms and condition in this ITB.
City of Sunny Isles Beach I Invitation to Bid No. 22-08-01
SECTION 5
BIDDER'S QUESTIONNAIRE
Proposers and their subcontractor must have prior successful experience performing maintenance and
repair services on automobiles, trucks and other vehicles, must be licensed to conduct business in the
State of Florida, and must possess all permits, licenses, certifications, approvals, equipment, materials,
and staff necessary to perform and/or carry out the requirements of the contract. Please supply the
information requested below. Attach additional sheets, if necessary, to provide required information.
Company Name: The Goodyear Tire & Rubber Com
Address: 12850 West Dixie Hwv North Miami .FL. 3:
Primary Contact: Allan t Alcerrc
Email: Gsr2556@goodvear.com
Phone Number: (305)891-4648
1. Number of years company has been in the business of vehicle maintenance and
repairs services: 124 Years
2. Number of repair employees: 7
3. Hours of operation:
8am-6pm Monday -Saturday
4. Is your company registered with the Florida Department of Agriculture and Consumer Services
(FDACS) per the Florida Motor Vehicle Repair Act?
S. Have you included copies of ASE Certified Master Mechanic certificates for your technicians?
6. Proximity to City of Sunny Isles Beach City Hall 6 miles
7. Name of Shop Manager(s) Allan E Alcerro
8. Has your shop ever been a subject of Better Business Bureau action? Yes No
9. How many bays are available for vehicles?
I
10. The contractor shall attach a copy of their drug and alcohol testing policy.
11. List subcontractors None
12. Electronic invoicing capabilitie Yes No
13. Does your shop conduct background checks prior to employment: B No
City of Sunny Isles Beach I Invitation to Bid No. 22-08-01
of sDt4 PY,_
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14. Number of ASE Certified employees 3
15. Is your contract price for a specific location or multiple locations (if you are a corporation):
yes
16. LIST OF REFERENCES
Bidder shall provide. references for no less than (2) two public or private/commercial sector
references in which Contractor serves as their primary repair/maintenance shop.
A. Client: EI Portal Police Department
Contact Name/Title: Alejandro Mendez / Chief
Phone Number/ Email Address: policechief@villageofelportal.org/305-335-2356
B. Client: Florida Department of correction
Contact Name/Title: Keondra Austin /Fleet Coordinator
Phone Number/ Email Address:keondra.austin@fdc.myflorida.com / 305-377-7040
C. Client: Florida Fish And' Wild Life Conservation Comission
Contact Name/Title: Manuel Pomares / Fleet Coordinator
Phone Number/ Email Address: Manuel.pomares@myfwc.com
City of Sunny Isles Beach I Invitation to Bid No. 22-08-01 In
Section 6
BID PRICE SHEET
-UNIT PRICE: Unit price should be numeric. Unit price left blank will be deemed "no bid" and a price of $0 will be
deemed "included at no charge."
. GROUP #T CTRU
ARS.AND CKS UP T0,1'k4b'k _-
Preventive Maintenance per Section 3.1
A
Indicate the actual Posted Shop Labor Rate
$ 145.00
B
Percentage Discount from the Posted Shop Labor Rate
15%
C„
Discounted kdi riy Shop Labor Rate
123
4
t 1 N
d
i t s
x
AND
Percentage Discount off the O E M-,' MSRP List for parts
1:0%
FLAT RATE SERVICES
No.
Description
Extended Cost
D.
Alignment of Front Axle Only (complete)
$
79.99
E.
Alignment of Front and Single Rear Axle (complete)
$
79.99
F.
Oil Change
$
25.99
(Up to 5 quarts of Oil and Oil Filter
F.1.
Synthetic Oil Change
$ 49.99 Synthetic Blend
(Up to 5 quarts of Oil and Oil Filter)
59.99 Full Synthetic
G
Preventative:Maintenapce Section 3
per ab
H.'
H.'
Minimum Diagnostic charge
$ 145.00
City of Sunny Isles Beach I Invitation to Bid No. 22-08-01
OF wV4 r",
r, 1j, ---
GROUP W2'$ .TRUCKS OVER 1% TON
Preventive Maintenance per Section 3.1
A
Indicate the actual Posted Shop Labor Rate
B
Percentage Discount from the Posted Shop Labor Rate
%
01 A
Labor Rate Mdtif, 2
Discounted, 6'
" qp� K
gt
tk
AND
ftrceritagbbiscbunt-6ff the 0iE.M.'/'NM0,1ist;f6r, , parts;"
FLAT RATE SERVICES
No.
Description
Extended Cost
D
Alignment of Front Axle Only (complete)
E
Alignment of Front and Single Rear Axle (complete)
F
Oil Change
(Up to 5 quarts of Oil and Oil Filter
$
FA
Synthetic Oil Change
(Up to 5 quarts of Oil and Oil Filter
$
eGt
reven ativeMainterianee,per Seaicibl 1, above,
,
H.
Minimum Diagnostic Charge
$
City of Sunny Isles Beach I Invitation to Bid No. 22-08-01
DELIVER TO: INVITATION TO BID
City of Sunny Isles Beach SECTION 7 OPENING: 11:00 A.M.
City Clerk BID SUBMITTAL FORMS 9/1/2022
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
08/15/2022 Pages 28 through 37
Sealed bids are subject to the Terms and Conditions of this Invitation to Bid 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.
ITB 22-08-01
Fleet Maintenance & Repair Services
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
The. Goodyear Tire & Rubber Company
Commodity Cadets):
RETURN ONE ORIGINAL AND FOUR COPIES OF BID SUBMITTAL PAGES.AND AFFIDAVITS
FAILURE TO SIGN PAGE 28 OF SECTION 5 BID SUBMITTAL WILL RENDER YOUR BID NON-RESPONSIVE
City of Sunny Isles Beach I Invitation to Bid No. 22-08-01
of SUS Pr
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BID SUBMITTAL FORM
Bid Title: Fleet Maintenance & Repair Services
The undersigned Proposers propose and .agree, if this Bid is accepted, to enter into an agreement with The City of
Sunny Isles Beach in the form included in the Contract Documents 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 Proposers accept all of the terms and conditions of the Advertisement or Invitation to Bid and Instructions to
Proposers, 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 Proposers agree 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 Proposers represent, as more fully set forth in the Agreement, that:
■ The Proposers have familiarized themselves 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 Proposers have 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 Proposers.
