HomeMy WebLinkAboutCHM Structural Eng.
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~T UqUR6.L: ENGIN.I:ER5, [,Le.
Marl< Mosbat P.E.
Samuel De Leon P.E.
Javier Alvarez Ph.D.
Jose Moncada P.E.
JUNE 17, 2009
CITY OF SUNNY ISLES
REQUEST FOR QUALIFICATIONS NO.09-05-01
THRESHOLD INSPECTION SERVICES FOR THE HERITAGE PARK
PARKING GARAGE
CITY OF SUNNY ISLES BEACH, MIAMI-DADE COUNTY, FLORIDA
RESPONSE TO SECTION 1.5 "STATEMENT OF QUALIFICATIONS"
1) History of the firm, including ownership and key management.
CHM Structural Engineers, LLC, has existed as a consulting engineering
firm specializing primarily in structural systems for buildings since 1961.
CHM limits its activities to producing structural services for the
design and inspection of buildings. In this regard, it offers the widest range of
experience and concentration of competent personnel.
It is currently a Limited Liability Corporation, its owners and managers are
Mark Mosbat, P.E. (President) and Samuel De Leon, P.E. (Vice-president)
2) A summary of any company changes that are anticipated to occur during the
project.
Change of Address on July 1 SI, 2009.
3) Location of corporate headquarters and other divisional offices.
Current location of our offices is 9200 South Dadeland Blvd., suite 409,
Miami, Florida 33156.
Starting July 1 sr, 2009 our offices will be at 9350 South Dixie Highway, suite
1420, Miami, Florida 33156
Please refer to item 3
Ff~CEIVED
JUN 1 9 2U09
4)
Location of office(s) that will be involved in this project.
9200 South Dadeland Boulevard. Suite 409.
Miami, FL 33156
Tel 305.667.1621
Fax 305.662.9673
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5)
Applicant shall demonstrate state certification for threshold inspector.
Please refer to Appendix A for copies of licenses for our four threshold
inspectors.
6)
Number of years of experience as threshold inspector.
Mark Mosbat...... .............. ...17 years
Samuel De Leon.................. .14 years
Jose Moncada........................ 5 years
Juan Vizcarra........................2 years
7)
Description of recent project experience, including projects of similar size,
and client references with contact information.
CHM has performed the design and threshold inspections for the parking
garages of the following projects within the city of Sunny Isles Beach:
Proiect name
Trump Tower I
Trump Tower II
Trump Tower III
Turnberry Ocean Colony I
Turnberry Ocean Colony II
Oceania towers IV
Oceania towers V
Acqualina remote parking
Ocean IV
Millennium
Le Meridian
Ocean Point
Reference
Joyce Bronson, TRG 305-674-8310
Joyce Bronson, TRG 305-674-8310
Joyce Bronson, TRG 305-674-8310
Bud Hall, Turnberry 305-682-4128
Bud Hall, Turnberry 305-682-4128
Edward Fallin, Coastal 305-599-4900
Edward Fallin, Coastal 305-599-4900
Rick Chitwood, WI 305-933-8301
John Leete, JMA 954-920-8550
Larry Cohan, BCA 305-663-8182
Kobi Karp, KKAID 305-573-1818
Lenny O'Neill, Coastal 954-620-1028
CHM has performed threshold inspections of the following precast garages
Proiect name
Turnberry on the green, A ventura
Duo, Hallandale
Cite, Miami
Reference
Bud Hall, Turnberry 305-682-4128
Randall Baukney, Triad 954-472-3099
Stu Cohen, CFE 305-826-3999
CHM has performed threshold inspections of the following Joist-Soffit type
garages.
