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HomeMy WebLinkAboutJorge A. Gutierrez Architect LLCorig i mgtL City of Sunny Isles Beach RFQ No. 12 -01 -03 Development of Site Plans and Survey for Placement of a Temporary Trailer PRICING RESPONSE SECTION JORGE A GUTIERREZ ARCHITECT LLC i 21 Page City of Sunny Isles Beach RFQ No. 12 -01 -03 Development of Site Plans and Survey for Placement of a Temporary Trailer Proposer's Price to the City The undersigned proposes to provide Professional Services for the "Development of Site Plans and Survey for Placement of a 24' x 56' Temporary Trailer ", scope of services as described in the RFQ No. 12- 01 -03, date 1/4/2012, for the sum of Fifty two thousand five hundred dollars, $52,500,00. Included in the services to be provided are Underground Utilities Survey, Land Surveying, Geotechnical Investigation and Foundation Recommendations, Architectural Site Plan, Accessibility Plan, Landscape Architecture, Structural Engineering, Civil Engineering, Plumbing, Fire Alarm, Electrical /Site Electrical Engineering, Cost Estimating, Coordination and Meetings, Permit Processing through the City of Sunny Isles Beach, North Miami Beach, FDOT, DERM, WASD, FPL, AT &T, Miami -Dade Fire Rescue, Health Department. 1. Proposal is for Professional Design Services only and processing of permits for construction of the work designed. 2. Proposal does not include payment for construction licenses, permits, inspections, special inspections, fines, testing, construction deficiencies in work, cost of regulatory requirements upon construction. 3. An allowance price amount (Proposer /Consultant to be reimbursed by Owner) is added for permit review fees, impact fees, required printing, postage and deliveries. 31 sage JORGE A GUTIERREZ ARCHITECT LLC City of Sunny Isles Beach RFQ No. 12 -01 -03 Development of Site Plans and Survey for Placement of a Temporary Trailer Fee Breakdown (includes Schematic and Construction Documents) • As built /Existing Conditions Documentation $4,500.00 • Underground Utilities Survey $3,000.00 • Land Surveying $3,500.00 • Geotechnical Investigation $1,500.00 • Schematic Design Documents $12,000.00 Architectural, Landscape, Structural, Civil, Electrical, Plumbing, Fire Alarm • Cost Estimate - Schematic $2,000,00 • Construction Documents 100% $16,000.00 Architectural, Landscape, Structural, Civil, Electrical, Plumbing, Fire Alarm • Cost Estimate — 100% Documents $2,000.00 • Permit Processing $4,000.00 Sunny Isles Beach, NMB, FDOT, MDFR, DERM, FPL, AT &T, WASD, Health Department • Coordination and Meetings $4,000.00 TOTAL $52,500.00 Allowance for Permit processing fees, impact fees, consultant fees to be reimbursed by Owner $20,000,00 Allowance for Printing, postage, carriers, consultant to be reimbursed by owner $ 2,500,00 Proposal does not include Site Plan Approval processing and documentation, renderings, testing, special inspections, traffic studies Respectfully submitted, Jorge A Gutierrez, AIA .JORGE A GUTIERREZ ARCHITECT LLG 41 Page orloi naL j t) t:) �3 4� i f, ,3 City of Sunny Isles Beach RFQ No. 12 -01 -03 Development of Site Plans and Survey for Placement of a Temporary Trailer 1) STATEMENT OF QUALIFICATIONS Table of Contents 1. Company Information a. Licenses b. State Certifications 2. Qualifications 3. Staffing 4. Approach /Methodology 5. References 6. Contract Forms 2) PRICING RESPONSE SECTION (in separate envelope) jorge a gutierrez architect Ilc L9 1 1 2 i j C) City of Sunny Isles Beach RFQ No. 12 -01 -03 Development of Site Plans and Survey for Placement of a Temporary Trailer 1. Company Information jorge a gutierrez architect Ilc L, 2 City of Sunny Isles Beach RFQ No. 12 -01 -03 3 Development of Site Plans and Survey for Placement of a Temporary Trailer 1. COMPANY INFORMATION NAME OF FIRM: Jorge A. Gutierrez Architect, LLC COMPANY LOCATION: 1156 98 STREET, Bay Harbor Islands, FL 33154 WEBSITE: www.iagaia.com BUSINESS ENTITY: Limited Liability Company DATE FOUNDED: November 10, 2010 HOME OFFICE ADDRESS: 1156 98 STREET, Bay Harbor Islands, FL 33154 TELEPHONE NUMBER: (954) 804 -3517 E -MAIL ADDRESS: Jgutierrez @iagaia.com LITIGATION: Jorge A. Gutierrez Architect LLC does not have currently and has not had any litigation, arbitration, or mediation involvement by the firm, against the firm, against sub - consultants or against project owners. AVAILABILITY: Our firm is immediately ready to provide professional services in response to this RFQ. All sub - consultant key personnel identified will be made available as the project schedule requires. Jorge Gutierrez AIA can dedicate close to 75% of his available working time to this contract. PROOF OF INSURANCE: see attached documentation following this page jorge a gutierrez architect Ilc h 3 4 S UNC0AST Insurance Inc. Shwe 1975 October 17, 2011 Jorge A. Gutierrez Architect, LLC 20801 Biscayne Blvd., Fourth Floor Aventura, FL 33180 RE: Availability of Increased Limits Dear Mr. Gutierrez; 'i5Y This letter is to inform any interested owner that your firm is in excellent standing with XL Specialty Insurance Company and could, at your desire, increase the Professional Liability Policy limits to $2,000,000 Each Claim / $2,000,000 Annual Aggregate to satisfy standard contractual requirements. If you have further questions, please do not hesitate to call. Respectfully, Suncoast Insurance Associates Brian King Account Representative ISU Insurance Services Suncoast Associates, Inc. Independently Owned & Operated Main Office P.O. Box 22668 Tampa, FI 33622 -2668 • 12363 Hampton Park Boulevard Tampa, FI 33624 Phone (813) 289.52W Fax (813) 289.4561 City of Sunny Isles Beach RFQ No. 12 -01 -03 Development of Site Plans and Survey for Placement of a Temporary Trailer AC.I 5380 ?78 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BOARD OF ARCHITECTURE 6 INTERIOR DESIGN $ECt#L10121600273 12116120.10 1109128817 AA26002181 The ARCHITECT CORPORATION I Name rov d below IS CERTIFIED Under the isions of Chapter 481 FS. P -�•; Expiration data: FEB 28, 2013 L. JORGE A GUITERREZ ARCHITECT LLC 20801 BISCAYNE BOULEVARD 4TH FLOOR - AVENTURA F1, 33180 CHARLIE CRIST CHARLIE LIEN GOVERNOR SECRETARY DISPLAY AS REQUIRED BY lAW ACt 5456290 �QSggTATE OF FLORIDA DEPARTMENT OF P ARCMITECTUREP &OINTEROIOR DESIGNATION $EDAL11021500625 �-]Af SE NBR -... __........__._....._.__... 02/15/2011')108178913 IAR0014571 The ARCHITECT Named below IS LICENSED Under the provisions of Chapter 481 FS. Expiration date: FEB 28, 2013 GUTIERREZ, JORGE A 1156 98 STREET BAY HARBOR ISLANDS FL 33154 RGR OVBRHOR CHARLIE LIEM EDBYLAW SECRETARY jorge a gutierrez architect Ilc b 5 Jorge A Gutierrez Architect LLC is a licensed Architectural Services Company authorized to do business in Florida Corporate License Architecture: 12/16/20101 Number: AA 26002181 Jorge A. Gutierrez AIA is a licensed Architect in the State of Florida. Number: AR00145711 f I State of Florida Department of State I certify from the records of this office that JORGE A. GUTIERREZ ARCHITECT LLC is a limited liability company organized under the laws of the State of Florida, filed on November 10, 2010. The document number of this limited liability company is L10000117338. I further certify that said limited liability company has paid all fees due this office through December 31, 2011, that its most recent annual report was filed on April 30, 2011, and its status is active. I further certify that said limited liability company has not filed Articles of Dissolution. Given under my hand and the Great Seal of Florida, at Tallahassee, the Capital, this the Third day of November, 2011 Secretary of State Authentication ID: 900213955629- 110311- L10000117338 To authenticate this certificate,visit the following site, enter this ID, and then follow the instructions displayed. https:Heftle.sunbiz.org /certauthver.html www.sunbiz.org - Department of State Page 1 of 1 FLORIDADEPARTMENT DIVISION CORPORAT IONS Home Contact Us E- Filing Services Document Searches Forms Help Annual Report Online Filing Document Number L10000117338 Thank you for filing your Annual Report online. Your report filed date will be today's date if there are no processing errors. Your confirmation number is 500221120285. Your charge amount is $143.75. 1 Home I Contact us I Document Searches I E- Filing Services I Forms I Help Copvriqht © and Privacv Policies State of Florida, Department of State 7 https: / /fis.sunbiz.org /scripts /ubrrfs.exe 2/8/2012 A City of Sunny Isles Beach RFQ No. 12 -01 -03 8 Development of Site Plans and Survey for Placement of a Temporary Trailer 2. Qualifications jorge a gutierrez architect Ilc M 8 City of Sunny Isles Beach RFQ No. 12 -01 -03 9 Development of Site Plans and Survey for Placement of a Temporary Trailer 2. QUALIFICATIONS i On behalf of the team of Jorge A Gutierrez Architect LLC and consultants, I am pleased to submit our response to your Request for Qualifications for the development of site plans and survey for the placement of a temporary 24' x 56' trailer to be located under SR 856 ( "Lehman Causeway ") With Jorge A Gutierrez Architect LLC you can rely on our: • Tested Teamwork - Proven Results! We have a proven track record of delivering successful projects as we seek to build strong relationships with our clients. In fact, more than 80% of our business comes from repeat clients. • Excellent Experience - Effective Immediately! Our experience partnering with South Florida Cities and Counties means that our team will have no learning curve. You will work with people who have a wide range of experience with local building codes, personnel, and procedures. • Superb Service - Client Focused! Through years of working with governmental clients, we have developed systems that meet your specific needs. Our extensive experience will enable our team to serve as an extension of your staff. Jorge A Gutierrez AIA LEED AP has 24 years of experience in the design of facilities from conception through construction, including post occupancy and warranty services. Jorge's expertise, knowledge, resourceful intuition, along with commitment, passion and loyalty add exceptional value to each and every individual project under his leadership. Jorge's specific qualifications for success in this project include: • Outstanding performance record in facilitating project communication between