HomeMy WebLinkAboutBureau Veritas N.A. Inc.
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BUREAU VERITAS NORTH AMERICA INC
STATEMENT OF QUALIFICA TIONS
EcelVED
JUN f 9 2009 -t:c.
1. HISTORY OF THE FIRM AND KEY MANAGE Ett!~r::~'8l18d1 \~'
Throughout its long and acclaimed history, Bureau Veritas has been recognized worldwide as Clerk
unbiased, reputable and independent source wherever expert judgment is sought. Beginning in 1828,
Bureau Veritas provided assessment services as to a vessel's seaworthiness, as well as the
condition of its equipment and the quality of its crew. Within two years, Bureau Veritas had
compiled a register of more that 10,000 vessels. In that year, Bureau Veritas opened an office in
Paris, France, which resulted in being Bureau Veritas Headquarters to this day.
By the turn of the century, Bureau Veritas recognized the growing industrialization and the need for
quality, health, and safety assessment services among the world's industries. Bureau Veritas
acquired U.S. Laboratories in the United States and united the most qualified, experienced, and
successful building inspection, plan review, geotechnical, environmental, construction materials
testing firms throughout the Unites States. With over 25 years of experience in Miami-Dade County,
Intercounty Laboratories-USL, Inc. (Intercounty) in North Miami Beach joined the Bureau Veritas
family in 2003. Therefore, Bureau Veritas is local, but is backed by over 20,000 technical,
professional and support personnel worldwide.
Alexander A. Hockman, P.E. is the former owner of Intercounty and is Chief Operating Officer for the
Testing and Inspections Division (CMT) of Bureau Veritas. His responsibility is to provide corporate
representation over the entire U.S. operation including representation for this important contract with
the City. Our Project Team is led by our Project Manager (Single Point of Dedicated Contact),
Steve Black, P.E., His office is located in North Miami Beach and he can be reached at 786-
248-3180. Mr. Black has over 30 years of experience and will be responsible for overseeing the
entire project and offering his expertise in Building Code Inspection services. Our project manager will
be supported by our Threshold Engineer, Terri Bailey, P.E. who has over 25 years of engineering
experience. Our Contract Administrator, Jason D. Hill, will be the liaison between the City and
Bureau Veritas. As a Bureau Veritas Senior Executive, Mr. Hill has over 15 years of experience and
has the authority to direct the appropriate resources to execute the contract with the City.
2. A SUMMARY OF ANY COMPANY CHANGES
Bureau Veritas has an excellent record of responsibility, performance, integrity, financial strength,
personnel and equipment resources and does not anticipate any changes that would impact the
timely completion and quality of services of the project.
Bureau Veritas North America, Inc. · 308 NW 170 Street · North Miami Beach, FL, 33169 1
Phone +1 (786) 248-3180 · Fax +1 (786) 248-3190. www.us.bureauveritas.com
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..B U REA U
VERITAS
RFQ NO. 09-05-01
THRESHOLD INSPECTION SERVICES
FOR THE HERITAGE PARK PARKING GARAGE
3.
LOCATION OF OFFICES
* Bureau Veritas Offices
,-'
. ,."'~I' ".
o
Ft. Lauderdale Office (21.1 miles from SIB)
Corporate Office
11860 West State Road 84, Suite 1
Fort Lauderdale, FL 33325
954-236-8100
4:) Tampa
\
~ Ft. Myers l
City of Sunny Isles Beach (SIB)
o
Miami Office (7.5 miles from SIB)
Divisional Office
308 NW 170 Street
North Miami Beach, FL 33160
(786) 248-3180
o Ft. Myers Office (141 miles from SIB)
Divisional Office
13851 Plantation Rd
Ft Myers, Florida 33912
(239) 278-0939
4.