Proiect name Reference
Southsidc Elementary, Miami Rafael Labrada, W A 305-666-5474
Lincoln, Place, Miami Beach Bruce Brosh, NBWW 305-695-1188
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9)
One Island Place, A ventura Lenny O'Neill, Coastal 954-620-1028
Harborside, A ventura Lenny O'Neill, Coastal 954-620-1028
Harbor Towers, A ventura Lenny O'Neill, Coastal 954-620-1028
Atlantic One, A ventura Lenny O'Neill, Coastal 954-620-1028
Atlantic Two, A ventura Lenny O'Neill, Coastal 954-620-1028
Atlantic Three, A ventura Lenny O'Neill, Coastal 954-620-1028
Atlantic Four, A ventura Lenny O'Neill, Coastal 954-620-1028
Atlantic Five, A ventura Lenny O'Neill, Coastal 954-620-1028
1000 Island Blvd, Williams Island Jose Quintairos, Arc-Tech 305-442-8554
2000 Island Blvd, Williams Island Jose Quintairos, Arc-Tech 305-442-8554
2600 Island Blvd, Williams Island Jose Quintairos, Arc-Tech 305-442-8554
7000 Island Blvd, Williams Island Jose Quintairos, Arc-Tech 305-442-8554
Parking tower D, Williams Island Jose Quintairos, Arc-Tech 305-442-8554
Parking tower E, Williams Island Jose Quintairos, Arc-Tech 305-442-8554
Parking tower F, Williams Island Jose Quintairos, Arc-Tech 305-442-8554
8)
A statement of experience summarizing threshold inspection services on
similar projects and a summary of what your firm can "bring to the table" for
the City of Sunny Isle Beach.
CHM Structural Engineers, LLC, has performed inspection services for over
50 parking garages in South Florida (32 of them listed on section 7).
During that process we have compiled extensive experience for most
structural systems, conditions and locations while dealing with critical
deadlines and requirements from municipal and state agencies.
By selecting our firm, you are assured of the engineering knowledge, strong
work ethic and unbiased spirit of cooperation with only one goal, making sure
your project is built according to plans and specs and on schedule.
A statement addressing your Firm's present and projected workload and now
this project will be schedules within that workload.
We are currently providing inspection services for The Saint Regis hotel and
Condominium on a full time basis, have in our staff four threshold inspectors
and five authorized representatives, which guarantee proper staffing for The
Heritage Park Garage.
10)
Evidence that the firm has the required license, insurance and financial and
bonding capacity necessary to fulfill its responsibility for this project.
Please refer to Appendix B for copies of licenses
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RESPONSE TO SECTION 1.7 SUBMITTAL REQUIRMENTS
1. Name, address and company, including, but not limited to, a business overview,
financial state of the business, annual revenue for past two years, and names and
addresses of persons having financial interest in the firm.
CHM Structural Engineers, LLC
9200 South Dadeland Blvd Suite 409, Miami FI 33156
Voice 305-667-1621 fax 305-662-9673
www.chmfl.com
After July 1 st 2009 our new address will be:
9350 South Dixie Highway, suite 1420, Miami, Florida 33156
Voice 305-667-1621 fax 305-662-9673
www.chmfl.com
CHM Structural Engineers, LLC is solely dedicated to the design and inspection
of structural building systems. Our current staff of 15 includes engineers,
inspectors, CAD technicians, project coordinators and administrative personnel.
We are a solid and reputable corporation, with the following revenues (in
Millions ):
2009 to date...$1.59M
2008... ........ .$5.40M
2007........... .$7.62M
*Financial statements will be provided upon request.
2. A list of all projects (including government projects) completed or in process for
the past five (5) years, and a corresponding list of client references with contact
names and telephone numbers.
Please refer to Appendix C for a list of projects where we have performed
threshold inspections.
3. Proof of authorization to transact business in Florida for the Florida Secretary of
State, from the prime as well as supporting firms.
Please refer to Appendix D
4. The name, title, qualifications, experience, and all contact information of the
proposed contact person.
Samuel De Leon, P.E (structural) and threshold inspector since 1995.
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Engineer of record and threshold inspector of over 30 major projects in the state
of Florida. Please refer to Appendix E for resume.
