HomeMy WebLinkAboutNextaff
N
SCHOOL CROSSING GUARD S'
Buffy A. Butler
e Butler Group of South Florida, LLC
d/b/a NEXT AFF
7481 West Oakland Park Boulevard
Suite 307
Lauderhill, Florida 33319
954.733.0777 Office. 954.733.0444 Fax
www.nextaff.com
May 24, 2011
Telephone No. ~ 3,). O'l'l \
Email Address: ~+t t" @ L.&.{\~-Ic:;) '(,Vw\
Fax No. ~., 2l3. 0l{lf'1
FEIN No.1JJ.-ldLiJJiJl:J];3.
* "BY SIGNING THIS DOCUMENT THE BIDDER AGREES TO ALL TERMS
SIGNATU~ ~.~
(SIGN~rU 'THORIZEDiGENT)
PRINT NAME~ 00--( 'L(L
TrrLE:~ )J...~.
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.
PAGE 27 OF 28
BID No.
PAGE 28 OF 28
BID NO.
NON-COLLUSION AFFIDAVIT
City of Sunny Isles Beach
18070 Collins Avenue
Sunny Isles Beach, FL 33160
Telephone: (305) 947-0606 Fax: (305) 949-3113
STATE OF FLORIDA
COUNTY oFlli~
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,
a, G~M ~u..L,1'l.t Gx.pArlvl ,formed under the laws of 11 /lflu,"\/t
(Type of Business) --r (State)
of which he is
"'
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
10.2, 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.
:tiJ i'..J>. J AA^r, Y/7\ AJ.f>>-{(:J'UL
~kNA~' ~TIJi .
TAKEN, SWORN AND SUBSCRIBED TO BEFORE ME this ~ of M ~'-. \ ,20(}
~ :r,~~ or Produced Identification )
Type of identification AI 6n<...-
(Affix seal here)
"
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~~Ift.1~. MYRTlE CORBIN
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DECEMBER 28, 2010
1 of 7
PUBLIC ENTITY CRIMES
City of Sunny Isles Beach
18070 Collins Avenue
Sunny Isles Beach, FL 33160
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.
whose business address is: r . ..I
'1 '-l e ( I Uf,\t- () A ll-fY1 \) P4nk ~&MWVvi}: ~'(- 3 [) 7
\..Cu....()~ 117 LL ~ -f1.o>vnlA- 20--31 q
and (if applicable) its Federal Employer Identification number (FEIN) is <-{ J -LI":) 3 L'b (-)
(If the entity had no FEIN, include the Social Security Number of the individual signing this sworn
statement: .)
11.2. I 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. I 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. I understand that an "affiliate" as defined in Para. 287.133(1 )(a), Florida Statutes, means:
a.)
b.)
predecessor or successor of a person convicted of a public entity crime; or
DECEMBER 28, 2010
Any entity under the control of any natural person who is active in the management of the entity
and who has been convicted of a public entity crime. The term "affiliate" includes those officers,
directors, executors, partners, shareholders, employees, members, and agents who are active in
the management of an affiliate. The ownership by one person of shares constituting a controlling
interest in another person, or a pooling of equipment or income among persons when not for fair
2 of?
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.
I understand that a "person" as defined in Para. 287 .133( 1 )( e), Florida Statutes, means any natural
person or entity organized under the laws of any state or of the United States with the legal power to
enter into a binding Contract and which Bids or applies to Bid on Contracts for the provision of goods or
services let by a public entity, or which otherwise transacts or applies to transact business with a public
entity. The term "persons" includes those officers, directors, executives, partners, shareholders,
employees, members, and agents who are active in management of any entity.
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.)
~
Neither the entity submitting this sworn statement, nor any of it's officers, directors, executives, partners,
shareholders, employees, members, or agents who are active in the management of the entity, nor any
affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1,
1989.
The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners,
shareholders, employees, members, or agents who are active in the management of the entity, or an
affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1,
1989.