■ This Bid is genuine and not made in the interest of or on behalf of any undisclosed
person, firm or corporation and is not submitted in conformity with any agreement or
rules of any group, association, organization, or corporation; the Proposers have not
directly or indirectly induced or solicited any other Proposers to submit a false or sham
Bid; the Proposers have not solicited or induced any person, firm or .corporation to
refrain from Bidding; and the Proposers have not sought by collusion to obtain for itself
any advantage over any other Proposers or over the City.
The Proposers understand and agree that the Bid is for unit prices to furnish and 'install individual Work Items for
maintenance and/or repair work, complete in place. Estimates are provided for the purposes of Bid Evaluation and
to establish unit prices for individual Work Items for maintenance and/or repair work to be contracted by the City
under individual Purchase Orders, based, on the unit prices established under this Bid.
The City and the successful Proposers will establish completion times for each individual Work Item and the
successful Proposers agree that the work will be completed within the time frames agreed upon and stipulated in
the individual Purchase Orders and/or Notice to Proceed.
City of Sunny Isles Beach I Invitation to Bid No. 22-08-01
Firm Name:
The Goodyear Tire & Rubber Company
Street Address:
12850 West Dixie Hwy North Miami ,FL, 33161
Mailing Address (if different):
Telephone No. (305)891-4648 Fax No.
Email Address: gsr2556@goodyear.com FEIN No. 3 4 -0 2 5 3 2 4 0
*`By signing this document the bidder agrees to all Terms
Signature:
(Signature
Print Name: Allan E AI'cerro
Title: Store Manager
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 Invitation to Bid No. 22-08-01
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
PART II:
Addendum #1, Dated
Addendum #2, Dated
Addendum #3, Dated
Addendum #4, Dated
Addendum #S, Dated
Addendum #6, Dated
Addendum #7, Dated
Addendum #8, Dated
❑ NO ADDENDUM WAS RECEIVED IN CONNECTION WITH THIS BID
FIRM NAME: OvoD/A94 //2/t�. P /eUABX-e- GOmtgAy
AUTHORIZED SIGNAT DATE:
TITLE OF OFFICER:
City of Sunny Isles Beach I Invitation to Bid No. 22-08-01
��lY OB' Svti Pt+-
REASON FOR "NO BID"
For firms choosing IN to bid/propose on this opportunity, the City appreciates your
response using this form.
Please return via email to Pu rchasingA-sibfl. net.
Why did your firm choose not to respond to this opportunity?
Circle all that apply from below list:
Other:
a. We do not offer these services or equivalent.
b. Insufficient time to respond to the solicitation.
c. Our project schedule would not permit us to perform.
d. Unable to meet requirements.
City of Sunny Isles Beach I Invitation to Bid No. 22-08-01
Ck CA
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City of Sunny Isles Beach I Invitation to Bid No. 22-08-01
.1141 Tli
!S(F��
O� SVZ,INY
NON -COLLUSION AFFIDAVIT
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City of Sunny Isles Beach
18070 Collins Avenue
�'s'� • cLoR�o �s"'
Sunny Isles Beach, FL 33160
crTr';o, sat.
Telephone: (305) 947-0606 Fax: (305) 949-3113
STATE OF FLORIDA
COUNTY OF 1
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,
of which he is
The Goodyear Tire & Rubber Company
(Name of Corporation, Partnership, Individual, etc.)
Tire Manufactureer & service center , formed under the laws of ohio
(Type of Business)
Owner, Partner; President, etc.)
(State)
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
1.0.2, 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.
LII,V 60--,(a
AFFIANT'S NAM
AFFIANT'S TITLE
TAKEN, SWORN AND SUBSCRIBED TO BEFORE ME this day of Aij &j2ad--)
Personally Known or Produced Identification f/
Type of identification
(Affix seal here)
�0- MANOUCHEKA L'AFORTUNE FELIX
c s Notary Public
State of Florida
y $ Comm# HH176908
s�NCF 19�� Expires 9/20/2025
DECEMBER 28, 2010
00( A ,C#H��v
NOTARY PUBLIC (name printed. or typed)
.. SVNNY lS�f ,
DISPUTE DISCLOSURE
V I
�.
City of Sunny Isles Beach
18070 Collins Avenue
SF :'�• Kuo�`�.6�e
Sunny Isles Beach, FL 33160
c�Tr,ve iuw"cue
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 x
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 x
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 x 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. , ,
The Goodyear Tire & Rubber Company store #2556
Firm
Auth nature
7
DECEMBER28,2010
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ate
Alp f, �etwo
Print or TVDe Name and titl
O�SVN
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FL V_ bit
C�Tr.OF SUN 1a
STATE OF FLO DA)
COUNTY OF c AA
ANTI -KICKBACK
City of Sunny Isles Beach
18070 Collins Avenue
Sunny Isles. Beach, FL 33160
Telephone: (305) 947-0606 Fax: (305) 949-3113
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:
Allan E Alcerro
Title: Store Manager
The foregoing instrument wa acknowledged before me this b day of
Q4 4 20 a by Q- >� �fhl.akd a�1 1�,[� [name
of pers ], as Allan E Alcerro [type of authority], for
The Goodyear Tire & Rubber Company store #2556 [name of party on behalf of whom instrument was
executed].