LOCATION OF PROJECT OFFICE
Bureau Veritas' local and project office is located in North Miami Beach (only 7.5 miles from
Sunny Isles Beach) at 308 NW 170 Street, North Miami Beach, FL 33169. This office has served
as the main office and testing laboratory for Intercounty (now Bureau Veritas) for over 20 years,
serving clients such as:
· City of North Miami Beach
· City of Dania Beach
Bureau Veritas North America, Inc. · 308 NW 170 Street · North Miami Beach, FL, 33169 2
Phone +1 (786) 248-3180 · Fax +1 (786) 248-3190. www.us.bureauveritas.com
o Jupiter Office (77.2 miles from SIB)
Divisional Office
1001 Jupiter Park Dr. Suite 118
Jupiter, Florida 33458
(561) 746-7698
o Tampa Office (272 miles from SIB)
Divisional Office
3710 Corporex Park Drive, Ste 220
Tampa, FL 33619
813-630-1680
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~8 U REA U~
VERITAS
.'>.'~~''- '-'
RFQ NO. 09-05-01
THRESHOLD INSPECTION SERVICES
FOR THE HERITAGE PARK PARKING GARAGE
. City of Hollywood
. City of Ft. Lauderdale
. City of Coral Gables
. City of Miami
. Miami Dade County
. Broward County
. Palm Beach County
In addition, our project office will be supported by our other offices in Ft. Lauderdale, Jupiter, Ft.
Myers and Tampa; which have the capacity to quickly respond to additional personnel and
resources on our projects at a moments notice.
5.
STATE CERTIFICATION FOR THRESHOLD INSPECTION
Bureau Veritas North America, Inc. Professional Engineer's License
~tate of 1JHnri~l1
Board of PJofessional Engineers
Bureau Veritas Nofth,.Km~rica, Inc.
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:=: ..1'1 ""E:I
Is authorized under the provisions of Sectiorf'~71,JX23rFbrida Statutes, to offer engineering services
to the public through a Professional Engirieer. duly licensed under Chapter 471, Florida Statutes.
Expiration: 28-FEB-11
Audit No: 22820112856
Certificate of Authorization
CANo:
26917
DISPLAY AS REQUIRED BY LAW
Terri Bailey's Professional Engineer's/lnspector License
,\at~ ;!l!Lann<t
Board of l ' ~. ,~G~~ngineers
i~~ ~!ff^~u1i~I:;}
Ther::.~~~:.E. .
>,.; >~or\l~
Is licensed as a Professional EngiffeeruiiCler Chapter 471, Florida Statutes
Expiration: 28-FEB-11 P. E. Lie. .No: 42462
Audit No: 228201122737 SI 51 Lie. No: 902
DISPLAY AS REQUIRED BY LAW
Bureau Veritas North America, Inc. · 308 NW 170 Street · North Miami Beach, FL, 33169 3
Phone +1 (786) 248-3180 · Fax +1 (786) 248-3190. www.us.bureauveritas.com
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;B U REA U
VERITAS
RFQ NO. 09-05-01
THRESHOLD INSPECTION SERVICES
FOR THE HERITAGE PARK PARKING GARAGE
6. YEARS OF EXPERIENCE AS A THRESHOLD INSPECTOR
Ms. Bailey has over 25 years of experience as an engineer and 19 years of performing threshold
inspections; as referenced in the Florida Department of Business and Professional Regulation
website.
Ucense Information
Ucense Type:
Rank:
Ucense Number:
Professional Engineer
Prof Engineer
42462
Current, Active
02/22/1990
02/28/2011
Status:
Ucensure Date:
Expires:
Spedal Qualifications
Building Code Core Course
Credit
Special Inspector
Qualification Effective
10/23/1990
7. PROJECT EXPERIENCE
THRESHOLD INSPECTIONS
MIRAMAR BEACH PARKING STRUCTURE
Threshold Inspections were performed for the recently completed project consisting of the
construction of a pile-supported parking structure adjacent to the beach on Old Scenic Route 98.
The site was destroyed by Hurricane Dennis in 2005.
Contact: Jonathan T. Armbruster, P.E.
Taylor Engineering, Inc.
9000 Cypress Green Drive
Jacksonville, FL 32256
Phone: (904) 731-7040
MIAMI INTERNATIONAL AIRPORT - NORTH TERMINAL
Threshold Inspections were performed on several projects on the North Terminal Project at Miami
International Airport which consisted of 50 passenger gates, an automated people mover system,
baggage handling system and other amenities (approximately 1.3 miles in length).
Contact: Enrique Perez
Miami Dade Aviation
4200 NW 36th Ave
Miami, FL 33142
(305) 876-7077
DGN TOWER
Threshold Inspections were performed for the 4-story building for Miami Jewish and Home and
Hospitals.