The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners,
shareholders, employees, members, or agents who are active in the management of the entity, or an
affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1,
1989. However, there has been a subsequent proceeding before a Hearing Officer of the State of
Florida, Division of Administrative Hearings and the Final Order entered by the Hearing Officer of the
State of Florida, Division of Administrative Hearings and the Final Order entered by the Hearing Officer
determined that it was not in the public interest to place the entity submitting this sworn statement on the
convicted vendor list. (Attach a copy of the final order.)
I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR THE
PUBLIC ENTITY IDENTIFIED IN PARAGRAPH 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:
r. )...... .
\,.
(Printed Na e)
(Title)~'6
Sworn to and subs ribed before me this A- day of
'- ~ .
.-1J.r;.~~.... MYRTlE CORBIN
i*: ~"= MY COMMISSION ~ DO 932672
~~ EXPIRES: October 28 2013
"'1, Bonded Thru Notary Public U~erwrilers
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S' nature: Notary Public - State of Florida
~ '-
pe Commissioned Name
, 20--L.l.-, by
~c~
~
OR Produced Identification
Type of Identification Produced
10/1998
3 of?
EQUAL OPPORTUNITY /
AFFIRMATIVE ACTION
City of Sunny Isles Beach
18070 Collins Avenue
Sunny Isles Beach, FL 33160
Telephone: (305) 947-0606 Fax: (305) 949-3113
EQUAL OPPORTUNITY I 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.
Firm:
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Signed:
Title:
Address:
DECEMBER 28, 2010
4 of?
CONFLICT OF INTEREST
0,- SUN
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 F~~t (\
COUNTY OF '.0n~
personally appeared~~ ~ .'l)Jt L't(L
\
with a loca~n/ll~~2r-{,rM\Jt-
, who was duly sworn,
BEFORE ME, the undersigned authority,
deposes, and states:
,18."rit am ti . the
\I\L ~~jJ., ~U( J
In,,{ . 'yt .
18.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No. If6 II-OS--<l~ described
as: l::andsGaf')e-Maintenance Services. The Affiant has made diligent inquiry and provides the information contained in this
Affidavit based upon his own knOWledge~toOL"~I"~~~
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.
of
and principal office in
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 anyone 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 anyone 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.
18.8 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.
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 of Sunny Isles Beach.
Dat~.s ~>,ay, of \V..~ ,{c?~ · ~
--~ -J ~6 fh:1. R-- H\...tk ~,JQ .}~N(.~
.y-5 / Print or Type Name ana Title 0
Sworn to and subscribed before me this i!l!l.. day of M aJJ ,~ I
~ Personally Known OR l I r
o Produced Idenlificat;on ; Ty~nlificalion . N t> h ~
~~~C'\~_o
NOTARY PUBLIC STATE OF FLORIDA ~
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.;-~\t/\..~. MYRllE CORBIN
f*( !./;....~ :*~ MY COMMISSION ~ DO 932672
~~$< D_S~!,IRES: October 28,2013
-'Iff,:li' ""'rue\] Thru Notary Public Unde!wrlIers
DECEMBER 28, 2010
7
DISPUTE DISCLOSURE
City of Sunny Isles Beach
18070 Collins Avenue
Sunny Isles Beach, FL 33160
Telephone: (305) 947-0606 Fax: (305) 949-3113
DISPUTE DISCLOSURE FORM
^nswer 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
'f
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 )C,
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.
0~l 6J~.l ~ h ~ Jv-u ~ 1 J.e
Firm a/b{lfrJ~
~ i'X DL
flu r' ed Signature
2J .A~ 20/ /
Date
A .'B,--t~
ffc,rL-.
DECEMBER 28, 2010
6 of?
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
STATE OF FLORIDA )
)
COUNTY or"B~ )
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: f l~'
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TItle: " ,q,-u.S1\ j-b:u.~
The foregoing instrument was acknowledged before me this
\l\o....~ , 20-.lL, by
person], \ as
!):pj; day of
[name
[type of authority], for
behalf of whom instrument was
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'-"<!l","-..~. MYRTI.ECORBIN
f*~ "iE.' i*~ MY COMMISSION # DO 932672
~~~$~ BooEXPIRES: October 28,2013
:'!!/"r,i.. ded Thru Notary Public Undenwiters
~~~~ Q
Notary Pub ic - State of Florida
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--
AFFIX NOTARY STAMP HERE:
Personally Know OR Produced Identification
Type 0 entification Produced N'bh~
DECEMBER 28, 2010
? of?
