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DELIVER TO:
City of Sunny Isles Beach
City Clerk
18070 Collins Avenue
Sunny Isles Beach, FL 33160
INVITATION TO BID
SECTION 4
BID SUBMITTAL FORMS
'RECE!VED}, ,,'
l ~:
" ~
SEP 2 ,2 2011 \tiP
Clty or Sunny Isles Beach I
OPENiNG':~10:00.A.'!' .
09/22/2011
PLEASE QUOTE PRICES F.O.B. DESTINATION, LESS TAXES, DELIVERED IN
CITY OF SUNNY ISLES BEACH, FLORIDA
NOTE: City of Sunny Isles Beach is exempt from all taxes (Federal, State, and Local). Bid price should be
less all taxes. Tax Exemption Certificate furnished upon request.
Issued by:
Purchasing Agent
Date Issued:
08/31/2011
This Bid Submittal Consists of
Pages 19 through 23
Sealed bids are subject to the Terms and Conditions of this Invitation to Bid and the accompanying Bid
Submittal. Such other contract provisions, specifications, drawings or other data as are attached or
incorporated by reference in the Bid Submittal, will be received at the office of the City Clerk at the
address shown above until the above stated time and date, and at that time, publicly opened for
furnishing the supplies or services described in the accompanying Bid Submittal Requirement.
ITB 11-08-03
Professionally Serviced Floor Mat Rentals
A Bid Deposit in the amount of 0% of the total amount of the bid shall accompany all bids
A Performance Bond in the amount of 0% of the total amount of the bid will be required upon execution
of the contract by the successful bidder and City of Sunny Isles Beach
Procurement AClent:
Marcanthony Tulloch
Firm Name:
Commodity Code(s):
RETURN ONE ORIGINAL AND FOUR COPIES OF BID SUBMITTAL PAGES AND AfFIDAVITS
FAILURE TO SIGN PAGE 23 OF SECTION 4 BID SUBMITTAL WILL RENDER YOUR BID NON-
RESPONSIVE
PAGE 19 OF 24
BID No. 11-01-01
BID FORM
Item Description Mat Counts Weekly Annual Extended
No. Unit Price Multinlier Price
1 SCRAPER MAT 3' x 5' 1 $ I, 5'""3 52 $ 71:5~
2 CITY LOGO MAT 5'x 8' 2 $ i./.1<J 52 $ 5<:19. ~~
3 BLACK MAT 3'x 10' 1 $ 3.0G, 52 $ I!'?,rl.
4 CITY LOGO POLICE MAT 3'x 5' 2 $ ';;,30 52 $ .J3<}.2.~
5 BLUE MAT 3'x 5' 2 $ /;oS 3 52 $ 151.i2
6 CITY LOGO POLICE MAT 4'x 6' 4 $ 3. I.SJ 7 52 $ 7~3.~~
7 BLUE MAT 4'x 6' 8 $ d. yS- 52 $l D/9.li.>
8 SCRAPER MAT 3' x 5' 4 $ I. S- "3 52 $ 3/<;.:J. ~
9 CITY LOGO Gov CENTER 3' x 5' 4 $ .).3<:> 52 $ '/7 ~- '/6
GREY
10 CITY LOGO MAT 4'x6' 2 $3.i..o7 52 $ 3~/ .GS>
11 CITY LOGO Gov CENTER 3'x 5' 2 $;;.3() 52 $
BLACK ,;;1:39..2 a
Grand Total Items 1 - 11: $ ~3.y {, .lo~
"The estimated annual quantity listed is based on a weekly schedule of pick-ups. If the schedule is
changed to a bi-weekly or monthly the weekly unit price will be multiplied accordingly.