Contact: Sandy Miot
The Miami Jewish Home and Hospital
5200 NE 2nd Avenue
Miami, FL 33137
(305) 751-8626
Bureau Veritas North America, Inc. · 308 NW 170 Street · North Miami Beach, FL, 33169 4
Phone + 1 (786) 248-3180 · Fax +1 (786) 248-3190. www.us.bureauveritas.com
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illS U REA U
VERITAS
RFQ NO. 09-05-01
THRESHOLD INSPECTION SERVICES
FOR THE HERITAGE PARK PARKING GARAGE
CHARLOTTE HIGH SCHOOL
Threshold Inspections were performed for the historic property which was established in 1926.
This historic property was damaged by Hurricane Charley in 2004 and has been restored and
improved with existing structures of approximately 150,000 square feet and an additional 240,000
square feet of new construction. In addition, Bureau Veritas has performed Threshold and
Building Code Inspection services for Charlotte County Public Schools since 2003.
Contact: Jerry Olivo
Interim Asst. Superintendent
1016 Education Avenue
Punta Gorda, FL 33950
(941) 255-0808
HAMPTON INN
Threshold Inspections were performed for the five story hotel.
Contact: Larry Wheeler
Naples Hotel Development
2630 Northbrooke Plaza Dr
Naples, FL 34119
(239) 596-1299
ADDITIONAL THRESHOLD INSPECTION PROJECTS
. HEIGHTS ELEMENTARY - 850 students capacity
. MARCO ISLAND CHARTER - 2 story academic building, arts building (69,000 SF)
. SPRING HILL SUITES - 4 story building with 106 rooms
ADDITIONAL PARKING GARAGE PROJECTS: INSPECTIONS AND/OR PLAN REVIEW
AND/OR OC/OA TESTING
. GILROY POLICE STATION AND TWO-
STORY PARKING GARAGE
. 151 MADISON AVENUE PARKING
GARAGE
. ATLANTIC STREET PARKING GARAGE
. AVALON CONCRETE GARAGE
BUILDING A
. AVENTURA MALL PARKING GARAGE
· BEARS STADIUM PARKING GARAGE
. BORGATA PARKING GARAGE
. BPG PARKING GARAGE EXPANSION
. CACHE CREEK PARKING GARAGE
DELTA
· CANCUN RESORT PARKING GARAGE
. CINEMA PLACE PARKING GARAGE
. COLUMBIA PUBLIC PARKING GARAGE
. CSA PARKING GARAGE
. DET. COMM. BANK / SECOND CITY
PARKING GARAGE
. DUPONT HOSPITAL PARKING GARAGE
. FARAH PLAZA PARKING GARAGE
. GOVT. CENTER PARKING GARAGE
. INTEL PARKING GARAGE
. JOHN MUIR PARKING GARAGE
. KIRKWOOD TOWERS PARKING
GARAGE
. PDC PARKING GARAGE
. MET 1 PARKING GARAGE
. METZGER PARKING GARAGE
Bureau Veritas North America, Inc. · 308 NW 170 Street · North Miami Beach, FL, 33169 5
Phone +1 (786) 248-3180 · Fax +1 (786) 248-3190. www.us.bureauveritas.com
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THRESHOLD AND BUILDING CODE INSPECTION EXPERIENCE
BROW ARD COUNTY PUBLIC SCHOOLS
1700 SW 17 Court
Ft. Lauderdale, FL 33312
(754) 321-1505
Michael Garrettson, Deputy Superintendent
Ronald Morgan, Chief Building Official
Project Description: Since 2003, BVNA has provided building code plan review, code
inspection, development review, materials testing/CMT and moisture intrusion detection services
to the School Board of Broward County.
SCHOOL DISTRICT OF LEE COUNTY
3308 Canal Street
Ft. Myers, FL 33916
(239) 479-4201
Reggie Snell, Director of Construction Services
Project Description: Since 2003, Bureau Veritas North America, Inc. has provided extensive
plan review and inspection services to the School District of Lee County.
MIAMI-DADE COUNTY PUBLIC SCHOOLS
1450 NE 2 Avenue, Rm. 305
Miami, FL 33132
(305) 995-2423
Nancy Tobin
Project Description: BVNA has provided Plan Review, Inspections, Geotechnical Engineering,
Construction Materials Testing, and Administration services to Miami-Dade County Public Schools
since 2003. Some of the projects completed under this contract include:
THE VILLAGE OF WELLINGTON
Jacek Tomasik, CBO
Building Official
Village of Wellington Building Division
Ph: 561.753.2505
Fax: 561. 791.4060
Email: jtomasik@cLwellington.fl.us
Project Description: Bureau Veritas North America, Inc. (BVNA) has provided Building Code
Compliance Plan Review services for the Village of Wellington for the past five years. BVNA was
just selected for an additional three year contract to continue providing these services.