AFFIX NOTARY STAMP HERE:
4 MMOUCHEM LAFORI UNE FELDC
Notary Public
0 12 c State of Florida
W NCE 1��r Comm# HH176908
Expires 9/20/2025
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N tart' Public — State 80 Florida
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Print or Type Commissioned Name
Personally Known OR Produced I eptificationl/
Type of Identification Produced 0)Ws— 14—LI)C)J— 0
DECEMBER 28, 2010
SUNNY IJ�F
CONTRACTOR ANTI -BOYCOTT CERTIFICATION
[PURSUANT TO FLORIDA STATUTE § 215.47251
I, Allan E Alcerro on behalf of The Goodyear Tire & Rubber Company store #2556
Print Name Company Name
certifies that The Goodyear Tire & Rubber Company 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.
Signatu
Store Manager
Title
Date
.7s.
FF
Florida Statute 448.095 directs all public employers, including municipal governments, to verify the
employment eligibility of all new public employees through the U.S. Department of Homeland Security's E -
Verify 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 of 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 (https://www.e-verify.gov/emplovers/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.
O'ek 14, now
311--DPs 34-A yv
Federal Employer Identification Number (FEIN)
p1-3301
�o a -
Date
Title
-
""' t1 1vv
Sworn to and subscribed before me on this this day of 2022.
By
❑ Is personally known to me
1 < �(,}�
tJ Has produced identification (type of identification produced: i` l f� l (Nt
Signature oIfN o t a r Public
MANOUCHEKA LAFORTUNE FELD(
_ / I Notary Public
I��Not
State of Florida
C f l�Comm# HH176908
WWPrint or Stamp oPublic Expiration Dae NSE 19� Expires 9/2o/2025
' NNY ys
FSJ
e CONFLICT OF INTEREST
. City of Sunny Isles Beach
18070 Collins Avenue
yf p�+FLORA s`' Sunny Isles Beach, FL 33160
car` o■ suN " 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 FLORIDA
COUNTY OF Dade
BEFORE ME, the undersigned authority, personally appeared Allan E Alcerro who was duly sworn,
deposes, and states:
18.1. 1 am the Store Manager of
The Goodyear Tire 8 Rubber Company store #2556
with a local .office in 12850 West Dixie Hwy Nortii Miami ,FL, 33161 and principal office In
200 Innovation Way Akron, OH 44316 .
18.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No. 22-08-01 described
as: Golden Shores Street Lighting. 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. ,,-
18.81 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 o Sunny Isles Beach.
Dated thisday of� 12022.
Allan E Alcerro
AFFIANT P,lint or Type Name and Title �i
Sworn to and subscribed before me this day of x'l, '2022.
O Personally Known OR C /,��,���al %�
Produced Identification ; Type of Ide tifi1A 4n
cation I `f' W"
NOTARY PUBLIC STATE OF FLORIDA
DECEMBER 28, 2010
�pSAR MANOUCHEKA LAFORTUNE FELLX
Notary Public
State of Florida
y a Commit HH176908
S�HCE tei� Expires 9/20/2025
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:
/
EQUAL OPPORTUNITY
Nn
The Goodyear Tire & Rubber Company
Y.."
AFFIRMATIVE ACTION
i-
City of Sunny Isles Beach
,•,,f��'✓iTG�.
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:
Title:
Firm:
The Goodyear Tire & Rubber Company
Address:
12850 West Dixie Hwy North Miami ,FL, 33161
i-
°t,::r:.'.�%' . kd°.;.17?Jt6s4i�,s:Fii
,•,,f��'✓iTG�.
DECEMBER28,.2010
PUBLIC ENTITY CRIMES
f �fis
City of Sunny Isles Beach
18070 Collins Avenue
Sunny Isles Beach, FL 33160
rY.or .0 "a 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
A
JM" 114�9WA&
forL10'
1pnn name of entity submiRng swom statementj
whose business address is:
and (if applicable) its Federal Employer Identification number (FEIN) is 34-0253240
(If the entity had no FEIN, include the Social Security Number of the individual signing this sworn
statement: )
11.2. 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.
11.3. 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.
11.4. 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 cr'ime`s or` Y
`
b.) Any entity under the control of any natural person who is acti4f,i the',M-6h6gemenf°of the entity
and who has been convicted of a public entity crime. The term`--"affiliafe'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
DECEMBER28,2010
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. 1 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.)
x 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 chargedk�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 Qrder•;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'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 OF ANY, CHANGE IN THE INFORMATION CONTAINED IN THIS FORM.
By:
(S
(Printed Name)
(Title)
g, Sworn nd subscribed before me thi004day of , 20J&, by
to AOAa
(AFFIX NOTARY STAMP HERE) 114 4112)C FUG l 14'e ,
MR MMNOUCaiEKA LAFQRTUNE FELIX
Notary Public Signaytug e:
:2 State of Florida ^'t a 9Q0 �i'f � R a�� (� I tV
Comm# 141-1176908
Expires 9/20/2025
Personally Known — OR Produced Identificationi(e.�i1�/l�IL
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City of Sunny Isles Beach I Invitation to Bid No. 22-08-01
Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid Social security number
backup withholding. For individuals, this is generally your social security number (SSN). However, for a
resident alien, sole proprietor, or disregarded entity; see the instructions for Part I, later. For other
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a
TIN, later. or
Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and Employer Identification number
Number To Give the Requester for guidelines on whose number to enter.
13141 - 0 1 2 1 5 1 3 1 2 1 4 1 0
Certification
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding; and
3. 1 am a U.S. citizen or other U.S, person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because
you have failed to report -all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid,
acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments
other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part 11, later.
Sign Signature of ' f W
Here U.S. person. 10-
V
General Instructions
Section references are to the Internal Revenue Code unless otherwise
noted.
Future developments. For the latest information about developments
related to Form W-9 and its instructions, such as legislation enacted
after they were published, go to wwvvJrs.gov/FormW9.
Purpose of Form
An individual or entity (Form W-9 requester) who is required to file an
information return with the IRS must obtain your correct taxpayer
identification number (TIN) which may be your social security number
(SSN), individual taxpayer identification number ([TIN), adoption
taxpayer identification number (ATIN), or employer identification number
(EIN), to report on an information return the amount paid to you, or other
amount reportable on an information return. Examples of information
returns include, but are not limited to, the following.