all stakeholders • Exceptional knowledge of design and construction and the relationship to drawings and specifications. • Clear understanding of cost estimating and scheduling • Extremely proactive, knowledgeable problem solving skills —time is of the essence • Design Intelligence —the summation of years of experience, knowledge, resourceful intuition, and commitment We are excited about the opportunity to partner with the City of Sunny Isles Beach. We thank you for considering our firm, and we look forward to the future of excellence that we can build together. Respectfully, Jorge A Gutierrez, AIA LEED AP As a supplement to our Qualifications, following is a list of past projects of similar scope and complexity. jorge a gutierrez architect Ilc 9 City of Sunny Isles Beach RFQ No. 12 -01 -03 10 Development of Site Plans and Survey for Placement of a Temporary Trailer Past Projects of Similar Scope and Complexity Modular Classrooms Colbert Elementary School Hollywood, Florida Modular Classrooms Addition TPM Westchester Elem. School —Coral Springs, Florida Modular Classrooms Addition TPM Quiet Waters Elem. School — Deerfield Beach, Florida Modular Classrooms Addition TPM Park Springs Elem. School — Coral Springs, Florida Modular Classrooms Addition TPM Banyan Elem. School — Sunrise, Florida Modular Classrooms Addition TPM Maplewood Elem. School — Coral Springs, Florida Modular Classroom Addition TPM AC Perry Elem. School — Miramar, Florida Modular Classroom Addition TPM Coral Park Elem. School — Coral Springs, Florida Modular Classroom Addition TPM Eagle Point Elem. School — Weston, Florida jorge a gutierrez architect Ilc L, 10 �s City of Sunny Isles Beach RFQ No. 12 -01 -03 11 Development of Site Plans and Survey for Placement of a Temporary Trailer 2. QUALIFICATIONS — SCHEDULE OF PROPOSED SERVICES The proposed schedule is based on the information provided in the RFQ and services would start upon notification to proceed. 1. Kick -off meeting with owner, stakeholders 1 day 2. Obtain any available project as -built documentation 3 days 3. Design team /owner team site visit 1 day 4. Prepare underground utility location survey 7 days 5. Prepare surface topographical survey 7 days 6. Prepare Schematic Site plan Architectural, Civil, Electrical and Estimate of Cost 21 days 7. Schematic Design Review meeting with owner 1 day 8. Schematic Site Plan Review meeting with FDOT 1 day 9. Schematic Site Plan Review meeting with NMB 1 day 10. Schematic Site Plan Review meeting with FPL 2 days 11. Schematic Design Owner Approval 14 days 12. Prepare Final Site Plan, Architectural, Civil, Electrical plans, specifications, and Estimate of Cost. 28 days 13. Final Site Plan review meeting with Owner 1 day 14. Final Site Plan Owner Approval 14 days 15. Submit plans for agency approvals 3 days 16. Building permit review process 30 days (concurrent) 17. FDOT permit review process 60 days (concurrent 18. City of NMB permit review process / Health Department 30 days (concurrent) 19. Responses to plan review comments 14 days 20. Final agency review /approvals — ready for permits 21 days TOTAL 200 days jorge a gutierrez architect Ilc hi 11 City of Sunny Isles Beach RFQ No. 12 -01 -03 12 Development of Site Plans and Survey for Placement of a Temporary Trailer 3. Staffing jorge a gutierrez architect Ilc L, 12 City of Sunny Isles Beach RFQ No. 12 -01 -03 13 Development of Site Plans and Survey for Placement of a Temporary Trailer 3. STAFFING Project Manager / Project Coordinator — Jorge A. Gutierrez AIA ®a 71 Jorge A Gutierrez is a Florida Registered Architect with over 24 years experience in the South Florida metropolitan area, including 19 years as a Principal of a Fort Lauderdale firm. His professional work encompasses the successful creation from inception through completion of a variety of office, commercial, retail, recreational, hospitality, educational, municipal, and residential facilities developed with utmost care for quality and completed within prescribed time and value limits. His expertise, knowledge, resourceful intuition, along with his commitment, passion and loyalty add exceptional value to each individual project under his leadership. As a strong proponent of sustainability, Jorge's expertise is enhanced specifically by his outstanding design knowledge of green, high performing and sustainable buildings, and excellent design /problem solving skills. His design philosophy is based on three fundamental principles: durability, reliability, and maintainability, blending these principles with quality design to create high performing, aesthetically pleasing architecture. By providing exceptional value and service, Jorge achieves his professional goals and objectives of complete client satisfaction and success. His dedication to client service is summed in a client's thank you letter: "Any client of yours is extremely fortunate to have you on their team as you guarantee success by your attitude and actions ". Professional Experience — Municipal /Government (Representative Projects) Sunrise Public Works Complex, City of Sunrise Village Multipurpose Building, City of Sunrise Fire Rescue Maintenance Facility, City