PAGE 20 OF 24
BID No. 11-01-01
SECTION 4
BID SUBMITTAL FOR:
ACKNOWLEDGEMENT OF ADDENDA
INSTRUCTIONS: COMPLETE PART I OR PART II, WHICHEVER APPLIES
PART I:
LIST BELOW ARE THE DATES OF ISSUE FOR EACH ADDENDUM RECEIVED IN
CONNECTION WITH THIS BID
Addendum #1, Dated
Addendum #2, Dated
Addendum #3, Dated
Addendum #4, Dated
Addendum #5, Dated
Addendum #6, Dated
Addendum #7, Dated
Addendum #8, Dated
PART II:
D NO ADDENDUM WAS RECEIVED IN CONNECTION WITH THIS BID
uf tf i ":-;'q i- Co rno(C~L.~
,
AUTHORIZED SIGNATURE: vI/~0 DATE:
TITLE OF OFFICER: LCJc~(~",,^ tAlCAMtu; t /;-
FIRM NAME:
12C/1/
/
PAGE 21 OF 24
BID No. 11-01-01
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BID SUBMITTAL FORM
Bid Title: Professionally Serviced Floor Mat Rentals
The undersigned Proposers proposes and agrees, if this Bid is accepted, to enter into an agreement with The City of
Sunny Isles Beach in the form included in the Contract Documents to perform and furnish all Work as specified or
indicated in the Contract Documents for the Contract Price and within the Contract Time indicated in this Bid and in
accordance with the other terms and conditions of the Contract Documents,
The Proposers accepts all of the terms and conditions of the Advertisement or Invitation to Bid and Instructions to
Proposers, including without limitation those dealing with the disposition of Bid Security. This Bid will remain subject
to acceptance for 90 days after the day of Bid opening. The Proposers agrees to sign and submit the Agreement with
the Bonds and other documents required by the Bidding Requirements within ten days after the date of the City's
Notice of A ward.
In submitting this Bid, the Proposer represents, as more fully set forth in the Agreement, that:
The Proposer has familiarized himself/herself with the nature and extent of the
Contract Documents, Work, site, locality, and all local conditions and Law and
Regulations that in any manner may affect cost, progress, performance, or
furnishing of the Work.
. The Proposer has given the City written notice of all conflicts, errors,
discrepancies that it has discovered in the Contract Documents and the written
resolution thereof by City is acceptable to the Proposer.
This Bid is genuine and not made in the interest of or on behalf of any
undisclosed person, firm or corporation and is not submitted in conformity with
any agreement or rules of any group, association, organization, or corporation;
the Proposer has not directly or indirectly induced or solicited any other
Proposers to submit a false or sham Bid; the Proposer has not solicited or
induced any person, firm or corporation to refrain from Bidding; and Proposer
has not sought by collusion to obtain for itself any advantage over any other
Proposers or over the City.
The Proposer understands and agrees that the Bid is for unit prices to furnish and install individual Work
Items for maintenance and/or repair work, complete in place. Estimates are provided for the purposes of
Bid Evaluation and to establish unit prices for individual Work Items for maintenance and/or repair work
to be contracted by the City under individual Purchase Orders, based on the unit prices established under
this Bid.
The City and the successful Proposer will establish completion times for each individual Work Item and
the successful Proposer agrees that the work will be completed within the time frames agreed upon and
stipulated in the individual Purchase Orders and/or Notice to Proceed.
PAGE 22 OF 24
BID No.
FIRM NAME:
u.. V\-, Fl (~ L6 r ~()r cv\-)c...v\
Street Address:
8'14D VJ w 71{ -+1- ~v-e
Mailing Address (if different):
~tL;,-\.e I
'Nq ~I -('L 33 \ (a (p
I
Telephone No. 1:?-'S - ~&l-ll\o.
Email Address: '^^ ,clAo.~l_,^\~'t::c,O
LL V\.\ i=", .~, . t
Fax No.
