HomeMy WebLinkAboutCreative Impressions
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City 01 Sunny ~oact1
OfilCe ot the CIty Clork
Request For Proposals For
City of Sunny Isles Beach
Beach Access Signs
RFP # 12-01-04
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Steven Welch - Accounts Manager
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Legal Name: Weisser Enterprises, LLC
DBA- Creative Impressions
Location: 4708 S. Old Peachtree Rd. Suite 500B
Norcross, Ga 30071
Office: (770) 582-9936 Fax: (678) 421-0932
URL: www.creativeimpressions-signs.com
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Creative Impressions has developed a unique ability to successfully communicate
the conceptual interests of our clients into highly praised products. From design to installation,
we look for every opportunity to continue our growth as a leader in the signage industry.
Drawing on a multitude of experience, commitment to our clients, creative use of materials,
and attention to detail; we eagerly seek out new challenges. These principles have been the
basis of our success, and we look forward to continuing this success with the City of Sunny
Isles Beach.
Creative Impressions will be determined to provide the highest level of service throughout the
projects various stages. As owner of Creative Impressions, I will have a regular and active
participation in this project. In addition, Steven Welch will be assigned to the day to day
communication and coordination of the project. In-house production meetings will be held weekly
to insure that we remain on schedule. It will be our determination to create an open line of
communication.
Upon approval of the project, we will create shop drawings of the proposed signs (estimated
time: 5 business days). Once approved, we will begin construction of the signage (estimated
time: 20 business days). Installation will take between 1-2 days. Our complete time frame, from
the official Notice to Proceed to installed and accepted signs, is 25-30 business days.
As both a design firm and fabricator, we have real-life experience with designing aesthetically
appealing signage that can be realistically constructed. It also gives us the ability to keep the
overall budget of the project consistent with our clients needs.
We are confident that our resources, experience, and determination will result in a successful
signage way-finding project for the City of Sunny Isles Beach. We will commit all of the
necessary resources to ensure all of your signage needs are abundantly cared for.
Creative Impressions
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4708 S. Old Peachtree Rd. 500-8.770-582-9936 fax 678-421-0932 · www.creativeimpressions-signs.com
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{'R E S S ION S
ronmenlal graphics design
W hen planning the design of a project, facility or community, two of the most
important elements to be considered are FORM and FUNCTION. Few other elements
included in any undertaking bring these elements together more visibly than signage.
Architectural signage serves a fundamental role in shaping a workplace or environment
achieving the function and aesthetic needs of today's fast-paced lifestyle. Signage is
communication, it is the written language that should effectively cross the verbal and lor
sightless language barrier. Pictograms, symbols, tactile and braille graphics composed in a
way that informs, directs and identifies while not eroding the aesthetic theme.
This is best achieved when all the elements that make up this effort (form, color, font,
symbols, materials) are combined to produce a unique sense of place. For this to be
effectively accomplished, signage must both complement and seamlessly integrate into the
environment, while at the same time be functionally designed for change and expansion.
CREATIVE IMPRESSIONS is up to that challenge. With almost 30 years experience in the
sign industry we have established a reputation for innovative and reliable sign design
and fabrication.
We provide a comprehensive and cost effective approach to your project. With a hands-on
philosophy towards the design of your signage, we confidently provide fabricators with
reliable plans resulting in the desired product.
We offer the following services:
Design consultation
Complete sign and graphic design
Sign fabrication
Oversight of all production and installation
We look forward to being of service.