Bureau Veritas North America, Inc. · 308 NW 170 Street · North Miami Beach, FL, 33169 6
Phone +1 (786) 248-3180 · Fax +1 (786) 248-3190. www.us.bureauveritas.com
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liB U REA UN
VERITAS
RFQ NO. 09-05-01
THRESHOLD INSPECTION SERVICES
FOR THE HERITAGE PARK PARKING GARAGE
8.
STATEMENT OF EXPERIENCE
The Threshold/Special Inspector responsible for qualifying the Threshold Inspections performed
by Bureau Veritas is Ms. Theresa M. Bailey, P.E. Ms. Bailey has over 25 years of experience as
an engineer and 19 years of performing threshold inspections. Ms. Bailey is an employee of
Bureau Veritas and is a Florida-licensed Professional Engineer (License No. 42462) and Special
Inspector (SI No. 0902). In addition, Ms. Bailey is backed by Florida Licensed Professional
Engineers and Licensed Building Inspectors to support the scope of services for the project as
referenced in the Florida Statutes:
Threshold Inspections shall be performed under the direction of a registered Professional
Engineer licensed in the State of Florida with a Special Inspector's license, pursuant to Chapter
471, Florida Statutes. Bureau Veritas Special Inspector may send a qualified and duly authorized
representative to perform threshold inspections on his/her behalf. Bureau Veritas employees who
will perform threshold inspections shall be licensed Building Inspectors, certified under Chapter
468, Florida Statutes, a licensed Professional Engineer certified under Chapter 471, Florida
States, a licensed Architect certified under Chapter 481, Florida Statutes, or a licensed Contractor
certified under Chapter 489, Florida Statutes. The following Bureau Veritas personnel are
authorized by Ms. Bailey to conduct Threshold Inspections:
Name
Mr. Wayne Smith
Mr. Vince Hines
Mr. Alan Jasin
Mr. Morris Tate
License No.
BN0002368
BN0005005
BN0003888
BN0005255
Experience
18
28
15
25
Qualification
Building Inspector
Building Inspector
Building Inspector
Building Inspector
Approach To PerforminQ Our Services
Bureau Veritas anticipates your project needs and responds with specific, immediate solutions to
the challenges associated with building inspections services. Consistency, responsiveness,
efficiency, and a positive attitude of our local staff are key components of our approach.
Timelv Initiation and Completion of All Work
Our experienced staff gives us the flexibility and experience to respond
quickly, but in a thorough manner so as not to sacrifice the time spent on
inspections. Because we are local, we can easily meet face to face with
the project participants and the City to start and complete the scope of
work in a timely manner, without sacrificing quality. The key to
establishing efficiency and timeliness is the communication among all
parties involved. Bureau Veritas is committed to establishing open lines
of communication with all parties to achieve this goal.
Our Commitment to Qualitv Control and Qualitv Assurance
In addition to code, Bureau Veritas provides comprehensive quality control and
quality assurance procedures to ensure compliance within our firm. This is
exemplified by our ISO 9001 :2000 certification worldwide. Our commitment
to maintaining professional integrity and quality processes will lead to an
overall level of service unmatched in the industry. This level of customer
services sets Bureau Veritas apart from our competition and will further
strengthen public perception.
ik-. Certificate ~
_!::~~::.R~:i~ration ~
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(Q) '1
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Bureau Veritas North America, Inc. · 308 NW 170 Street · North Miami Beach, FL, 33169 7
Phone +1 (786) 248-3180 · Fax +1 (786) 248-3190. www.us.bureauveritas.com
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MBUREAUoI
lV,E R I T AS
-
RFQ NO. 09-05-01
THRESHOLD INSPECTION SERVICES
FOR THE HERITAGE PARK PARKING GARAGE:
9. PROJECT WORKLOAD
For this important contract, Bureau Veritas has the staff and resources available for immediate
impact. Recently completed projects include: Miramar Beach Parking Garage, Capri on the Bay
Condominiums, Aventura Mall Parking Garage and Broward County - Fort Lauderdale-Hollywood
International Airport. Currently, our projects workload include: Miami Dade County Public
Schools (ongoing), The City of Sunrise and Miami International Airport MIC/MIA People Mover.
Due to the slow current economic conditions, we have no prospective large projects. Therefore,
our services for the Heritage Park Parking Garage will not be affected.