• Form. 1099 -INT (interest earned or paid)
Date ► 1/1/2022
• Form 1099 -DIV (dividends, including those from stocks or mutual
funds)
• Form 1099-MISC (various types of income, prizes, awards, or gross
proceeds)
• Form 1099-B (stock or mutual fund sales and certain other
transactions by brokers)
• Form 1099-S (proceeds from real estate transactions)
• Form 1099-K (merchant card and third party network transactions)
• Form 1098 (home mortgage interest), 1098-E (student loan interest),
1098-T (tuition)
• Form 1099-C (canceled debt)
• Form 1099-A (acquisition or abandonment of secured property)
Use Form W-9 only if you are a U.S. person (including a resident
alien), to provide your correct TIN.
If you do not return Form W-9 to the requester with a TIN, you might
be subject to backup withholding. See What is backup withholding,
later.
Cat. No. 10231X Form W-9 (Rev. 10-2018)
W'9
Request for Taxpayer
Give Form to the
Form
(Rev. October 2018)
Identification Number and Certification
requester. Do not
Department of the Treasury
send to the IRS.
Internal Revenue Service
► Go to www.irs.gov/FormW9 for instructions and the latest information.
1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank.
The Goodyear Tire & Rubber Company
2 Business name/disregarded entity name, if different from above
cD
�P
3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the
Y
4 Exemptions codes apply only to
P• ( PP Y Y
M
following seven boxes,
certain entities, not individuals; see
Q.
C
❑ Individuallsole proprietor or ❑✓ C Corporation ❑ S Corporation ❑ Partnership ❑ Trust/estate
instructions on page 3):
o
single -member LLC
Exempt payee code (f any)
CL
Z
❑ Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership) ►
`o w
Note: Check the appropriate box in the line above for the tax classification of the single -member owner. Do not check
Exemption from FATCA reporting
A w
C
LLC if the LLC is classified as a single -member LLC that is disregarded from the owner unless the owner of the LLC is
another LLC that is disregarded from
code if an
( y) D
S
not the owner for U.S. federal tax purposes. Otherwise, a single -member LLC that
is disregarded from the owner should check the appropriate box for the tax classification of its owner.
d
❑ Other (see instructions) ►
(Applies to accounts maintained outside the U.S.)
N
5 Address (number, street, and apt, or suite no.) See instructions.Requester's
name and address (optional)
d
ua)
200 Innovation Way
6 City, state, and ZIP code
Akron, OH 44316-0001
7 List account number(s) here (optional)
Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid Social security number
backup withholding. For individuals, this is generally your social security number (SSN). However, for a
resident alien, sole proprietor, or disregarded entity; see the instructions for Part I, later. For other
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a
TIN, later. or
Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and Employer Identification number
Number To Give the Requester for guidelines on whose number to enter.
13141 - 0 1 2 1 5 1 3 1 2 1 4 1 0
Certification
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding; and
3. 1 am a U.S. citizen or other U.S, person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because
you have failed to report -all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid,
acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments
other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part 11, later.
Sign Signature of ' f W
Here U.S. person. 10-
V
General Instructions
Section references are to the Internal Revenue Code unless otherwise
noted.
Future developments. For the latest information about developments
related to Form W-9 and its instructions, such as legislation enacted
after they were published, go to wwvvJrs.gov/FormW9.
Purpose of Form
An individual or entity (Form W-9 requester) who is required to file an
information return with the IRS must obtain your correct taxpayer
identification number (TIN) which may be your social security number
(SSN), individual taxpayer identification number ([TIN), adoption
taxpayer identification number (ATIN), or employer identification number
(EIN), to report on an information return the amount paid to you, or other
amount reportable on an information return. Examples of information
returns include, but are not limited to, the following.
• Form. 1099 -INT (interest earned or paid)
Date ► 1/1/2022
• Form 1099 -DIV (dividends, including those from stocks or mutual
funds)
• Form 1099-MISC (various types of income, prizes, awards, or gross
proceeds)
• Form 1099-B (stock or mutual fund sales and certain other
transactions by brokers)
• Form 1099-S (proceeds from real estate transactions)
• Form 1099-K (merchant card and third party network transactions)
• Form 1098 (home mortgage interest), 1098-E (student loan interest),
1098-T (tuition)
• Form 1099-C (canceled debt)
• Form 1099-A (acquisition or abandonment of secured property)
Use Form W-9 only if you are a U.S. person (including a resident
alien), to provide your correct TIN.
If you do not return Form W-9 to the requester with a TIN, you might
be subject to backup withholding. See What is backup withholding,
later.
Cat. No. 10231X Form W-9 (Rev. 10-2018)
Form W-9 (Rev. 10-2018)
By signing the filled -out form, you:
1. Certify that the TIN you are giving is correct (or you are waiting for a
number to be issued),
2. Certify that you are not subject to backup withholding, or
3. Claim exemption from backup withholding if you are a U.S. exempt
payee. If applicable, you are also certifying that as a U.S. person, your
allocable share of any partnership income from a U.S. trade or business
is not subject to the withholding tax on foreign partners' share of
effectively connected income, and
4. Certify that FATCA code(s) entered on this form. (if any) indicating
that you are exempt from the FATCA reporting, is correct. See What is
FATCA reporting, later, for further information.
Note: If you are a U.S. person and a requester gives you a form other
than Form 1111-9 to request your TIN, you must use the requester's form if
it is. substantially similar to this Form W-9.
Definition of a U.S. person. For federal tax purposes, you are
considered a U.S. person if you are:
• An individual who is a U.S, citizen or U.S. resident alien;
• A partnership, corporation, company, or association created or
organized in the United States or under the laws of the United States;
• An estate (other than a foreign estate); or
• A domestic trust (as defined in Regulations section 301.7701-7).