of Pembroke Pines Fire Station No. 101 and EOC, City of Pembroke Pines Fire Station No. 99, City of Pembroke Pines Fire Station No. 33, City of Pembroke Pines Fire Station No. 79, City of Pembroke Pines Pembroke Shores Gymnasium and Park, City of Pembroke Pines Public Works Facility, City of Weston Fire Station No. 81, City of Weston Fire Station No. 67, City of Weston West Broward YMCA, Weston Weston Tennis Center, City of Weston Community Center, City of Weston Davie Fleet Maintenance Building, Town of Davie Bus Wash / Recycling at Central Maintenance, School Board of Broward County Fire Station No. 6, City of Plantation Volunteer Park Community Center, City of Plantation Fire Station No. 78, City of Tamarac Fire Station No. 3, City of Margate Fire Station No. 1 Addition and Remodeling — City of Dania Beach Fire Administration Addition and EOC, City of Miramar jorge a gutierrez architect Ilc h, 13 City of Sunny Isles Beach RFQ No. 12 -01 -03 14 Development of Site Plans and Survey for Placement of a Temporary Trailer Past Projects of Similar Scope and Complexity developed by Jorge A. Gutierrez AIA as Architect /Project Manager: Modular Classrooms Colbert Elementary School — Hollywood, Fl. Modular Classrooms Addition TPM — Westchester Elem. School — Coral Springs, Fl. Modular Classrooms Addition TPM — Quiet Waters Elem. School — Deerfield Beach, Fl. Modular Classrooms Addition TPM — Park Springs Elem. School — Coral Springs, Fl. Modular Classrooms Addition TPM — Banyan Elem. School — Sunrise, Fl. Modular Classrooms Addition TPM — Maplewood Elem. School — Coral Springs, Fl. Modular Classroom Addition TPM — AC Perry Elem. School — Miramar, Fl. Modular Classroom Addition TPM — Coral Park Elem. School — Coral Springs, Fl. Modular Classroom Addition TPM — Eagle Point Elem. School — Weston, Fl. e 1 F � r a� r+ .1 jorge a gutierrez architect Ilc 14 City of Sunny Isles Beach RFQ No. 12 -01 -03 15 Development of Site Plans and Survey for Placement of a Temporary Trailer Civil Engineer — Robert Ross, P.E. j �11 .: -_,�_� Robert is a Water Resources Engineer with over 16 years of experience in hydraulics and hydrology, stormwater modeling, drainage design, utility design including sizing pumps, flood control, environmental resource permitting, stormwater master planning studies, canal - culvert design and stormwater management plan review. He has worked in South Florida since 1996. In 2003 he started the company Ross Engineering with his wife Melissa. Education Bachelor of Engineering Technology, 1994 Bachelor of Civil Engineering, 2000 Master of Civil Engineering, 2003 Registration & Certifications Florida Registered Professional Engineer Ad -ICPR (H &H Model) Training, 1996, HEC -RAS Training, 1999 XP -SWMM (Stormwater Management Model) Training 2002, 2004 FDEP Qualified Stormwater Management Inspector HEC23 — Stream Stability and Scour at Hydraulic Structures, 2003 Professional Experience Ross Engineering, Inc. 2003 — present SFWMD Big Cypress basin (BCB) — Immokalee Stormwater Master Plan Project Manager and Lead Engineer City of North Miami Basin 5 Drainage Basin, North Miami Responsible Engineer for best management practices for water quality and flood mitigation Hollywood Firefighters Union Hall, Hollywood Project Manger City of North Miami Basin 5 Drainage Improvements, City of North Miami BCPS Ft. Lauderdale High school, Fort Lauderdale Engineer of Record for the analysis, design, permits and civil construction administration Seminole Tribe of Florida, Big Cypress Police, Fire and Emergency Operation Center, Big Cypress Reservation Project Manager and Engineer of Record Seminole Tribe of Florida, Brighton Police, Fire and Emergency Operation Center, Brighton Reservation Project Manager and Engineer of Record Broward County School Board: Colbert Elementary, Hollywood Design drainage, utilities and permitting administration building. jorge a gutierrez architect Ilc W 15 6 1 i, I i a City of Sunny Isles Beach RFQ No. 12 -01 -03 16 Development of Site Plans and Survey for Placement of a Temporary Trailer Electrical Engineer — George San Juan, P. E. George San Juan founded Delta G Consulting Engineers Inc. in 1992. Since then, George ha led the growth of the firm to nineteen engineers and staff. He is an Electrical Engineer witl «` over 28 years of experience that include the design and managing of innumerable project! in the municipal, commercial ,retail, educational and residential areas. Projects under his direction have been developed with a high degree of commitment to quality, y h professionalism and within the proposed schedules. George leads the projects with an extraordinary understanding of the project- specific criteria, the technical requirements an the customer expectations. His vast knowledge and expertise have allowed him to complete all projects successfully. �Arc:v k€esprt@ �l¢nt+tr Education t L Y t Associate of Art, Florida Atlantic University 1983 Bachelor of Science, Florida Atlantic University 1988 aCK flaidu 11111111111 - Registration & Certifications Professional Engineer (Licensed in 6 States) LEED Accredited Professional, 2009 USGBC , United States Green Building Council