~C> S - &~7 - 7 1 0 vI
FEIN No. .&!1-.1:i1J!2JJJ.!iJh!2
* "BY SIGNING THIS DOCUMENT THE BIDDER AGREES TO ALL TERMS
(SIGNATURE OF AUTHORIZE ENT)
PRINT NAME: M rdr.adALY9 1)c~
TITLE: Loc ~'lh'\. Wl ~cur" v
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 ABOYE
BY AN AUTHORIZED REPRESENTATIYE SHALL RENDER THE PROPOSAL NON-RESPONSIYE. THE CITY
MAY, HOWEYER, IN ITS SOLE DISCRETION, ACCEPT ANY PROPOSAL THAT INCLUDES AN EXECUTED
DOCUMENT WHICH UNEQUIYOCALL Y BINDS THE PROPOSER TO THE TERMS OF ITS OFFER.
PAGE 23 OF 24
BID No.
PAGE 24 OF 24
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 OF MiOM,ti:Va.d~
The undersigned being first duly sworn as provided by law, deposes, and says:
This Affidavit is made with the knowledge and intent that it is to be filed with the City of Sunny Isles Beach City Commission and that it will be
relied upon by said County, in any consideration which may give to and any action it may take with respect to this Bid.
The undersigned is authorized to make this Affidavit on behalf of,
of which he is
Vw?irst COrpoyaJo1A
(Name of Corporation, Partnership, Individual, etc.)
a, 1v~~tiYia.! UUi{or~ ~taJ 1\ 0!;~~~er the laws of MasSllCkM S~ffg
(Type of Business) (State)
lOCQfi ~sole~~r~l~er, President, etc.)'
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 hereof.
Ice 1t/4,W7 f/J7.(JMQJ-L- V
AFFIANT'S TITLE
TAKEN, SWORN AND SUBSCRIBED TO BEFORE ME this :;0 day of
Personally Known ~or Produced Identification
S-epl.emhcr rI J
~ ' 20'/1.
Type of identification
~~
(Affix seal here)
~YPCl~
~'l<r.
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Notary Public State of Florida
Blanca Feliz
My Cummission 00875176
Expires 03/29/2013
DECEMBER 28. 2010
1 of 7
PUBLIC ENTITY CRIMES
0' \ ~j'~
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.
This sworn statement is submitted to City of Sunny Isles Beach
Mi c ~Cter tiu Locatrff1A- H1l\A.a_ .~y
by
for
2Pi 0 N. W. 'r4.f~ AI(f}.MJ.€
Medky ! 'fL 33( 0 (;,
and (if applicable) its Federal Employer Identification number (FEIN) is 04 - Z( 03 L{ roo.
(If the entity had no FEIN, include the Social Security Number of the individual signing this sworn
statement: .)
whose bL!siness 3d~ress is:
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.)
predecessor or successor of a person convicted of a public entity crime; or
b.)
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,
direGtors, executors, partrers, 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
20f7
DECEMBER 28. 2010
market value under an arm's length agreement, shall be a prime facie case that one person
controls another person. A person who knowingly enters into a joint venture with a person who
has been convicted of a public entity crime in Florida during the preceding 36 months shall be
considered an affiliate.
11.5. 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 T;O O~~~ INFORMATION CONTAINED IN THIS FORM.
(Si9;:.nr:lt'J"/ ~ fk S
(printed:J:e) .,
1cK r-c.-'" ~~ V v
(Title)
Sworn to and subscribed before me this blo
day of .s;jJJ(!,n.6~r ,20~, by
#~~
(AFFIX NOTARY STAMP HERE)
o~~y PIJ. ~(., Nota. ry Public State of Florida
~ "Blanca Feliz
~.::: " i My CCimmission DD875176
".~ OF f'O~ Expires 03/29/2013
Personal. _~~~
Signature: Notary Pu,blic - State of Florida
/3Ja~c6 /-e..,!-"Z...