Special. rules for partnerships. Partnerships that conduct a trade or
business in the United States are generally required to pay a withholding
tax under section 1446 on any foreign partners' share of effectively
connected taxable income from such business. Further, in certain cases
Where a Form W-9 has not been received', the rules under section 1446
require a partnership to presume that a partner is a foreign person, and
pay the section 1446 withholding tax. Therefore, if you are a U.S. person
that is a partner in a partnership conducting a trade or business in the
United States, provide Form W-9 to the partnership to establish your
U.S. status and avoid section 1446 withholding on your share of
partnership income.
In the cases below, the following person must give Form W-9 to the
partnership for purposes of establishing its U.S. status and avoiding
withholding on its allocable share of net income from the partnership
conducting a trade or business in the United States.
• In the case of a disregarded entity with a U.S. owner, the U.S. owner
of the disregarded entity and not the entit;.
• In the case of a grantor trust with a U.S. grantor or other U.S. owner,
generally, the U.S. grantor or other U.S. owner of the grantor trust and
not the trust; and
• In the case of a U.S. trust (other than a grantor trust), the U.S. trust
(other than a grantor trust) and not the beneficiaries of the trust.
Foreign person. If you are a foreign person or the U.S. branch of a
foreign bank that has elected to be treated as a U.S. person, do not use
Form W-9. Instead, use the appropriate Form W-8 or Form 8233 (see
Pub. 515, Withholding of Taxon Nonresident Aliens and Foreign
Entities).
Nonresident alien who becomes a resident alien. Generally, only a
nonresident alien individual may use the terms of a tax treaty to reduce
or eliminate U.S. tax on certain types of income. However, most tax
treaties contain a provision known as a "saving clause." Exceptions
specified in the saving clause may permit an exemption from tax to
continue for certain types of income even after the payee has otherwise
become a U.S. resident alien for tax purposes.
If you are a U.S. resident alien who is relying on an exception
contained in the saving clause of a tax treaty to claim an exemption
from U.S. tax on certain types of income, you must attach a statement
to Form W-9 that specifies the following five items.
1. The treaty country. Generally, this must be the same treaty under
which you, claimed exemption from tax as a nonresident alien.
2. The treaty article addressing the income.
3. The article number (or location) in the tax treaty that contains the
saving clause and its exceptions.
4. The type and amount of income that qualifies for the exemption
from tax.
5. Sufficient facts to justify the exemption from tax under the terms of
the treaty article.
Page 2
Example. Article 20 of the U.S.-China income tax treaty allows an
exemption from tax for scholarship income received by a Chinese
student temporarily present in the United States. Under U.S. law, this
student will become a resident alien for tax purposes if his or her stay in
the United States exceeds 5 calendar years. However, paragraph 2 of
the first Protocol to the U.S.-China treaty (dated April 30, 1984) allows
the provisions of Article 20 to continue to apply even after the Chinese
student becomes a resident alien of the United States. A Chinese
student who qualifies for this exception (under paragraph 2 of the first
protocol) and is relying on this exception to claim an exemption from tax
on his or her scholarship or fellowship income would attach to Form
W-9 a statement that includes the information described above to
support that exemption.
If you are a nonresident alien or a foreign entity, give the requester the
appropriate completed Form W-8 or Form 8233.
Backup Withholding
What is backup withholding? Persons making certain payments to you
must under certain conditions withhold and pay to the IRS 24% of such
payments. This is called "backup withholding." Payments that may be
subject to backup withholding include interest, tax-exempt interest,
dividends, broker and barter exchange transactions, rents, royalties,
nonemployee pay, payments made in settlement of payment card and
third party network transactions, and certain payments from fishing boat
operators. Real estate transactions are not subject to backup
withholding.
You will not be subject to backup withholding on payments you
receive if you give the requester your correct TIN, make the proper
certifications, and report all your taxable interest and dividends on your
tax return.
Payments you receive will be subject to backup withholding if:
1. You do not furnish your TIN to the requester,
2. You do not certify your TIN when required (see the instructions for
Part II for details),
3. The IRS tells the requester that you furnished an incorrect TIN,
4. The IRS tells you that you are subject to backup withholding
because you did not report all your interest and dividends on your tax
return (for reportable interest and dividends only), or
5. You do not certify to the requester that you are not subject to
backup withholding under 4 above (for reportable interest and dividend
accounts opened after 1983 only).
Certain payees and payments are exempt from backup withholding.
See Exempt payee code, later, and the separate Instructions for the
Requester of Form W-9 for more information.
Also see Special rules for partnerships, earlier.
What is FATCA Reporting?
The Foreign Account Tax Compliance Act (FATCA) requires a
participating foreign financial institution to report all United States
account holders that are specified United States persons. Certain
payees are exempt from FATCA reporting. See Exemption from FATCA
reporting code, later, and the Instructions for the Requester of Form
W-9 for more information.
Updating Your Information
You must provide updated information to any person to whom you
claimed to be an exempt payee if you are no longer an exempt payee
and anticipate receiving reportable payments in the future from this
person. For example, you may need to provide updated information if
you are a C corporation that elects to be an S corporation, or if you no
longer are tax exempt. In addition, you must furnish a new Form W-9 if
the name or TIN changes for the account; for example, if the grantor of a
grantor trust dies.
Penalties
Failure to furnish TIN. If you fail to furnish your correct TIN to a -
requester, you are subject to a penalty of $50 for each such failure
unless your failure is due to reasonable cause and not to willful neglect.
Civil penalty for false information with respect to withholding. If you
make a false statement with no reasonable basis that results in no
backup withholding, you are subject to a $500 penalty.
Form W-9'(Rev.10-2018)
Criminal penalty for falsifying information. Willfully falsifying
certifications or affirmations may subject you to criminal penalties
including fines and/or imprisonment.
Misuse of TINs. If the requester discloses or uses TINs in violation of
federal law, the requester may be subject to civil and criminal penalties.
Specific Instructions
Line 1
You must enter one of the following on this line; do not leave this line
blank. The name should match the name on your tax return.