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4708 S. Old Peachtree Rd. 500-8 · 770-582-9936 fax 678-421-0932 · www.creativeimpressions-signs.com
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Company Profile
Name: Creative Impressions
Home Office: Norcross, Georgia
Owner: David Weisser
Years Incorporated: Since 1991
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; PfR E S S ION S
Ylronmenlal graphics design
Medical Facilities:
Northside Hospital Tower Interior, Exterior & Parking Deck- Atlanta, GA
Alpharetta Pediatrics Center Interior & Exterior - Atlanta, GA
St. Lukes Cypress Woods Interior & Exterior - Houston ,TX
Educational and Commercial Facilities:
University of Louisville Campus Way-Finding - Louisville, KY
Town of Bluff ton, Historical District Way-Finding - Bluff ton, SC
Gordon College Campus Way-Finding - Barnesville, GA
Gordon College Dormitory Additions Interior & Exterior - Barnesville , GA
West Georgia University Campus Way-Finding - Douglasville, GA
Crystal River, City Way Finding Project - Atlanta, GA
Shaw Industries Industrial Campus Way-Finding - Dalton, GA
Macon State College Interior - Macon, GA
Pinnacle Office Bldg & Parking Deck - Atlanta, GA
Two Live Oak Office & Parking Deck - Atlanta, GA
Mirant Trading Center Office Bldg. & Parking Deck - Atlanta, GA
Apartment Projects:
The Seasons at Texas State - San Marcos, TX
Hill Street Lofts - Atlanta, GA
Oxford Ridge - Jonesboro, GA
Oxford Summit - Cumming, GA
Oxford Walk - Tampa, FL
Oxford Gateway - West Chester, PA
Alta Lofts - Houston,TX
Alta Crescent - Greer, SC
Alta Verde - Raliegh, NC
Post Peachtree - Atlanta, GA
Post Paseo - Pasedena, CA
Alta Bay Apt. - Duram, NC
Post Addison Circle - Houston TX
North 38 - Durham, NC
Alta Oakridge - Richmond, VA
Lafayette Estates - Lafayette, LA
Perimeter Station - Charlotte, NC
Hotel, Restaurants & Sports Venues:
Von Braun Center - Interior Arena Way-Finding - Huntsville, AL
The Mansion on Peachtree - Exterior and Interior - Atlanta, GA
Craft Restaurant- Exterior and Interior - Atlanta, GA
Turner Stadium Coke Field - Painted Graphics - Atlanta, Ga.
1996 Olympic Stadium - Painted Graphics -Atlanta, Ga.
1996 Olympic Venues (Nike, Coke) - Painted Graphics - Atlanta, GA
Four Seasons Hotel and Lumiere Casino Resort - Specialty Interior Way-Finding System - St. Louis, MO
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Company Profile
Ownerl Director of Sales and Marketing: David Weisser
David@ci-signs.com
David Weisser is the new owner of Creative Impressions with 20+ year of management experience in a Fortune 100
company. David's leadership experience is helping to grow and expand Creative Impressions into challenging new roles
in the sign age and way finding industry. His positive and engaging management style has enabled the quick development
of a capable, creativity, and knowledgeable team. The depth of experience on the Creative Impressions team is leading to
faster solutions to challenging problems. David's results orientated approach to project management and a proven history
of on-time delivery is helping to exceed customer's expectations on every new project. His sales and marketing leadership
is helping to push Creative Impressions into new areas of creativity and expansion.
Creative Director and Lead Project Manager: Brian N. Smay
Brian@ci-signs.com
Atlanta College of Art alumnus with 30+ years of architectural signage design and fabricating experience. Original founder of
Creative Impressions and principle artistic director. Brian has brought innovation and creativity to the signage industry by
combing complex design themes together with simplistic fabrication methods.
Sales and Project Management: Steven Welch
Steven@ci-signs.com
10 Years of experience in sales, including 5 years in the design and fabrication of architectural signage.
Steven has adopted a unique balance of creativity and resourcefulness that has proved to build solid relationships
between Creative Impressions and their clients. His energetic and dedicated approach has served Creative Impressions
and their clients equally well.
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Marketing/Design/Production: Kevin Dean (Kevin@ci-signs.comJ & Michael Corchran (Michae/@ci-sians.comJ
With over a combined 15 years of experience these two gentlemen are the glue that keep Creative Impressions moving
forward. Through their experience in various technologies and machineries they keep Creative Impressions at the cutting
edge of the signage industry, and are able to communicate design into functioning products. Their hard work and dedication
to details keep Creative Impressions clients satisfied.