Please refer to section one for business address. Email: sam@chm.cc
5. A listing of the proposed personnel to be assigned to this project including their
qualification experience.
Please refer to Appendix F
6. Sworn statement pursuant to Section 287.133(3)(A), Florida Statutes, on Public
Entity Crime, a copy of which is attached hereto.
Please refer to Appendix G
7. Non-collusive Affidavit, a copy of which is attached hereto.
Please refer to Appendix H
Respectfully submitted,
Samuel De Leon, P.E.
/Vice President
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APPENDIX A
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Is licensed as a Professional Engiheer--unoer Chapter 471, FlOrida Statutes
Expiration: 28-FEB-11 P. E. Lie. No: 38164
Audit No: 228201111247 51 Lie. No: 994
DISPLAY AS REQUIRED BY LAW
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Is licensed as a Professional Engrn:k'Phffaer Chapter 471, Florida Statutes
Expiration: 28-FEB-11 P. E. Lie. No: 49030
Audit No: 228201122745 51 51 Lie. No: 1082
DISPLAY AS REQUIRED BY LAW
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Is licensed as a Professional EngTn~~crnder Chapter 471, Florida Statutes
Expiration: 28-FEB-11 P. E. Lie. No: 58116
Audit No: 22820112870251 ;# ) 51 Lie. No: 7015322
, IS, lITRED BY LAW
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,\ate ;~~lntiD~
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Is licensed as a Professional Engmeet"under Chapter 471, Florida Statutes
Expiration: 28-FEB-11 P. E. Lie. No: 56988
Audit No: 228201128678 51 51 Lie. No: 6998581
DISPLAY AS REQUIRED BY LAW
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APPENDIX B
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Is authorized under the provisions of Secti~p~J.u~~.,~l9J:ida Statutes, to offer engineering services
to the public through a Professional Engin'eei?,~wYJicensed under Chapter 471, Florida Statutes.
Expiration: 28.Feb.11
Audit No: 22820111265
Certificate of Authorization
CANo:
26249
DlSPLA Y AS REQUIRED BY LAW
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CERTIFICATE OF LIABILITY INSURANCE
OP 10 YB DATE (MMlDDIYYYY)
CHM:CO-1 04 07 09
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
DUCER
Ihn-carlin & Company, Inc.
50 S. Dixie Highway
ami FL 33133-9984
Phone: 305-446-2271 Fax:305-448-3127
'(RED
INSURERS AFFORDING COVERAGE
The Zeni th Insurance Company
NAlC#
29424
13269
CHM: Structural EngineersA LLC
9200 S. Dadeland Blvd. ff409
Miami FL 33156
INSURER A:
INSURER B:
INSURER C:
INSURER 0:
INSURER E:
Hart~ord Casualty Insurance Co
Houston Casualt
VERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
IY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
Y PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH
L1CIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
11.,,,< ~~~i POLICY NUMBER rDATE iMMIDDlYY1 P~k~1{I~MIDDIYYT LIMITS
LTR TYPE OF INSURANCE
I ~NERAL LIABILITY EACH OCCURRENCE $1 000,000
X COMMERCIAL GENERAL LIABILITY 21SBARP0028 04/01/09 04/01/10 ~~;SES lEa occurencel $ 300,000
.1 CLAIMS MADE [!] OCCUR MED EXP (Anyone person) $10 000
I ~ PERSONAL & ADV INJURY $1 000,000
GENERAL AGGREGATE $2,000,000
~L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2.000,000
n PRO- n
POLICY JECT LOC
I AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
~ $1,000,000
ANY AUTO 21SBARP0028 04/01/09 04/01/10 (Ea accident)
~
~ ALL OWNED AUTOS BODILY INJURY
$
'I SCHEDULED AUTOS (Per person)
-
~ HIRED AUTOS BODILY INJURY
$
~ NON-OWNED AUTOS (Per accident)
: . PROPERTY DAMAGE $
(Per accident)
'. GARAGE LIABILITY AUTO ONLY. EA ACCIDENT $
==1 ANY AUTO OTHER THAN EA ACC $
. AUTO ONLY: AGG $
il EXCESSlUMBRELLA LIABILITY EACH OCCURRENCE $ 4.000.000
IA ~ OCCUR 0 CLAIMS MADE 21SBARP0028 04/01/09 04/01/10 AGGREGATE $ 4 ,000,000
I $
~ DEDUCTIBLE $
X RETENTION $10,000 $
WORKERS COMPENSATION AND X I TORY LIMITS I IUJH.