If this Form W-9 is for a joint account (other than an account
maintained by a foreign financial institution (FFI)), list first, and then
circle, the name of the person or entity whose number you' entered in
Part I of Form W-9. If you are providing Form W-9 to an FFI to document
a joint account, each holder of the account that is a U.S. person must
provide a Form W-9.
a. Individual. Generally, enter the name shown on your tax return. If
you have changed your last name without informing the Social Security
Administration (SSA) of the name change, enter your first name, the last
name as shown on your social security card, and your new last name.
Note: ITIN applicant: Enter your individual name as it was entered on
your Form W-7 application, line 1 a. This should also be the same as the
name you entered on the Form 1040/1040A/1040EZ you filed with your
application.
b. Sole proprietor or single -member LLC. Enter your individual
name as shown on your 1040/1040A/1040EZ on line 1. You may enter
your business, trade, or "doing business as" (DBA) name on line 2.
c. Partnership, LLC that is not a single -member LLC, C
corporation, or S corporation. Enter the entity's name as shown on the
entity's tax return on line 1 and any business, trade, or DBA name on
line 2.
d. Other entities. Enter your name as shown on required U.S. federal
tax documents on line 1. This name should match the name' shown on the
charter or other legal document creating the entity. You may enter any
business, trade, or DBA name on line 2.
e. Disregarded entity. For U.S. federal tax purposes, an entity that is
disregarded as an entity separate from its owner is treated as a
"disregarded entity." See Regulations section 301.7701-2(c)(2)(iii). Enter
the owner's name on line 1. The name of the entity entered on line 1
should never be a disregarded entity. The name on line 1 should be the
name shown on the income tax return on which the income should be
reported. For example, if a foreign LLC that is treated as a disregarded
entity for U.S. federal tax purposes has a single owner that is a U.S.
person, the U.S. owner's name is required to be provided on line 1. If
the direct owner of the entity is also a disregarded entity, enter the first
owner that is not disregarded for federal tax purposes. Enter the
disregarded entity's name on line 2, "Business name/disregarded entity
name." If the owner of the disregarded entity is a foreign person, the
owner must complete an appropriate Form W-8 instead of a Form W-9.
This is the case even if the foreign person has a U.S. TIN.
Line 2
If you have a business name, trade name, DBA name, or disregarded
entity name, you may enter it on line 2.
Line 3
Check the appropriate box on line 3 for the U.S. federal tax
classification of the person whose name is entered on line 1. Check only
one box on line 3.
Page 3
IF the entity/person on line 1 is
THEN check the box for ....
a(n)...
• Corporation
Corporation
• Individual
Individual/sole proprietor or single-
• Sole proprietorship, or
member LLC
• Single -member limited liability
company (LLC) owned by an
individual and disregarded for U.S.
federal tax purposes.
• LLC treated as a partnership for
Limited liability company and enter
U.S. federal tax purposes,
the appropriate tax classification.
• LLC that has filed Form 8832 or
(P= Partnership; C= C corporation;
2553 to be taxed as a corporation,
or S= S corporation)
or
• LLC that is disregarded as an
entity separate from its owner but
the owner is another LLC that is
not disregarded for U.S. federal tax
purposes.
• Partnership
Partnership
• Trust/estate
Trust/estate
Line 4, Exemptions
If you are exempt from backup withholding and/or FATCA reporting,
enter in the appropriate space on line 4 any code(s) that may apply to
you.
Exempt payee code.
• Generally, individuals (including sole proprietors) are not exempt from
backup withholding.
• Except as provided below, corporations are exempt from backup
withholding for certain payments, including interest and dividends.
• Corporations are not exempt from backup withholding for payments
made in settlement of payment card or third party network transactions.
• Corporations are not exempt from backup withholding with respect to
attorneys' fees or gross proceeds paid to attorneys, and corporations
that provide medical or health care services are not exempt with respect
to payments reportable on Form 1099-MISC.
The following codes identify payees that are exempt from backup
withholding. Enter the appropriate code in the space in line 4.
1—An organization exempt from tax under section 501(a), any IRA, or
a custodial account under section 403(b)(7) if the account satisfies the
requirements of section 401(f)(2)
2—The United States or any of its agencies or instrumentalities
3—A state, the District of Columbia, a U.S. commonwealth or
possession, or any of their political subdivisions or instrumentalities
4—A foreign government or any of its political subdivisions, agencies,
or instrumentalities
5—A corporation
6—A dealer in securities or commodities required to register in the
United States, the District of Columbia, or a U.S. commonwealth or
possession
7—A futures commission merchant registered with the Commodity
Futures Trading Commission
8—A realestate investment trust
9—An entity registered at all times during the tax year under the
Investment Company Act of 1940
10—A common trust fund operated by a bank under section 584(a)
11—A financial institution
12—A middleman known in the investment community as a nominee or
custodian
13—A trust exempt from tax under section 664 or described in section
4947
Form W-9 (Rev. 10-2018)
The following chart shows types of payments that may be exempt
from backup withholding. The chart applies to the exempt payees listed
above, 1 through 13.
IF the payment is for ...
THEN the payment is exempt
for...
Interest and dividend payments
All exempt payees except
for 7
Broker transactions
Exempt payees 1 through 4 and 6
through 11 and all C corporations.
S corporations must not enter an
exempt payee code because they
are exempt only for sales of
noncovered securities acquired
prior to 2012.
Barter exchange transactions and
Exempt payees 1 through 4
patronage dividends
Payments over $600 required to be
Generally, exempt payees
reported and direct sales over
1 through 52
$5,000'
Payments made in settlement of
Exempt payees 1 through 4
payment card or third parry network
transactions
See Form 1099-MISC, Miscellaneous Income, and its instructions.
2 However, the following payments made to a corporation and
reportable on Form 1099-MISC are not exempt from backup
withholding: medical and health care payments, attorneys' fees, gross
proceeds paid to an attorney reportable under section 6045(% and
payments for services paid by a federal executive agency.