Professional Experience Delta G. Consulting Engineers, Inc. (Since 1992 — present) Sunrise Public Works, City of Sunrise Mitigation and Operation Emergency Center, Deerfield Beach Pembroke Pines Fire Rescue Maintenance Building, Pembroke Pines Miramar Fire Police Station Phase 2, City of Miramar Weston City Hall, City of Weston Weston Fire Station No.55, City of Weston Fort Lauderdale - Hollywood International Airport Terminal 1 Information Center, Fort Lauderdale Coral Springs City Hall Deerfield Beach Fire Station, Deerfield Beach • +�* �� ■ Transit Center Bus Canopy, Pompano Beach Broward County Edgar Mills Multipurpose Center Dania Beach Library, City of Dania Beach jorge a gutierrez architect Ilc hi 16 0 7 t t i w City of Sunny Isles Beach RFQ No. 12 -01 -03 17 Development of Site Plans and Survey for Placement of a Temporary Trailer ORGANIZATIONAL CHART Saad El Hage Consuiti Engineers, Inc. Saad El Hage, P.E. Landscape Land Stewardshi Jo Ellen Leisinger, RLA Project Man Ross Engineering In obert Ross, P.E. ndergroun tw. Locatii Ground Ho jorge a gutierrez architect Ilc L 17 id Survey Cousins Survey ichard Cousins, St Estimating Scheduling City of Sunny Isles Beach RFQ No. 12 -01 -03 18 Development of Site Plans and Survey for Placement of a Temporary Trailer 4. Approach / Methodology jorge a gutierrez architect Ilc IN 18 City of Sunny Isles Beach RFQ No. 12 -01 -03 19 Development of Site Plans and Survey for Placement of a Temporary Trailer 4. APPROACH / METHODOLOGY A. Approach Working in partnership with the Team will ensure a safe facility site design that will be cost - effective to build and effective to operate within the life cycle of the facility. The facility will be designed to provide: • ease of access to site • ease of access to and from components within site • building connections to structure capable of withstanding impact from storm events • Civil engineering — Conceptual and detailed site engineering leading to effective solutions • Landscape Architecture — Conceptual and detailed landscape design following sustainable solutions • Architecture — Conceptual and detailed design, proactive/ effective project management • Structural Engineering —Conceptual and detailed design of foundations • Cost Estimating — current cost estimating with each deliverable jorge a gutierrez architect Ilc hi 19 3 rj 4 f =fir 20 B. Methodology City of Sunny Isles Beach RFQ No. 12 -01 -03 Development of Site Plans and Survey for Placement of a Temporary Trailer Due Diligence Review • Obtain site survey • Obtain Underground utilities survey • Review existing site as built plans • Review facility & space program • Review existing site limitations, conflicts and possibilities available to inform design • Re- assert City project objectives, needs, program requirements • Re- assert City budget goals • Re- assert City project time constrains • Establish project sustainability goals Schematic Plans and Specifications • Develop plans and specifications • Architectural Site building codes analysis • Civil Engineering conceptual plan • Structural Engineering conceptual • Electrical, Fire Alarm Engineering conceptual design • Landscape Architecture Conceptual plan (xeriscaping & low maintenance design) • Outline Specifications • Cost Estimate — preliminary • Establish basic design relationships between programmed components • Establish coordination between design disciplines • Ascertain compliance with City project goals and objectives Final Plans and Specifications • Develop Final Plans and Specifications • Architectural, Civil Engineering, Landscape Architecture, Structural Engineering, Electrical, Plumbing, Fire Alarm System • Engineering plans and specifications developed to 100% • Cost Estimate • Developed plans have incorporated and meet City project needs, requirements, goals and objectives • Developed plans have been coordinated to ensure compliance with applicable codes and regulations • Developed plans have been coordinated between design disciplines to ensure Quality • Cost Estimate will ensure compliance with City budget requirements jorge a gutierrez architect Ilc 20 City of Sunny Isles Beach RFQ No. 12 -01 -03 21 Development of Site Plans and Survey for Placement of a Temporary Trailer Corrected Final /Ready to Advertise • Final Plans and Specifications updated incorporating City, review agencies comments • Review City construction contract agreement requirements • Final Plans and Specifications and construction contract requirements are prepared and reviewed to ensure minimum risk of errors /omissions • Permit submittal and approvals — obtain approvals and have plans ready for selected contractor to obtain permits jorge a gutierrez architect Ilc h 21 City of Sunny Isles Beach RFQ No. 12 -01 -03 22 Development of Site Plans and Survey for Placement of a Temporary Trailer 5. References jorge a gutierrez architect Ilc b 22 i r � 8) E' ) 4 i -� 23 5. REFERENCES City of Sunny Isles Beach RFQ No. 12 -01 -03 Development of Site Plans and Survey for Placement of a Temporary Trailer • Scott Hennigar, Project Manager School Board of Broward County Fort Lauderdale, Florida (954)- 593 -3776 • Mathew