In addition, Mr. Hockman, Mr. Black, Ms. Bailey and Mr. Hill have all reviewed their current and
proposed future schedules and have determined that each will have sufficient availability to assist
with any services when required.
Bureau Veritas Key Personnel
2009 Six-Month Projected Workload
50
45
40
35
30
25
20
15
10
5
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10. RESPONSIBILITY: LICENSE, INSURANCE, FINANCIAL
Bureau Veritas operate in diversified markets, in all business sectors, for all sizes of companies,
and in all geographical zones and possesses unrivalled expertise and skills on a global scale in a
number of sectors of the economy. The diversified markets we operate are:
ri7
· Building & Facilities
· Energy and Process
Manufacturing
Transport and logistics
Marine
International Trade
· Consumer Products
Aeronautics & Space
Our diversity gives us a stability that explains the excellent financial results and continuous growth
since 1995. We are a global company recognized by many governments and public
authorities for some of our activities, but the wide range of value-added services to companies
around the world accounts for most of our revenue.
Bureau Veritas North America, Inc. · 308 NW 170 Street · North Miami Beach, FL, 33169 8
Phone +1 (786) 248-3180 · Fax +1 (786) 248-3190. www.us.bureauveritas.com
- -
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~BUREAU
VERITAS
RFQ NO. 09-05-01
THRESHOLD INSPECTION SERVICES
FOR THE HERITAGE PARK PARKING GARAGE
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Annual Revenue for Testing and Inspections in Florida:
2008 $ 8,145,991
2007 $ 10,103,776
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Financial Interest:
Bureau Veritas personnel do not have a financial interest in the firm.
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Business Information: Bureau Veritas is providing the name and contact information of the
financial officer of the firm responsible for providing financial information.
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Berta C. Alonso
CMT Financial Controller
Bureau Veritas - I&F North America
Office: 954-236-8100
Fax: 954-236-8101
Email: berta.alonso@us.bureauveritas.com
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Bonding Capability: Bureau Veritas can provide the necessary bonding capacity to meet the
requirements of the City.
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Occupational License
Florida Corporation Registration
Document #: F03000001638
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MlAMl-DADE COUNTY
TAX COllECTOR
140 W. FLAGLER ST.
14th FLOOR
fAIAMI, FL 33130
2001 LOCAL BUSINESS TAX RECEIPT 2009
MlAMl.oADE COUNlY . STAtE OF FLORIDA
EXPIRES SEPT. 30, 2009
MUST Bf DtSPLAYED AT PlACE OF BUSINESS
PURSUANT TO COUNT\' COOE CHAPTER SA . ART. I & to
THislsNaT A'BlU-OONOTPAY
ARST-Cl.ASI
u.s. POSTAGE
""0
I/IAM~ Fl
PERMIT NO. 231
State of Florida
Department of State
'I
522111-4
.""''O'R"lA'a''~~'R''ftl'rNORTH AHERICA IHC
308 NW 170 ST
33169 NORTH HIAI'II lEACH
RENEWAL
AECElPTNO, 147820-5
""1Ul!EAU VERITAS NORTH AHERICA INC
Socz'n" 'Ul!mt BUSINESS
NOT A CONTRACTORS RECEIPT
EMPLOYEE/S
29
I certify from the records of this office that BUREA U VERIT AS
NORTH AMERICA. INC. is a corporation organized under the laws of
Delaware, authorized to trans.act business in the State of Florida,
qualified on April I , 2003.
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DO NOT FORWARD
The document number of this corporation is f03000001638.
