HomeMy WebLinkAboutADDENDUM 1 - REVISED FORMADDENDUM # 1
REVISION – “ATTACHMENT C” AND “CONFLICT OF INTEREST” AFFIDAVIT
DATE: SEPTEMBER 25, 2026
TO: ALL PLANHOLDERS
FROM: GENESIS CUEVAS, PROCUREMENT DIRECTOR
RFP NO.: RFP # 26-09-01 TOWING & STORAGE SERVICES
SUBJECT: ADDENDUM NO. 1
PLEASE NOTE RECEIPT OF THIS ADDENDUM BY COMPLETING
ACKNOWLEDGEMENT OF ADDENDA’ WITH YOUR PROPOSAL’S SUBMISSION.
PROPOSERS MUST USE THE
SE REVISED FORMS
WITH THEIR PROP
OSAL SUBMISSION
Email address
Proposal for Towing Services
1. Business Name : --------
2. Business Address : _______________________ _
Phone : ________ City : __________ .Z ip: _____ _
Mailing Address: ________________________ _
City: ________________ .Z ip: _____ _
State type of business enterprise (e.g. corporation, association, partnership , organization, joint venture ,
trust, foundation, firm , group, soc iety , individual natural person, etc .):
3. NAME ALL OWNERS , OFFICERS , AND PERSONS HAVING AN INTEREST IN THE TOWING AGENCY :
(Attach additional sheets if necessary)
a. NAME SS#
ADDRESS PHONE
CITY STATE BIRTHDATE
b. NAME SS#
ADDRESS PHONE
CITY STATE BIRTHDATE
C. NAME SS#
ADDRESS PHONE
CITY STATE BIRTHDATE
d. NAME SS#
ADDRESS PHONE
CITY STATE BIRTHDATE
e. NAME SS#
ADDRESS PHONE
CITY STATE BIRTH DATE
4. Has the business enterprise , or any person whose name appears in this application, ever been convicted of any
crime?
If so, list the name , the arrest and conviction record of each person :
(Attach Additional sheets if necessary)
5. If a corporation , supply the following :
A TT A C.HMF.NT "C'" 25
Office
Office
Office
Office
Office
Corporate Name : _________________________ _
Date Incorporated: _____________ State of Charter: ______ _
6. What is the fictitious name under which the business will be conducted (if applicable): ____ _
7. Has this business ever been suspended, revoked or been the subject of suspension, revocation or
violation of Local, County, or State Law?
8. How many wreckers does the towing agency have in each class?
Refer to Equipment Requirements of specifications for class description
CLASS A WRECKER
CLASS A SLIDE BACK CARE CARRIER ___ _
CLASS B WRECKER
CLASS B SLIDE BACK CAR CARRIER
CLASS C WRECKER
CLASS D WRECKER
OTHER: (DESCRIPTION AND NUMBER) ____________ _
Please provide complete information for each wrecker on the attached equipment form.
9.Do you have any contracts with private companies within the City of Sunny Isles Beach? ______
If so, list all including the name and phone number of your contact at these companies: ___ _
10. Has the towing agency filed for insolvency, reorganization or bankruptcy petition (voluntary or involuntary)?
11. List five (5) references preferably public agencies with current or past contracts: AGENCY CONTACT
TELEPHONE
12. How long has this towing agency been in the towing business?
26
21.List below and identify the personnel, address, telephone number and storage capacity
(inside and outside) of Subcontractor(s) proposed for the contract:
13. How long have the owner(s), listed in item 3, been in the towing business? (List by name)
14 . Are the payment office and the storage facility located at the same site? ________ _
15 . Prov ide the address of the payment office:
16 . Provide the address of the storage facility; indicate how many outside storage spaces are at this facility and
how many inside storage spaces: Address: __________________ _
Outside: _____________ Inside: ____________ _
17 . Is the towing agency located entirely within the City of North Miami Beach limits? ______ _
18 . Enclose a copy of your license(s), Cert ificate of Use and Occupancy , proof of ownership or first party
lease of all facilities , Certificates of Insurance , and ev idence of ownership or valid first party lease of the
wreckers and slide back earners that will be uti lized to perform the services .
19 . Complete the attached personnel form including all the employees to be util ized in performance of the contract
work .
20. Please attach a narrative statement to describe the Proposer's ability to meet or exceed all request for
proposal requirements, the capacity to perform the services specified , and the Proposes ability and
commitment to respond in emergency situations.
27
CONFLICT OF INTEREST
City of Sunny Isles Beach
18070 Collins Avenue
Sunny Isles Beach, FL 33160
Telephone: (305) 947-0606 Fax: (305) 949-3113
CONFLICT OF INTEREST STATEMENT
The award of any contract hereunder is subject to the provisions of Chapter 112, Florida State Statutes. Proposers must
disclose with their Bids, the name of any officer, director, partner, associate or agent who is also an officer or employee of the
City of Sunny Isles Beach or its agencies.
STATE OF FLORIDA
COUNTY OF ___________________
BEFORE ME, the undersigned authority, personally appeared _____________________________, who was duly sworn,
deposes, and states:
1. I am the _________________________________________________ of
__________________________________with a local office in _____________________________ and principal office in
_____________________.
2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, RFP No. 26-09-01 described as:
Towing & Storage Services The affiliate has made diligent inquiry and provides the information contained in this
Affidavit based upon his own knowledge.
3 The Affiant states that only one submittal for the above Bid is being submitted and that the above named entity has
no financial interest in other entities submitting Bids for the same project.
4. Neither the Affiant nor the above named entity has directly or indirectly entered into any agreement, participated in
any collusion, or otherwise taken any action in restraints of free competitive pricing in connection with the entity’s submittal for
the above Bid. This statement restricts the discussion of pricing data until the completion of negotiations if necessary and
execution of the Contract for this project.
5. Neither the entity nor its 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.
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.
7. I certify that no member of the entity’s ownership or management is presently applying for any employee position or
actively seeking an elected position with the City of Sunny Isles Beach.
8. I certify that no member of the entity’s ownership or management, or staff has a vested interest in any aspect of the City of
Sunny Isles Beach.
9. In the event that a conflict of interest is identified in the provision of services, I, on behalf of the above named entity, will
immediately notify the City of Sunny Isles Beach.
Dated this _________ day of _____________________________________, 2026.
_________________________________ _________________________________
AFFIANT Print or Type Name and Title
Sworn to and subscribed before me this _____ day of ______________________, 2026.
Personally Known ________ OR
Produced Identification ________; Type of Identification _________________________
__________________________________
NOTARY PUBLIC STATE OF FLORIDA