Exemption from FATCA reporting code. The following codes identify
payees that are exempt from reporting under FATCA. These codes
apply to persons submitting this form for accounts maintained outside
of the United States by certain foreign financial institutions. Therefore, if
you are only submitting this form for an account you hold in the United
States, you may leave this field blank. Consult with the person
requesting this form if you are uncertain if the financial institution is
subject to these requirements. A requester may indicate that a code is
not required by providing you with a Form W-9 with "Not Applicable" (or
any similar indication) written or printed on the line for a FATCA
exemption code.
A—An organization exempt from tax under section 501(a) or any
individual retirement plan as defined in section 7701(a)(37)
B—The United States or any of its agencies or instrumentalities
C—A state, the District of Columbia, a U.S. commonwealth or
possession, or any of their political subdivisions or instrumentalities
D—A corporation the stock of which is regularly traded on one or
more established securities markets, as described in Regulations
section 1.1472-1(c)(1)(i)
E—A corporation that is a member of the same expanded affiliated
group as a corporation described in Regulations section 1. 1472-1 (c)(1)(i)
F—A dealer in securities, commodities, or derivative financial
instruments (including notional principal contracts, futures, .forwards,
and options) that is registered as such under the laws of the United
States or any state
G—A real estate investment trust
H—A regulated investment company as defined in section 851 or an
entity registered at all times during the tax year under the Investment
Company Act of 1940
I—A common trust fund as defined in section 584(a)
J—A bank as defined in section 581
K—A broker
L—A trust exempt from tax under section 664 or described in section
4947(a)(1)
Page 4
M—A tax exempt trust under a section 403(b) plan or section 457(8)
plan
Note: You may wish to consult with the financial institution requesting
this form to determine whether the FATCA code and/or exempt payee
code should be completed.
Line 5
Enter your address (number, street, and apartment or suite number).
This is where the requester of this Form W-9 will mail your information
returns. If this address differs from the one the.requester already has on
file, write NEW at the top. If a new address is provided, there is still a
chance the old address will be used until the payor changes your
address in their records.
Line 6
Enter your city, state, and ZIP code.
Part I. Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. If you are a resident alien and
you do not have and are not eligible to get an SSN, your TIN is your IRS
individual taxpayer,identification number (ITIN). Enter it in the social
security number box. If you do not have an ITIN, see How to get a TIN
below.
If you are a sole proprietor and you have an EIN, you may enter either
your SSN or EIN.
If you are a single -member LLC that is disregarded as an entity
separate from its owner, enter the owner's SSN (or EIN, if the owner has
one). Do not enter the disregarded entity's EIN. If the LLC is classified a:
a corporation or partnership, enter the entity's EIN.
Note: See What Name and Number To Give the Requester, later, for
further clarification of name and TIN combinations.
How to get a TIN. If you do not have a TIN, apply for one immediately.
To apply for an SSN, get Form SS -5, Application for a Social Security
Card, from your local SSA office or get this form online at
www.SSA.gov. You may also get this form by calling 1-800-772-1213.
Use Form W-7, Application for IRS Individual Taxpayer Identification
Number, to apply for an ITIN, or Form SS -4, Application for Employer
Identification Number, to apply for an EIN. You can apply for an EIN
online by accessing the IRS website at www.irs.gov/Businesses and
clicking on Employer Identification Number (EIN) under Starting a
Business. Go to wwwdrs.gov/Forms to view, download, or print Form
W-7 and/or Form SS -4. Or, you can go to.www.irs.gov/OrderForms to
place an order and have Form W-7 and/or SS -4 mailed to you within 10
business days.
If you are asked to complete Form W-9 but do not have a TIN, apply
for a TIN and write "Applied For" in the space for the TIN, sign and date
the form, and give it to the requester. For interest and dividend
payments, and certain payments made with respect to readily tradable
instruments, generally you will have 60 days to get a TIN and give it to
the requester before you are subject to backup withholding on
payments. The 60 -day rule does not apply to other types of payments.
You will be subject to backup withholding on all such payments until
you provide your TIN to the requester.
Note: Entering "Applied For" means that you have already applied for a
TIN or that you intend to apply for one soon.
Caution: A disregarded U.S. entity that has a foreign owner must use
the appropriate Form W-8.
Part II. Certification
To establish to the withholding agent that you are a U.S. person, or
resident alien, sign Form W-9. You may be requested to sign by the
withholding agent even if item 1, 4, or 5 below indicates otherwise.
For a joint account, only the person whose TIN is shown in Part I
should sign (when required). In the case of a disregarded entity, the
person identified on line 1 must sign. Exempt payees, see Exemptpayee
code, earlier.
Signature requirements. Complete the certification as indicated in
items 1 through 5 below.
Form W-9 (Rev. 10-2018)
1. Interest, dividend, and barter exchange accounts opened
before 1984 and broker accounts considered active during 1983.
You must give your correct TIN, but you do not have to sign the
certification.
2. Interest, dividend, broker, and barter exchange accounts
opened after 1983 and broker accounts considered inactive during
1983. You must sign the certification or backup withholding will apply. If
you are subject to backup withholding and you are merely providing
your correct TIN to the requester, you must cross out item 2 in the
certification before signing the form.
3. Real estate transactions. You must sign the certification. You may
cross out item 2 of the certification.
4. Other payments. You must give your correct TIN, but you do not
have to sign the certification unless you have been notified that you
have previously given an incorrect TIN. "Other payments" include
payments made in the course of the requester's trade or business for
rents; royalties, goods (other than bills for merchandise), medical and
health care services (including payments to corporations), payments to
a nonemployee for services, payments made in settlement of payment
card and third party network transactions, payments to certain fishing
boat crew members and fishermen, and gross proceeds paid to
attorneys (including payments to corporations).
5. Mortgage interest paid by you, acquisition or abandonment of
secured property, cancellation of debt, qualified tuition program
payments (under section 529), ABLE accounts (under section 529A),
IRA, Coverdell ESA, Archer MSA or HSA contributions or
distributions, and pension distributions. You must give your correct
TIN, but you do not have to sign the certification.