I ER
EMPLOYERS' LIABILITY Z066763805 01/01/09 01/01/10 $ 1.000 000
ANY PROPRIETORIPARTNERlEXECUTlVE E.L. EACH ACCIDENT
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ 1 .000 000
g~~M1"~~v':s1<5~s below E.L. DISEASE - POLICY LIMIT $ 1,000 000
I OTHER
Professional H70815422 10/04/08 10/04/09 Limit $1,000,000
Liabilitv Deductibl S50.000
ICRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
I
CERTIFICATE HOLDER
CANCELLATION
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PROOF OF COVERAGE FOR INSURED
PROOF-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED R ESENTAT E
@ACORD CORPORATION 1988
ORD 25 (2001/08)
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APPENDIX C
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CHM Structural Engineers LLC
Projects for the last five years where CHM has
performed Threshold Inspections
I Project Names
1060 Brickell A venue
50 Biscayne
50 Biscayne
Apogee
Artech
Artech
Asia
A ventura Marina I
A ventura Marina II
Beach Club I
Beach Club II
Beach Club III
Bellini
Brickell on the River
Continuum II
Diplomat Tower
DUO Condominiums
Eclipse
Fontainebleau III -& Resort
IconBrickell I
IconBrickell II
IconBrickell III
IL Lugano
Indian Creek Parking Garage
Infinity @ Brickell
Marriott Residence & Courtyard
Nobe Bay
Ocean IV
Palazzo Del Sol
Sapphire
Southside Elementary School
Spring Hill Suites
St. Regis Hotel & Condo
SunnyBrook
Symphony
Trump Hollywood
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Location
Miami
Miami
Miami
Miami Beach
A ventura
A ventura
Miami
A ventura
A ventura
Hallandale Beach
Hallandale Beach
Hallandale Beach
Williams Island
Miami
Miami Beach
Hollywood
Hollywood
Ft. Lauderdale
Miami Beach
Miami
Miami
Miami
Ft. Lauderdale
Miami Beach
Miami
Miami
Miami Beach
Sunny Isles Beach
Miami Beach
Ft. Lauderdale
Miami
Miami
Bal Harbour
Miami
Ft. Lauderdale
Hollywood
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CHM Structural Engineers LLC
Projects for the last five years where CHM has
performed Threshold Inspections
I Project Names
Trump Tower I
Trump Tower II
Trump Tower III
Tumberry Ocean Colony I
Turnberry Ocean Colony II
Two City Plaza
Uptown Marina
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Location
Sunny Isles Beach
Sunny Isles Beach
Sunny Isles Beach
Sunny Isles Beach
Sunny Isles Beach
West Palm Beach
A ventura
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APPENDIX D
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www.sunbiz.org - Department of State
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Page 1 of2
Next on List
Ke.tYI!LLCLL..ist
Entity Name Search
[ Submit I
No Name History
etail by Entity Name
HM STRUCTURAL ENGINEERS, LLC
Information
ocument Number L04000092280
EI/EIN Number 202038857
ate Filed 12/20/2004
State FL
tatus ACTIVE
ffective Date 01/01/2005
e istered A ent Name & Address
ANGIERO, DAVID
12790 SOUTH DIXIE HWY
IAMI FL 33156 US
Manager/Member Detail
OSBA T, MARK
524 SIENA AVE
CORAL GABLES FL 33146 US
~itle MGRM
E LEON, SAMUEL
12831 SW 117 STREET
flAMI FL 33186 US
Itp://www.sunbiz.org/scripts/cordet.exe?action=DETFIL&inCL doc _ number=L04000092280&inCL came_f... 6/3/2009
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APPENDIX E
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.......,.' 51 UC;TURALcENGINEE~5,I.I.C~
Mark Mosbat P.E.