Print or Type Commissioned Name
Identification
Type of Identification Produced
10/1998
3 of 7
EQUAL OPPORTUNITY /
AFFIRMATIVE ACTION
QJ \1,)''''
City of Sunny Isles i3each
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:
~~
U-c ~ {eon #!a.~..a-}' ~ ;/
UNIFIRST CORPORATION
8140 NW 74TH AVE UNIT 1
Signed:
Title:
Address:
DECEMBER 28, 2010
40f7
CONFLICT OF INTEREST
0' \\J'"
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 MiaWltl ~ Vttde
with a local
/Vfieitatf .;{1l~3;/J:3
LocaftOV1 ~a,ua.1~.Y
office in M,CHHf
, who was duly sworn,
BEFORE ME, the undersigned authority, personally appeared
deposes, and states:
18.1. J .~ t am./..
I L<< 'YS Co~~ttll~
~;p tmu)(Ul.O 1~ f ctc. I, 'PI-
I I
18.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No. described
as: Landscape Maintenance Services. The Affiant has made diligent inquiry and provides the information contained in this
Affidavit based upon his own knowledge.
the
of
and principal office in
18.3 The Affiant states that only one submittal for the above Bid is being submitted and that the above named entity has
no financial interest in other entities submitting Bids for the same project.
18.4 Neither the Affiant nor the above named entity has directly or indirectly entered into any agreement, participated in
any collusion, or otherwise taken any action in restraints of free competitive pricing in connection with the entity's submittal for
the above Bid. This statement restricts the discussion of pricing data until the completion of negotiations if necessary and
eXt:culian uf the Cunlrdct fal ihi~ prajeci.
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.
18.7 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.
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.
Dateg..t~A' 2J}./tt day of ge//!€M.f&eY ,201~.
~~ /??~d~~k~c, ~'kt #f~J<L v
AFFIANT Print or Type Nam d Title v
Sworn to and subscribed before me this aD day of Sepf(,rnhe./' ,20111
--rJ Personally Known - OR
o Produced Identification ; T~ of Id~~.ti
NOTARY PUBLIC STATE OF FLORIDA ~ ~ ~
:f<JS'..tY ~1I8G- Nota. ry Public State of Florida
., ': Blanca Feliz
~",c.. ',5 My Commission 00875176
~o,(\.o'" Expires 03/29/2013
""'~
DECEMBER 28. 2010
5 of 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
Answer the following questions by placing a "X" after "Yes" or "No". If you answer "Yes", please
explain in the space provided, or on a separate sheet attached to this form.
19.1. Has your firm or any of its officers, received a reprimand of any nature or been suspended by the
Department of Professional Regulations or any other regulatory agency or professional associations within the last
five (5) years?
YES
NO
x:
I
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
';(
19.3. Has your firm had against it or filed any requests for equitable adjustment, contract c1dims, 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 Y 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.
U Y\l r~I(':-.+ (Ot';)()(J,.<-o^
Firm _~~'
Author~d Signat
a.jlC/ /2 01 ,
'Date'
tfllci. ",J jJ"qfr I~ La<"'/'... I1ftuf"ff ~
Print or Type Name' nd Title
DECEMBER 28,2010
60f7
ANTI-KICKBACK
0' 'HJt~
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 OF Mlallli-1JOde ~
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:
d$~
u(' ~ ~ 1/tfQ.M. CleM v
/
Title:
2'~. foregoing instrumRnt was acknowled9~d before me this W"'" day of
-:3et'U!l116.e Y , 20-11-, by MidAael f"itl.j cr'US [name
of b.erson], as LOr3a.{;mf MMt.a~eY [type of authority], for
UWPirs't {I()rf;oYa:lt~ [na e of party on behalf of whom instrument was
executed]. (
vv~
o,ts'.~y PlIe<< Notary Public State of Florida
~ \ ': Blanca Feliz
~.::.. "it My Commission D0875176
-v,.. OF f'>O~ Expires 03/29/2013
w~~
Notary Public - State of Florida
'?k/?LC{ ~/ z-
Print or Type Commissioned Name
AFFIX NOTARY STAMP HERE:
Personally Known V OR Produced Identification
Type of Identification Produced
DECEMBER 28. 2010
7 of 7