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4708 S. Old Peachtree Rd. 500-8. 770-582-9936 fax 678-421-0932 · www.creativeimpressions-signs.com
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ronmenlal graphics design
City of Crystal River
123 NW HWY 19, Crystal River, FL 34428
Contact:
Jackie Gorman
(352) 795-4216
Gordon College
419 College Dr., Barnesville, GA 30204
Contact:
Richard Vereen
(678) 359-5103
jgorman@crystalriverfl.org
richard@gdn.edu
University of Louisville
421 West Cardinal Blvd., Louisville, KY 40202
Contact:
Geoffrey Atherton
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(502) 852-6841
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gathe01 @Iouisville.edu
4708 s. Old Peachtree Rd. 500-8.770-582-9936 fax 678-421-0932 · www.creativeimpressions-signs.com
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Historic Old Town Wayfinding Project -
Bluff ton , SC
Project consisted of street names signs, vehicular directionals, and pedestrian kiosks.
The intent of the wayfinding plan was to direct visitors to the heart of Bluffton's historic
town center, primarily Calhoun St. Vehicular directionals were placed strategically at the
town's extremities to draw them to the town, while the pedestrian kiosks were placed
at the town's historic locations. All of the street blade signs within the historic district were
replaced to match the directionals and kiosk signs.
Scope of project included:
48- Street blade signs
5- Vehicular directional signs (11 additional Vehicular Directionals pending production)
12- Pedestrian kiosk signs
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) Gordon College Wayfinding Project-
-, -) Barnesville, GA
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) Original campus wayfinding project completed by Creative Impressions in 1998. As college
\ expanded and additional signs needed, a new design was released for bid. Upon successful
, bid we worked once again alongside Richard Vereen (Facilities Director) to create an
) extensive wayfinding plan that would service the campus for years to come.
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) Scope of project included:
) 4- Campus Gateways
I 6- Vehicular Directionals
15- Campus Directories
I J 6- Pedestrian Directionals
J 26- Building Identification- Ground Mounted
) 17- Parking Lot Identifications
Over 700 Interior signs for all campus buildings
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Historic City Center Wayfinding Project-
Crystal River, FL
Project consisted of street names signs, vehicular
directionals, and parking directionals. Basis of design
was patterned after the cities decorative street lamp
poles, which created a cohesive design aspect. Much attention was given to directing
visitors to Crystal Rivers historic fixtures, and their unique habitat of Manatees.
Scope of project included:
9- Street blade signs
11- Large vehicular directional signs
2- Small vehicular directional signs
3- Parking directional signs
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4708 s. Old Peachtree Rd. 500-8 · 770-582-9936 fax 678-421-0932 . www.creativeimpressions-signs.com
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Page 1
February 17,2012
Attn: City of Sunny Isles Beach
Re: Beach Access Signs
From: Steven Welch
(770) 582-9936
(678) 421-0932 -fax
Creative Impressions proposes to fabricate and install the following:
Beach Access Signs
ST
QTY Text
1
9 Beach Access Sians- Double-sided Aluminum panels (27 -
3/4" x 31- 1/4"), 4" round aluminum post and a 19 -1/4"
diameter x 1" deep water-jet cut topper.
Sub Total
Mobilization/FOB
Installation
Total
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Unit Price
Total Price
$
773.00 $ 6,957.00
$ 6,957.00
$ 1,725.00
$ 900.00
$ 9,582.00
4708 South Old Peachtree Road, Building 500 Suite B, Norcross, Georgia 30071
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CREAT-3
OP 10: AW
~'fD-:;t.''''''''~ERJIFICATE OF LIABILITY INSURANCE I DATE (MM/DO/YVYYI
11/17/11
THIS CERTIFICATE IS' ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificete holder in lieu of such endorsement(~l.