What Name and Number To Give the Requester
For this type of account: I Give name and SSN of:
1. Individual
2. Two or more individuals Qoint
account) other than an account
maintained by an FFI
3. Two or more U.S. persons
(joint account maintained by an FFI)
4. Custodial account of a minor
(Uniform Gift to Minors Act)
5. a. The usual revocable savings trust
(grantor is also trustee)
b. So-called trust account that is not
a legal or valid trust under state law
6. Sole proprietorship or disregarded
entity owned by an individual
7. Grantor trust filing under Optional
Form 1099 Filing Method 1 (see
Regulations section 1.671-4(b)(2)()
(A))
The individual
The actual owner of the account or, if
combined funds, the first individual on
the account
Each holder of the account
Page 5
For this type of account: I Give name and EIN of:
14. Account with the Department of The public entity
Agriculture in the name of a public
entity (such as a state or local .
government, school district, or
prison) that receives agricultural
program payments
15. Grantor trust filing under the Form The trust
1041 Filing Method or the Optional
Form 1099 Filing Method 2 (see
Regulations section 1.671-4(b)(2)(i)(B))
' List first and circle the name of the person whose number you furnish.
If only one person on a joint account has an SSN, that person's number
must be furnished.
2 Circle the minor's name and furnish the minor's SSN.
3 You must show your individual name and you may also enter your
business or DBA name on the "Business name/disregarded entity"
name line. You may use either your SSN or EIN (if you have one), but the
IRS encourages you to use your SSN.
° List first and' circle the name of the trust, estate, or pension trust. (Do
not furnish the TIN of the personal representative or trustee unless the
legal entity itself is not designated in the account title.) Also see Special
rules for partnerships, earlier.
*Note: The grantor also must provide a Form W-9 to trustee of trust.
Note: If no name is circled when more than one name is listed, the
number will be considered to be that of the first name listed.
Secure Your Tax Records From Identity Theft.
Identity theft occurs when someone uses your personal information
such as your name, SSN, or other identifying information, without your
permission, to commit fraud or other crimes. An identity thief may use
your SSN to get a job or may file a tax return using your SSN to receive
a refund.
To reduce your risk:
• Protect your SSN,
The minor2 • Ensure your employer is protecting your SSN, and
• Be careful when choosing a tax preparer.
The grantor -trustee' If your tax records are affected by identity theft and youreceive a
notice from the IRS, respond right away to the name and phone number
The actual owner printed on the IRS notice or letter.
If your tax records are not currently affected by identity theft but you
The owner3 think you are at risk due to a lost or stolen purse or wallet, questionable
credit card activity or credit report, contact the IRS Identity Theft Hotline
The grantor* at 1-800-908-4490 or submit Form 14039.
For this type of account:
Give name and EIN of:
8. Disregarded entity not owned by an
The owner
individual
9. A valid trust, estate, or pension trust
Legal entity"
10. Corporation or LLC electing
The corporation
corporate status on Form 8832 or
Form 2553
11. Association, club, religious,
The organization
charitable, educational, or other tax-
exempt organization
12. Partnership or multi -member LLC
The partnership
13. A broker or registered nominee
The broker or nominee
For more information, see Pub. 5027, Identity Theft Information for
Taxpayers.
Victims of identity theft who are experiencing economic harm or a
systemic problem, or are seeking help in resolving tax problems that
have not been resolved through normal channels, may be eligible for
Taxpayer Advocate Service (TAS) assistance. You can reach TAS by
calling the TAS toll-free case intake line at 1-877-777-4778 or TTY/ TDD
1-800-829-4059.
Protect yourself from suspicious emails or phishing schemes.
Phishing is the creation and use of email and websites designed to
mimic legitimate business emails and websites. The most common act
is sending an email to a user falsely claiming to be an established
legitimate enterprise in an attempt to scam the user into surrendering
private information that will be used for identity theft.
f �
Form W-9 (Rev. 10-2018) Page 6
The IRS does not initiate contacts with taxpayers via emails. Also, the
IRS does not request personal detailed information through email or ask
taxpayers for the PIN numbers, passwords, or similar secret access
information for their credit card, bank, or other financial accounts.
If you.receive an unsolicited email claiming to be from the IRS, .
forward this message to phishing@irs.gov. You may also report misuse
of the IRS name, logo, or other IRS property to the Treasury Inspector
General for Tax Administration (TIGTA) at 1-800-366-4484. You can
forward suspicious emails to the Federal Trade Commission at
spam@uce.gov or report them at www.ftc.gov/complaint. You rcan
contact the FTC at www.ftc.gov/idtheft or 877-IDTHEFT (877-438-4338).
If you have been the victim of identity theft, see.www.1dentityTheft.gov
and Pub. 5027.
Visit www.irs.govIldentityTheft to learn more about identity theft and
how to reduce your risk.
Privacy Act Notice
Section 6109 of the Internal Revenue Code requires you to provide your
correct TIN to persons (including federal agencies) who are required to
file information returns with the IRS to report interest, dividends, or
certain other income paid to you; mortgage interest you paid; the
acquisition or abandonment of secured property; the cancellation of
debt; or contributions you made to an IRA, Archer MSA, or HSA. The
person collecting this form uses the information on the form to file
information returns with the IRS, reporting the above information.
Routine uses of this information include giving it to the Department of
Justice for civil and criminal litigation and to cities, states, the District of
Columbia, and U.S. commonwealths and possessions for use in
administering their laws. The information also may be disclosed to other
countries under a treaty, to federal and state agencies to enforce civil
and criminal laws, or to federal law enforcement and intelligence
agencies to combat terrorism. You must provide your TIN whether or
not you are required to file a tax return. Under section 3406, payers
must generally withhold a percentage of taxable interest, dividend, and
certain other payments to a payee who does not give a TIN to the payer.
Certain penalties may also apply for providing false or fraudulent
information.