B. Decker, Project Manager School Board of Broward County Fort Lauderdale, Florida (954) 804 -9942 • Paul Edelstein, Assistant Director Public Works, City of Pembroke Pines Pembroke Pines, Florida (954) 538 -3645 • Darphine Snell, Owner Carol City Early Learning Center Miami Gardens, Florida (305) 505 -2411 • Robert Romeo, Project Manager City of Sunrise Sunrise, Florida (954) 888 -6060 jorge a gutierrez architect Ilc h 23 r F. 11+1 :�. • ria_a• •.' • 1111 iin di 14, Ilk g,'. A- gliat iii CIIS - PROJECT EVALUATION Saturday, February 19, 2011 - 2:21:46 PM 24 MIAMI -DADE COUNTY, FLORIDA MIAMMADE Capital Improvements Information System Miami -Dade Water and Sewer Department Contractor / Consultant Evaluation EDP Project: EDP -WS -S -148 Evaluation Type: Standard Evaluation Title: WATER TRANSMISSION SYSTEM COMPUTER MODEL Contractor: ROSS ENGINEERING, INC. FEIN: 450500482 Department Contact: Patty David 7865528040 Award Amount: $0.00 Page 1 of 2 Evaluator ID: DJEDW01 Date: 2/19/2011 Period: Completion of study or design Rating " N/A Criteria Schedule - Quality of schedule & adherence to schedule resulting in timeliness and minimizing delay to the owner and community. Cost effectiveness &efficiency - Budget compliance &value of work. Vision - Design - Concepts or adherence to criteria. I Cooperation - Teamwork &relationship with owner, subs and suppliers. Coordination - Ability to organize, schedule and complete 000aaa tasks in adherence to the schedule. Accuracy & Technical Skills - Cost estimating, scheduling, shop and other drawings, plans, manuals, project documentation and conflict resolution. Completeness -Compliance with contract documents, permits, Codes &standards. Responsiveness - Timely, clear &concise responses to owner comments and correspondence. Commitment - Intangibles & contribution to project success. 10- 00000 Personnel - Quality and dedication of project staff. Management - Leadership ability. Quality - Work performed correctly the first time. Overall Performance Average: 4_0 Documentation that supports this evaluation and Contractor's /Consultant's comments can be obtained by contacting: Dan Edwards at Phone# 786 -552 -8354 Evaluation Reviewed by: Supervisor PI Division Chief [' °a Assistant Director 11 Director [_`] The method of delivery of this evaluation to contractor /consultant: Certified Mail 1' l EMail Pv( Fax 11 1 Hand P_::1 (Unresponsive Performance by contractor /consultant requires 2 delivery methods, one MUST be Certified Mail.) Evaluation delivered to: Robert Ross, P.E., Ross Engineering, Inc. Ratina Key 4 Superior performance - Exemplary quality, no intervention required - project completed on time or early at or below budget with no change orders or amendments other than owner requested changes. 24 http: / /intra.miamidade.gov /CIIS /Contr acts /f - inConti- actorEvaluatioii .asp ?SelCICCNO =O &... 2/19/2011 CIIS - PROJECT EVALUATION Saturday, February 19, 2011 - 2:21:46 PM Page 2 of 2 25 3 Satisfactory performance - Minor errors noted, addressed with timely corrective action. No serious errors noted or corrective action needed. 2 Guarded performance Errors and Omissions documented in writing with timely corrective action. 1 Unresponsive performance documented in writing without timely corrective action. N /A. No Information 25 littp: / /intra. miamidade. gov /CI I S/ Contracts /frmContractorEvaluation .asp ?Se1CICCNO =0 &... 2/19/2011 08!15!2008 11:37 3657871038 26 1 ) l 3 ) i j City of North Miami 776 Northeast 125th Street, P.O. Box 619085, North Miami, Florlda 33261 -9085 August 14. 2008 R Ross Engineering, Inc. Letter of Recommendation – Basin 5 Improvemea s To Whom It May Conceri: PAGE 01101 (305) 893 -6511 Ross Engineering, Inc. has recently worked with the City of North Miami on the City's Priotity Basin No. 5 Drainage Improvements. We highly recommend using Ross Engineering due to their high level of service, quality work, speed and efficiency of obtaining permits. Ross Engincenng has worked cl.oseiy vdtll our staff to keep Construction costs to a M111i1TIU.m on. OUT PrOJeCtS. Si.n.cereiy, "X—A A cctii - Assis . bii&-W -4r Director 26 27 } July 29, 2009 BIG CYPRESS BASIN SOUTH FLORIDA WATER MANAGEMENT DISTRICT 2640 Golden Gate Parkway, Suite 205, Naples, FL 34105 (239) 263 -7615 • Fax (239) 263 -8166 • www.sfwmd.gov /beb/ TO WHOM IT MAY CONCERN: Ref: Letter of Recommendation for Mr. Robert Ross, P.E. In 2005 -2006, the Big Cypress Basin developed a Stormwater Management Master Plan for the Immokalee area at the request of Collier County through the consulting engineering firm H.W. jLochner, Inc. Mr. Robert Ross, P.E. worked as the primary project engineer of the consulting team. Mr. Ross (presently President of Ross Engineering, Inc.) worked closely with the Big Cypress Basin office to complete in developing a successful Stormwater Management Master Plan for the Immokalee urban area. During the project his responsibilities spanned project management, performing modeling analysis with Dr. Fernando Miralles - Wilhelm, P.E., and providing conceptual L ) alternatives to alleviate the deficiencies in flood control and water quality protection for the t