Samuel De Leon P.E.
Javier Alvarez Ph.D.
Jose Moncada P.E.
VICE PRESIDENT
EDUCA TION
REGISTRA TION
PREVIOUS FIRMS
TECHNICAL
ORGANIZA TIONS
SAMUEL DE LEON, PE, SEeB
CHM STRUCTURAL ENGINEERS, LLC
1994 - to present
Post Graduate Degree in Structural Engineering 1988
Technological Institute of Santo Domingo
Bachelor of Science in Civil Engineering 1985
Technological Institute of Santo Domingo
Structural Engineer - Florida 1995
Special Inspector - Florida 1996
Structural Engineers Certification Board 2006
VSL Corporation, Miami, FL
1992 - 1994
Project Engineer
Crouse-Honderich-Mosbat Consulting Engineers, Inc.
1989 - 1992
Project Engineer
Samuel De Leon, Civil Engineer
1987 - 1989
Structural design of custom homes and low-rise
commercial buildings in Santo Domingo, D.R.
Contesa, Santo Domingo, D.R.
1985 - 1987
Project Engineer
American Society of Civil Engineers 1997
American Consulting Engineers Council 1997
Florida Engineering Society 1998
American Concrete Institute 1998
9200 South Dadeland Boulevard. Suite 409.
Miami, FL 331 56
Tel 305.667.1621
Fax 305.662.9673
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Samuel De Leon
Page 2
EXPERIENCE
Mr. De Leon's has experience in design of a large
spectrum of building types, including residential.
hotels and mixed-use high-rise buildings, historic
preservation, institutional facilities, custom homes.
retail and parking structures.
He has also provided turnkey solutions for warehouses and
industrial buildings and has been responsible for the design
and supervision of post-tensioned structures in the U.S and
Chile.
CURRENT PROJECTS
Mr. De Leon is partner in charge for the Fairmont Turnberry
Isle Hotel and Condo in City of Sunny Isles Beach, Marriott
Residence Inn and Courtyard in Miami, Sunnybrook
Medical Office Building in Miami
And Oasis Towers in Fort Myers.
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APPENDIX F
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5T UCTURALLENQINEER5, LLC.
Mark Mosbat P.E.
Samuel De Leon P.E.
Javier Alvarez Ph.D.
Jose Moncada P.E.
PROJECT MANAGER
EDUCA TION
REGISTRA TIONS
FIRMS
JOSE S. MONCADA, P.E.
CHM STRUCTURAL ENGINEERS, LLC
Bachelor of Science in Civil Engineering, 1994
University of Florida, Gainesville, FL
Registered P. E. Structural - Florida
CHM STRUCTURAL ENGINEERS, LLC. (2003 to present)
Project List:
· Trump Towers. Sunny Isles Beach, FL. Three 44-stories
condominium concrete buildings with 4-story post tensioned
parking garage.
· Ocean Palms Condominium. Hollywood, FL. One 43-story
condominium concrete building with a 4-story post tensioned
parking garage.
· Gables Marquis Condominium. Miami, FL. One 20-story
condominium concrete building with 7-story post tensioned
parking garage.
· Las Olas Beach Club. Ft. Lauderdale, FL. One 30-story
condominium concrete building with a 6-story post tensioned
parking garage.
· Two City Plaza. West Palm Beach, FL. One 29-story
condominium concrete building with a 9-story post tensioned
parking garage.