I further certify that said corporation has paid all fees due this office
through December 31, 2008, that its most recent annual report was filed
on April 17,2008, and its status is active
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BUREAU VERITAS NORTH AMERICA INC
ALEXANDER HOCKMAN PRES
308 NW 170 ST
N MIAMI 8CH FL 33169
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I further certify that said corporation has not filed a Certificate of
Withdrawal
SEf: OTHER SIDE
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Bureau Veritas North America, Inc. · 308 NW 170 Street · North Miami Beach, FL, 33169 9
Phone +1 (786) 248-3180 · Fax +1 (786) 248-3190. www.us.bureauveritas.com
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E;M
BUR E A UIIj
VERITAS
RFQ NO. 09-05-01
THRESHOLD INSPECTION SERVICES
FOR THE HERITAGE PARK PARKING GARAGE
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ACORo'M CERTIFICA TE OF LIABILITY INSURANCE I DATE IMMIDIlIVYYY)
3/112010 3/1 012009
PRODuceR Locklon Companies, LlC-R Florida THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
3601 SW I 60th Ave ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Suite 200 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Miram.r FL 33021
954.883.2000 INSURERS AFFORDING COVERAGE NAIC#
iNSURED Bureau Veril3s North America. Inc. INSURER A: Commerce and Industrv Insurance Company 19410
1312101 308NW 110Slrcet INSURER B: New Hamoshire Insurnnee Como.ny 23841
NOl1h Miami Beach FL 33169 INSURER C: Illinois National Insurance Company 23811
,NSURER 0: Granite State Insurance COl11oanv 23809
, INSURER E:
COVERAGES TE ~~~::,~~~::~:tp~C~~~:T~J~~~~~: ~~~~~E=~T~~~:~.INO
TfJE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
IHSR DO POLICY NUMBER ~..:-{~~~tc6&W,E Pgk'fl ~~N L1MIT$
LTR NSR TYPE OF INSURANCE
GENERAL LIABILITY EACH OCCURRENCE S I 000 000
- ~~~~g~~9F~~~nce)
A 2~tJ)M"'ERCIAL GENERAL UAB..,TY 6439313 3/112009 3/112010 S 1,000,000
_ CLAJMS MADE 0 OCCUR MEO exp fAnv one person $ 10,000
.! $10,000 Dedue,ible PERSONAL'& AnY INJURY $ 1,000,000
- GENERAL AGGREGATE S 2,000,000
GEN'l AGCREGA TE LIMIT APPLIES PER: PRODuCTS. COMP/OP AGO S 2,000,000
""l POLICY ril- ~:-~T fXllOC
~UTOMOBJLI! UABIUTY COMBINeo SINGLE WAIT 5 1,000,000
~ ANY AUTO lEa accident)
B ~ All OWNED AUTOS CA901086 (AOS) 3/1/2009 3/1/2010 BOOII. Y INJURY
S XXXXXXX
SCHEDULED AUTOS (P.r person)
f-
D ~ HIRED AUTOS CA9070B1 (MA) 3/1 12009 3/112010 BODILY INJURY
S XXXXXXX
X NON.(}WNEO AUTOS (Peracci~t)
~ Comp/ColI-Ded. $1000 PROPERTY DAMAGE
f.:.:. (Per accident) S XXXXXXX
RRAGE LIABILtTY AUTO Of'IL Y . EA ACCIDENT S XXXXXXX
ANY AlJTO NOT APPLICABLE OTHER THAN EAACC S XXXXXXX
AUTO ONL V: AGG S XXXXXXX
OeESSIUMBRELLA LIAB'LtTY EACH OCCURRENCE S XXXXXXX
OCCUR 0 CLAIMS MADE NOT APPLICABLE ACOREOA TE S xxYY1<YX
R 0 UMBRELLA $ XXXXXXX
DEDUCTIBLE FORM 5 XXXXXXX
RETENTION $ S XXXXXXX
A WORKERS COMPENSA lION AND WC4374921 (AOS) 3/1/2009 3/112010 X I T,,;;~mJNs I IOJ~'
EMPL.OYERS'LIABILITY
B ANY PROPRIeTOR/PARTNER/EXECUTIVE WC4374922 (CA) 3/1/2009 3/112010 E.L EACH ACCIDENT S 1,000,000
C OFFICERJMEMBER EXCLUDED? NO WC4314923 (MI) 3/112009 3/112010 E.L. DISEASE. EA EMPLOYEE S I 000,000
~X~~l~t~v~~~~s b91a.v E.l. DISEASE - POLICY LIMIT S I ,000,000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS (VEHICLES' l!XCI.USIONS ADDEO BY ENDORSEMENT / SPHCIAL PROV!SIONS
CERTIFICATE HOLDER
CANCELLATION
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SHOULD ANY OF THE ABOVe oeSCRI&eD POLICIES BE CANCELLED BEFORE THE EXPIRATION
PROOF OF INSURANCE DATE THEREOF, THE ISSUING INSURER WllL ENDEAVOR TO MAIL 30 DAYS WRITTEN
Nonce TO THE CERTIFICATE HOLDER NAMEO TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KINO UPON THE INSURER, ITS AGENTS OR
REPRESENTAl1VES.
AUTHORI~~ ..
'/'';~~ -----..