Immokalee area. He attended the Immokalee Master Plan and Visioning Committee and BCB Board meetings with the team, where the project was discussed in detail with the stake holders in the area. Mr. Ross demonstrated excellent qualitative and quantitative approach of stormwater management problem solving. The successes of his efforts are reflected in conceptual design solutions to be implemented for the benefit of the public. The project was completed to our satisfaction and the budget and schedule was kept on track throughout the project with no need for any additional service agreements or change orders. We would not have any hesitation in recommending Mr. Ross for providing stormwater management planning and design on any future projects. Should you have any question or need information on project specific data, we remain available and can be contacted at (239) 263 -7615. Sincerely, UA� , V-' Max Guerra, P ., P.E. Senior Engineer BIG CYPRrss BASIN GOVERNING BOARD Charles J. Dauray, Chair, Ex officio - Lee Costaty Alice E. Abbott - Marro Island Liesa Priddy, Secrelary - Immokalee John F. Sorey III, Vice Chair - Naples Libby Anderson - Naples Jon C. Staiger, Ph.D. - Naples 27 DIRECTOR Clarence S. Tears, Jr. 28 AFFILIATED WITH FLORIDA PROFESSIONAL FIRE FIGHTERS BROWARD COUNTY COUNCIL OF PROFESSIONAL FIRE FIGHTERS AFL -CIO GREATER SOUTH FLORIDA MARITIME TRADES COUNCIL KO A ! / / Zocae 1375 310 S. 62nd Avenue . Hollywood, Florida 33023 -1327 January 27, 2009 Mr. Robert J. Ross, P.E. Ross Engineering, Inc. 3325 S. University Dr., Suite 111 Davie, FL 33328 Dear Mr. Ross, On behalf of The Hollywood Professional Fire Fighters, Local 1375 we want to thank you for the outstanding service you provided us in our endeavor to rebuild our Union Hall. Your firm provided us with quality, professional service in a timely manor. With your guidance, we were able to efficiently deal with the multiple agencies required to obtain permits and inspections. We would be pleased to recommend you to any potential client. Please feel free to use us as a referral wherever it might be helpful. Thank you again on behalf of our members. Sincerely, pW�kzw Russell R. Chard President 28 �I City of Sunny Isles Beach RFQ No. 12 -01 -03 29 Development of Site Plans and Survey for Placement of a Temporary Trailer 6. Contract Forms jorge a gutierrez architect Ilc b 29 /Jk Of SON P'%_ DELIVER TO. STA TEMENT OF City of Sunny Isles Beach QUALIFICATIONS/ OPENING: 10:00 A.M. City Clerk PROPOSAL 02/14/2012 18070 Collins Avenue SECTION 6 Sunny Isles Beach, FL 33160 BID SUBMITTAL FORMS 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: This Bid Submittal Consists of 01/14/2012 Pages 22 through 25 Sealed bids are subject to the Terms and Conditions of this Statement of Qualifications / Proposal 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. RFQ 12 -01 -03 Development of site plans and survey for the placement of a temporary 24'x56'trailer 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 Agent: Firm Name: Marcanthony Tulloch Y_CJA�, Commodi Code(s): RETURN ONE ORIGINAL AND TWO COPIES OF BID SUBMITTAL PAGES AND AFFIDA VITS FAILURE TO SIGN PAGE 25 OF SECTION 6 BID SUBMITTAL WILL RENDER YOUR BID NON- RESPONSIVE City of Sunny Isles Beach I Request for Proposal No. 12 -01 -03 a SECTION 6 BID SUBMITTAL FOR: ACKNOWLEDGEMENT OF ADDENDA INSTRUCTIONS: COMPLETE PART I OR PART II, WHICHEVER APPLIES PART I: %µµy S,= Q '� stop 5 �} 71 SUN P LIST BELOW ARE THE DATES OF ISSUE FOR EACH ADDENDUM RECEIVED IN CONNECTION WITH THIS BID PART II: Addendum #1, Dated Addendum #2, Dated Addendum #3, Dated Addendum #4, Dated Addendum #5, Dated Addendum #6, Dated Addendum #7, Dated Addendum #8, Dated ® NO ADDENDUM WAS RECEIVED IN CONNECTION WITH THIS BID FIRM NAME: JORGE A GUTIERREZ ARCHITECT LLC AUTHORIZED SIGNATURE: DATE: 2-14 -2012 TITLE OF OFFICER: Operating Manager City of Sunny Isles Beach I Request for Proposal No. 12 -01 -03 1, ,777 4 ya. �r'�r OF SI}N f1119 BID SUBMITTAL FORM Bid Title: Development of site plans and survey for the placement of a temporary 24'xS6' i trailer 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 Statement of Qualifications / Proposal 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 Award. 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. City of Sunny Isles Beach I Request for Proposal No. 12 -01 -03 1K• O - i y y'• p�p4.�� y4v �� Ir Of SUN P��p U� a 0NY!S� c , * F LOS o /rY OF SUN P� T v C� 7 G.J City of Sunny Isles Beach I Request for Proposal No. 12 -01 -03 SV O NYFS4 F NON - COLLUSION AFFIDAVI City of Sunny Isles Beach 18070 Collins Avenue y 9'' • F- lOa\pP Ij Sunny Isles Beach, Fl- 33160 FNO Telephone: (305) 947 -0606 Fax: (305) 949 -3113 STATE OF FLORIDA ) COUNTY OF A I 1A, 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, Jorge A Gutierrez Architect LLC (Name of Corporation, Partnership, Individual, etc.) a Architect formed under the laws of Florida (Type of Business) (State) of which he is Operating Manager (Sole Owner, Partner, 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 102 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. Jorge A Gutierrez Operating Manager AFFIANT'S NAME