Addendum NO.1
CITY OF SUNNY ISLES BEACH
Crossing Guard Services
CITY BID NO. 11-05-03
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.
y Request for Clarification:
· What is the hourly bill rate being charged by your current vendor?
The current rate is $14 per hour.
· Must we provide the bond if awarded this contract? Are there any
amendments?
No bond is required. All addenda have been posted on www.demandstar.com
END OF SECTION
t '!PI\
f'f'
Addendum NO.2
CITY OF SUNNY ISLES BEACH
Crossing Guard Services
CITY BID NO. 11-05-03
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.
Section 2.0 Paragraph 2.5 shall be replaced with the following;
METHOD OF AWARD
Award of this contract will be made to the lowest responsive, responsible vendor who
submit an offer on all items listed in the solicitation and whose offer represents the
lowest price when all items are added in the aggregate. If a vendor fails to submit an
offer on all items, its overall offer will be rejected. In addition to other City and contract
requirements, all bidders shall meet or exceed the following qualification requirements
to qualify for this contract;
1. Maintain an office staffed by competent company representatives authorized to
discuss matters pertaining to the contracted service, who can provide
information, and who are cognizant of the industry and industry standards.
· A list of the firm's key personnel, including their roles and contact information,
shall be included with the bidder's submittal. The list shall include' the
personnel's applicable experience and their qualifications. This document
shall demonstrate to the City's satisfaction that the bidder's staff meets the
requirement described in the paragraph above.
2. Shall be regularly engaged in the business of providing crossing guard services.
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. Two (2) current references, consisting of existing customers, shall be listed in
the bidder's submittal. The references listed must be customer that are
currently receiving or have recently received from the bidder the services
described in this solicitation. The references must include the customer's
company name, and the name, title, address, and telephone number of the
contact person who can verify that the bidder has successfully provided the
and services that the bidder is offering under this solicitation. These
references shall ascertain to the City's satisfaction that the bidder has
sufficient experience and expertise. References from firms in the south
Florida region are preferred.
END OF SECTION
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N
KEY PERSONNEL
Buffy A. Butler, Managing Member
With over 20 years experience in administrative operations and human resources
management, Ms. Butler leads NEXTAFF's South Florida operations. Ms. Butler, a
Certified School Crossing Guard Trainer, has a keen understanding of workflow
processes and day-to-day operations.
Delisa S. Williams, Field Operations, Manager
A Navy veteran, Ms. Williams, has an extensive background in management and
training. With over 10 years of training experience, Ms. Williams is a Certified School
Crossing Guard Trainer, and she serves as our lead trainer, As lead trainer, she insures
the content of our classroom and field training classes are in compliance with the
Florida Department of Transportation's guidelines and regulations.
Martha Slifkin, Field Operations, Certified School Crossing Guard Trainer
Mrs. Slifkin has over five years experience in the school crossing guard arena. She is
a part of our supervisory team, and as a certified trainer, she is a vital part of our
training process.
Sharon Adt, Field Operations, Certified School Crossing Guard Trainer
A member of our supervisory team, Mrs. Adt has two years experience as a school
crossing guard team leader, and over 10 years experience in human resources and
staffing management, as the former owner of a temporary staffing agency.
7481 West Oakland Park Boulevard
Suite 307
Lauderhill, Florida 33319
954.733.0777 Office
954.733.0444 Fax
:".".
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Company/Agency:
Contact:
Title:
Address:
Telephone:
Scope of Contract:
Company/Agency:
Contact:
Title:
Address:
Telephone:
Scope of Contract:
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, . or
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NEXTAFF
REFERENCES
T own of Davie
Lori Lysfjord
Office Manager/Quartermaster
1230 South Nab Hill Road, Davie, Florida 33324
954.693,8268
Temporary Staffing - School Crossing Guard Services
Town of Jupiter
Lieutenant Sam Miller
Using Agency Liaison
210 Military Trail, Jupiter, Florida 33458
561.746.5134
Temporary Staffing - School Crossing Guard Services
-;'ti.,-
X