ACORD 25 (2001/08) For qUottlont ROIl,dll1g Ihi. <<lrtUlc.alo, conla<:llhtt number Iitled kllllll '''rOOUtDr' .~on .bo..... @ACORDCORPORATION 1988
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Bureau Veritas North America, Inc. · 308 NW 170 Street · North Miami Beach, FL, 33169 10
Phone +1 (786) 248-3180 · Fax +1 (786) 248-3190. www.us.bureauveritas.com
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SWORN STATEMENT PURSUANT TO SEcrION 287.133(3)(a)
FLORIDA STATurES, ON PUBLIC ENTITY CRIMES
THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A
NOTARY PUBLIC OR OTHER OFFICIAL AUTHORIZED TO ADMINISTER
OATHS.
1. This sworn statement iJ. submitted j
to "/""A@~ C iyY ~ <:;'U/'1t7 <.# L$("les PROfcj,
/
by C]a )'0,/1 Lt,' 1/
for ~(jR.QO.U Ue~~s /VA) ITlc.
whose business address is
30! NW j 70 slR.e.i'T
AJn..aL l'1tCtm j l?et?1c/) 1--[ Z3IC9
/
and (if applicable) its Federal Employer Identification Number (FEIN)
DID-Iv, SqciLfY
(If the entity had no FEIN, include the Social Security Number of the individual
signing this sworn statement:
2. I understand that a "public entity crime" as defmed in Section 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 of the United States, including, but not
limited to, any bid or conkact for goods or services to be provided to any public entity
or an agency or political subdivision of any other state or of the United States and
involving antitrust, fraud. theft, bribery, collusion, racketeering, conspiracy, or
material misrepresentation.
3. I understand that "convicted" or "conviction" as defmed in Section 287.1330)(b),
Florida Statutes means a fmding of guilt or a conviction of a public entity crime, with
or without an adjudication of guilt, in any federal or state trial court of record relating
to charges brought by indictment or information after July 1, 1989, as a result of a
jury verdict, nonjury trial, or entry of a plea of guilty or nolo contenders.
4. I understand that an "affiliate" as defmed in Section 287.133(1)(a), Florida Statutes,
means:
a. A predecessor or successor of a peISOn convicted of a public entity crime~ or
b. An entity under the control of any natural person who is active in the
management of the entity and who hu been convicted of a public entity crime.
The term "affiliate" includes those officers, directors, executives, 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 penon, or a pooling of equipment or income among pelSons
when not for fair market value under an arm's length agreement, shall be a prima
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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.
S. I understand that a "person" as defmed in Section 281.133(IXe), 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 "person" includes those officers, directors, executives, partners, shareholders,
employees, members, and agents who are active in management of any entity.
6. Based on information and belief, the statement which I have marked below is true
in a relation to the entity submitting this sworn statement. (please indicate which
one (1) of the following three (3) statements is applicable.)
L(1) Neither the entity submitting this sworn statement, nor any of its officers,
directors, executives, partners, shareholders, employees, members, or agents who are
active in the management of the entity, or any affiliate of the entity has been charged
with and convicted of a public entity crime within the past 36 months.
_(2) 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 any affiliate of the entity has been charged
with and convicted of a public entity crime within the past 36 months.
_(3) 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 agents who are active in management of the
entity, or any affiliate of the entity has been charged with and convicted of a public
entity crime within the past 36 months. However, there has been a subsequent
proceeding before a Hearing Officers of the State of Florida, Division of Administrative
Hearings and the Final Order by the Hearing Officer detennined that it was not in the
public interest to place the entity submitting this sworn statement on the convicted
vendor list. (Attached is a copy of the final order.)
I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE
CONTRACTING OFFICER FOR TIlE PUBLIC ENTITY IDENTIFIED IN
PARAGRAPH 1 (ONE) ABOVE IS FOR THE PUBLIC ENTITY ONLY AND, THAT
TIDS FORM IS VALID THROUGH DECEMBER 31 OF THE CALENDAR YEAR
IN WHICH IT IS Fll..ED AND FOR THE PERIOD OF TIlE CONTRACf ENTERED
INTO, WHICHEVER. PERIOD IS LONGER. I AlSO UNDERSTAND TIlAT I AM
REQUIRED TO INFORM THE PUBLIC ENTITY PRIOR TO ENTERING INTO A
CONTRAcr IN EXCESS OF THE THRESHOLD AMOUNf PROVIDED IN
SECfION 287.017, FWRIDA STATlITES FOR THE CATEGORY TWO OF ANY
CHANGE IN THE INFORMATION CONTAINED IN THIS FORM.