AFFIANT'S TITLE TAKEN, SWORN AND SUBSCRIBED TO BEFORE ME this � day of '!t b Rk A1Z 20kz Personally Known or Produced Identification t/ ;; p Type of identification F/- t� t-•#- � 3 ��42 1 --5� / —1 3 —Z) (Affix seal he PATSY ANN GIBBS MY Cp1p,11581" M EE132M EXMM: (*&w 23, 3013 T R. Hoffy Ewa e.M a. DECEMBER 28, 2010 1 of 7 RY PUBLIC name printed or typed roe Q S,14 -�, Fs PUBLIC ENTITY CRIMES �I City of Sunny Isles Beach r • 18070 Collins Avenue Sunny Isles Beach, FL 33160 'Y or SUN 'a 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 Sunnv Isles Beach by Jorge A Gutierrez, Operating Manager [print inaiviauars name ana tniel for Jorge A Gutierrez Architect LLC [print name of entity submitting sworn statement] whose business address is: 1156 98 Street, Bay Harbor Islands, Florida 33154 and (if applicable) its Federal Employer Identification number (FEIN) is 27--3976841 (If the entity had no FEIN, include the Social Security Number of the individual signing this sworn statement: ) 11.2. 1 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. 1 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. 1 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, 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 DECEMBER 28, 2010 2 of 7 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. 1 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.) xxx 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: (Signature) Jorge A Gutierrez (Printed Name) Operating Manager (Title) Sworn to and subscribed before me this 3 day of 20 l by (AFFIX NOTARY STAMP HERE) PATSY ANN O1i98S MY COAL ISSION M U117S70 B MRO: baeW 29.3015 Signature: Notary Public — State of Florida P&'�Ty A .0;� ,6r Printor /TyCommissioned Name Personally Known OR Produced Identification Type of Identification Produced a -) L .9 [r 3 k of —4 2/ — -/S 3 —0 10/1998 3 of 7 N Sv - NY / _S,FJ` EQUAL OPPORTUNITY / AFFIRMATIVE ACTION R-`_O City of Sunny Isles Beach c,TY or suN'NO 18070 Collins Avenue Sunny Isles Beach, FL 33160 Telephone: (305) 947 -0606 Fax: (305) 949 -3113 EQUAL OPPORTUNITY /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. Signed: IV Title: Operating Manager r Firm: Jorge A Gutierrez Architect LLC Address: 1156 98 St, Bay Harbor Islands, FI 33154 DECEMBER 28, 2010 4 of 7 tiO� SvN NY '�v CONFLICT OF INTEREST City of Sunny Isles Beach 18070 Collins Avenue oP h F Sunny Isles Beach, FL 33160 suN " 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 Miami Dade BEFORE ME, the undersigned authority, personally appeared Jorge A Gutierrez who was duly sworn, deposes, and states: 18.1. 1 am the Operating Manager of Jorge A Gutierrez Architect LLC with a local office in Bay Harbor Islands., Florida and principal office in 18.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No. RFQ 12 -01 -03 described as: Lid .cape- PA&iHtef)apc- e-Sewie -es- The Affiant has made diligent inquiry and provides the information contained in this Affidavit based upon his own knowledge. 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 execution of the Contract for this project. 18.5 Neither the entity nor its affiliates, nor any one associated with them, is presently suspended or otherwise ineligible from participation in contract letting by any local, State, or Federal Agency. 18.6 Neither the entity, nor its affiliates, nor any one associated with them have any potential conflict of interest due to any other clients, contracts, or property interests for this project. 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 1 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. Dated this 13 _—.dav of_ February 2012 .Q - Print or Type Name and Title 0 '.2-. Sworn to and subscribed before me thistal day of H- 2W. O Personally Known OR O Produced Identification Type of Idea tip tion F-1- �l L b 2 '�i '11 NOTARY PUBLIC STATE OF FLORIDA P611Sy 14 NN uiBBS MY COMMISSION/ EE132130 EXPIRES: Oudw 23, 201! T 19. NO" abmw Amm C& DECEMBER 28, 2010 5 of 7 SVNNY'i$, s �I .fix F-_lp�y'�' 4� fC,Tr Os SUN PNO 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 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 X 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. Jorge A Gutierrez Architect LLC 2 -13 -2012 Firm Authorized Signature Date Jorge A Gutierrez, Operating Manager Print or Type Name and Title DECEMBER 28, 2010 6 of 7 SVNNNY E s ;I Z yF C'gJ -' O F'l�0.\OO yet )y r SUT� PN STATE OF FLORIDA ) COUNTY OF At1'& K;- o 0 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 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: Jorge A Gutierrez Title: Operating Manaizer The foregoing instrument was acknowledged befor me this 1� day of =� k A rt 20 1 � by �S 2 R i� � [name of person], s i Yv a� [type of authority], for o . G k I Pv Z R c + ��} [name of party on behalf of whom instrument was executedl. AFFIX NOTARY STAMP HERE: er , PATSY ANN GIBBS MY COMMISSION R EE 132820 EXPIRES: OdobQ 23, ]Ol5 1.♦foDl�iORAlIY A. Nolsy Dirorrt Arne, Q. 1 c otary Pu lic — State of F orida eA-� sy A. 6,,'b b Print or Type Commissioned Name Personally Known OR Produced Identification Type of Identification Produced _ EL-'-b Z_ -4k T - .3G DECEMBER 28, 2010 7 of 7