· Duo Condominium. Hallandale, FL. One 28-story
condominium concrete building with a post tensioned parking
garage.
· The Edge. West Palm Beach, FL. One 16-story condominium
concrete building with a 7-story post tensioned parking garage.
· Oasis on the Bay. Two 23-story condominium concrete
building with a 7-story post tensioned parking garage.
Project Manager
WOLFBERG, ALVAREZ & PARTNERS. Miami, FL (2001-2003)
Project List:
9200 South Dadeland Boulevard. Suite 409.
Miami. FL 33156
Tel 305.667.1621
Fax 305.662.9673
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· NASA OSB II Building. Cape Canaveral, FL
· Aqua. Miami Beach, FL
· Mary Brickell Village. Miami, FL
Jose S. Moncada
Page 2
Project Manager
THE RAUL PUIG GROUP, P.A. Miami, FL (1998-2000)
Project List:
· J.W. Marriott Hotel. Miami, FL
· Barclays Financial Center. Miami, FL
· The Setai Hotel. Miami Beach, FL
Project Engineer
SHORE ENGINEERS, INC. Naples, FL (1996-1997)
Project List:
· Community Middle School Library. Naples, FL
· Best-Inn Hotel. Naples, FL
Project Engineer
SIDDIQ KHAN & ASSOCIATES. Miami, FL (1994-1995)
Project List:
· Analysis & design of Miami-Dade School facilities.
EXPERIENCE
Use of different software programs to achieve more accurate and
feasible solutions to any small or complex structural project.
Steel and concrete frame analysis:
ET ABS, ST AAD, RAM-STEEL, SAP 2000.
Concrete Post-tension analysis and design:
FLOOR 2.1, PT-PLUS, ADAPT.
Conventional concrete analysis and design:
SAFE, PCA-ADOSS.
Foundations analysis and design:
SAFE.
General structural components:
ENERCALC, EXCELL, STRUCT ETC., PCA COLUMN,
PCA BEAM.
Auto-cad 2004:
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Mark Mosbat P.E.
Samuel De Leon P.E.
Javier Alvarez Ph.D.
Jose Moncada P.E.
Experience Range
4/01 - Present
12/99 - 4/01
5/99 - 11/99
5/95 - 4/99
1 991 - 1 994
EDUCA TION
JORGE E. GARCIA
Civil Engineer with over 16 years experience in design and
structural field inspection of reinforced concrete, steel and
wood residential and commercial structures
CHM STRUCTURAL ENGINEERS, LLC
9200 S. Dadeland Blvd., Suite 409
Miami, Fl. 33156.
Field Services Manager
Structural Field Engineer for threshold buildings.
McCann Group of South Florida
Project Field Engineer
DeSimone Consulting Engineers
Structural Field Inspector
Riva Timmons & Partners, Structural Engineers
Structural Field Inspector
Brunstein Ingenieria, C. A., Caracas, Venezuela.
Senior Resident Engineer & Project Manager
BS in Civil Engineering
Universidad Central de Venezuela, Caracas, Venezuela
Certified Engineer Intern, State of Florida
Licensed Building Inspector, State of Florida
Certified General Contractor, State of Florida
9200 South Dadeland Boulevard. Suite 409.
Miami, FL 33156
Tel 305.667.1621
Fax 305.662.9673
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Mark Mosbat P.E.
Samuel De Leon P.E.
Javier Alvarez Ph.D.
Jose Moncada P.E.
EXPERIENCE
10/2001 - Present
OS/2001 - 10/2001
02/2000 - OS/2001
04/1 999 - 11/1 999
01/1997 - 03/1999
08/1996 - 12/1996
11/1995 - 07/1996
06/1994 -- 07/1995
EDUCA nON
CERTIFICA TION
FABIO A. JARAMILLO
Civil Engineer experienced with structural field inspections,
foundations, masonry, steel structures, and reinforced concrete
inspections.