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,-;;;;~("')V1 /Jil/
,
(Printed or Typed Legal Name of Affiant)
State of Florida of County of Miami-Dade CliJ-...
Sworn to and subscribed before me this fcr'
2009, \
::\0 SCV\ t-h \
N Seal """~'~~"" INGRI,) A, CARUSO .
otary : .'''fo!'; :(~ Notary Public. State of Flonda
: . ~ My Commission Expires Dee 18, 2010
~"'... · florj Commission # DO 623084
"",i'~ ~",,,,
"".Rr,~,\,'" Bonded Through National Notary Assn.
day of 1u~
by
.-LnqVlcto ' CoV'u~o
Notary s Name Printed, Stamped or Typed
Personally Known: ~ or Produced Identification _
Identification Produced
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Addendum NO.1
CITY OF SUNNY ISLES BEACH
Threshold Inspection Services for the Heritage Park Parking Garage
CITY RFQ NO. 09-05-01
To All Bidders:
Bidders for the above-referenced project shall take note of the following changes,
additions, deletions, clarifications, etc. to the Plans and Specifications, which in
accordance with the Contract Documents shall become a part of and have precedence
over anything shown or described otherwise.
The City is requesting information from applicants to determine the most qualified and
responsive applicant based on the City's evaluation of the Statement of Qualifications in
accordance with Section 1.5 of the RFQ.
1. The general contractor chosen for the job will be responsible for the material
testing.
2. Section 1.5 (Statement of Qualification) is the information needed to be
submitted as part of Section 1.7 (Submittal Requirements). Some of the
information requested in Section 1.7 is a duplicate of the information requested
under Section1.5.
3. Total number of pages to be submitted in the package is 10 pages except for
1.7(6) Sworn Statement (public entity crime) and 1.7(7) Non-Collusive affidavit.
4. The Non-Collusive affidavit is to be part of the submittal. It is attached as part of
this addendum.
END OF SECTION
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NON-COLLUSIVE AFFIDA VIT
State of
Florida)
County of
Miami-Dade)
'--.x4 .5 (j/}
and says that:
AI}'; I
being fIrst duly sworn, deposes
(1) He/she is the (Owner, Partner, Officer, Representative or Agent) of the Bidder that has
submitted the attached Bid;
(2) He/she is fully informed respecting the preparation and contents of the attached Bid and
of all pertinent circumstances respecting such Bid;
(3) Such Bid is genuine and is not a collusive or sham Bid;
(4) Neither the said bidder nor any of its officers, partners, owners, agents, representatives,
employees or parties in interest, including this affiant, have in any way colluded, conspired,
connived or agreed, directly or indirectly, with any other Bidder, fIrm, or person to submit a
collusive or sham Bid in connection with the Work for which the attached Bid has been
submitted; or to refrain from bidding in connection with such Work; or have in any manner,
directly or indirectly, sought by agreement or collusion, or communication, or conference with
any Bidder, firm, or person to fIx the price or prices in the attached Bid or of any other Bidder, or
to fix any overhead, profit, or cost elements of the Bid price or the Bid price of any other Bidder,
or to secure through any collusion, conspiracy, connivance, or unlawful agreement any
advantage against the City of Sunny Isles Beach, Florida, or any person interested in the
proposed Work;
(5) The price or prices quoted in the attached Bid are fair and proper and are not tainted by
any collusion, conspiracy, connivance, or unlawful agreement on the part of the Bidder or any
other of its agents, representatives, owners, employees or parties in interest, including this
MfIan .
0Zi<:;{)/! Jlil!
(Printed or Typed Legal Name of MfIant)
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State of Florida of County of Miami-Dade
Sworn to and subscribed before me this ) 8fh day of
30 ~Gn -\-t \ \
Notary Seal:
,,~:,l;~~~';-" INGRI,) A. CARUSO
$~o . . (~'-,- Notary Public . State of Florida
[. ; : . E My Commission Expires Dee 18, 2010
~;;." ,"","Q~$ Commission # DO 623084
, .. OF f\..U"\'"
'Tngl/\ . '''''''' Bonded Through National NotafyAssn.
Notary's Name Printed, Stamped or Typed
Personally Known: $- or Produced Identification
Identification Produced
,\ vYU2-
. 2009 by
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