CHM STRUCTURAL ENGINEERS, LLC
9200 S. Dadeland Blvd., Suite 409
Miami, Fl. 33156.
Structural Field Engineer for threshold buildings (commercial and
residential high-rises).
All Design Systems, Inc., Miami, FL
Design Engineer
Roorda Builders, Inc., Tampa, FL
Foreman Carpenter
Generali of Colombia, Pereira, Colombia
Inspector of Structures
Constructions & Roads, S.A., Manizales, Colombia
Director of Technical Operations
Construction and Roads, S.A., Aguadas, Colombia
Manager of Asphalt Concrete Plant
Construction and Roads, S.A., Belacazar, Colombia
Project Engineer
Metallic Structures Ltd., Manizales, Colombia
Senior Design Project Internship
BS in Civil Engineering
National University of Colombia
PTI Post-Tensioning Inspector & Installer
Tel 305.667.1621
Fax 305.662.9673
9200 South Dadeland Boulevard. Suite 409.
Miami. FL 33156
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APPENDIX G
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: - / :sTRueTURAl E"'NEERS, lle
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SWORN STATEMENT PURSUANT TO SECTION 287.133(3)(a)
FLORIDA STATUTES, 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 is submitted
to_ City~!..Su~nJ~sles Beach_
by Samuel De Leon
f CHM Structural Engineers LLC
or
whose business address is
9200 South Dadeland Blvd. Suite 409, Miami, Florida 33156
and (if applicable) its Federal Employer Identification Number (FEIN)
202038857
(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 defined in Section 287.133(l)(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 contract 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 defined in Section 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 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 defined in Section 287.133(1)(a), Florida Statutes,
means:
a. A predecessor or successor of a person 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 has 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 person, or a pooling of equipment or income among persons
when not for fair mar~7 / 'pt- an ann'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.
5. I understand that a "person" as defined in Section 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 "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.)
. (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 determined 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 THE PUBLIC ENTITY IDENTIFIED IN
PARAGRAPH 1 (ONE) ABOVE IS FOR THE PUBLIC ENTITY ONLY AND, THAT
THIS FORM IS VALID THROUGH DECEMBER 31 OF THE CALENDAR YEAR
IN WHICH IT IS FILED AND FOR THE PERIOD OF THE CONTRACT ENTERED
INTO, WHICHEVER PERIOD IS LONGER. 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 THE CATEGORY TWO OF ANY
CHANGE IN THE INFORMATION CONTAINED IN THIS FORM.
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ClCufL-
Sj*,XURE OF AFFIANT
jamuel De Leon
(Printed or Typed Legal Name of Affiant)
State of Florida of County of Miami-Dade '1
Sworn to and subscribed before me this \ day of
2009, &ry\LltI Dt IJOY\ \) .,r
,)u!\t ~ooq
Notary's Name Printed, Stamped or Typed
Personally Known: /'or Produced Identification _
Identification Produced
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. APPENDIX H
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1/ ,/ ; STRUCTURAL ENGINEERS. LLC.
Fm:Onvia.com Inc To: Sam De Leon (13056629673)
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12:10 06/10109GMT-04 Pg 02-03
NON-COLLUSIVE AFFIDA VIT
State of
Florida)
County of
Miami-Dade)
Samuel De Leon
being first duly sworn, deposes
and says that:
(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
Oth~oz;L)t~ a.gents, representatives, owners, employees or parties in interest, including this
AffIant.
~ ./ k Samuel De Leon
S7A TORE OF AFFIANT (Printed or Typed Legal Name of Affiant)
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Fm:Onvia.com Inc To: Sam De Leon (13056629673)
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State of Florida of County of Miami-Dade
Sworn to and subscribed before me this \ 1
,-SC\mLAi \ Ul Lwf\ ~. p.
12:10 06/10/09GMT-Q4 Pg 03-03
day of Ju rLl
Notary Seal:
Personally Known:
or Produced Identification
Identification Produced
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