PRODUCER 770-381-5000 ~~~~CT Ashley Williams
L1~d Pro Group Inc. - Duluth ~jkE.tl: ---- ----Tfl,[NO}: 770-814-7187
26 5 Brecklnridge Blv, Ste 100
Duluth, GA 30096 Jt'DA~~SS: awllllams@/Ioydprogroup.com
Jennifer Straughter - ~_._--_._-
INSURER(S) AFFORDING COVERAGE NAIC ~
- INSURER A: Accident Insurance Co - ----------- - -.
INSURED Creative Impressions INSURER II : National Fire Ins of Hartford 524126
4708 S. Old Peachtree Rd 5008 INSURER C : CONTINENTAL CASUALTY COM P ANY
Norcross, GA 30071
INSURER D : ---
INSURER E : I
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INSURER F : i
COVERAGES
CERTIFICATE NUMBER:
REVISION NUMBER:
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THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAlD CLAIMS.
IN~~ ' ~DDl ,"UBI< 'rpI'i[jI"y EFF ~m-~?Y EXP liMITS
l'lTR TYPE OF INSURANCE '~"D r..;.~,:.. POLICY NUMBER M iiNYVvl
GENERAL liABiliTY I EACH OCCURRENCE S 1,000,000
-
8 .-!... :3'MERCIIU. GENERAl LIABILITY X B4018250912 I 05121111 05121112 ~~S E8 occurrence' S 300,000
CLAIMS-MADE 00 OCCUR --.----- 10,000
- I MED EXP (Any 0"" person) S
___u 1,000,000
PERSONA1. a AnV INJURY S
- 2,000,000
f-- I GENERAL AGGREGATE S
nl A~Em LIMIT APnS PER: I PRODUCTS - COMP/OP AGG S ___2~000,O~_~
POLICY X ~,9,: lOC I S
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AUTOMOBILE liABilITY i I ~OMBlNED SINGLE LIMIT 5 1,OOO,OO(
- Ea accldenl
8 ANY AUTO I B4018250912 05121111 05121112 BOOllY INJURY (Per person) S
- IU.l OWNEO - SCHEOULED -
AUTOS AUTOS BOOll Y INJURY (Per accidenl) S
- - NQN.OWNED ip~=~GE --------------
..!. HIRED AUTOS ..!. AUTOS S
S
~ UMBRellA lIAB ~ OCCUR EACH OCCURRENCE Is 3,OOO,OO~
C EXCESS llAB CLAIMS-MADE B4018250960 05121111 05121112 AGGREGATE s 3.000,OOC
CEO I X I RETENTIONS ---_.-
10,000 S
WORKERS COMPENSATION X IT~~Tl"uT}4" I PJH-
AND EMPLOYERS' liABILITY ER
Y/N WCV6066039 500,000
A IWY PROPRIETORlPARTNERlEXECUTIVE 0 05121111 05121112 E.L EACH ACCIDENT S
OFFICERlMEMIlER EXCLUDED? N/A 500,000
(Mandatory In NH) E.l. DISEASE - EA ElAPLOYEE S -- --
~rssc:~~ 'b~PERATIONS below E.L DISEASE - POLICY liMIT $ 500,000
8 B4018250912 05121111 05121112 PROPERTY 128,00(
'DESCRIPTlON OF OPERATIONS flOCATIONS f VEHICLES ~lllChACORD 101, Addlllonal Romarl<. SchlOdul.. If mOlO lpace II requlrod)
Re: prodect:Trident Medical Center at 9330 edlcal Plaza Drive, CharlestOn
SC 294 6
The Certificate Holder, project owner, architect and en9ineers, Including
their officers, arents, and employees are named Additional Insureds, as per
written contrac .
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CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
, ~cL.W~
ACORD 25 (2010/05)
@ 1988-2010 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
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DELIVER TO:
City of Sunny Isles Beach
City Clerk
18070 Collins Avenue
Sunny Isles Beach, FL 33160
REQUEST FOR PROPOSAL
SECTION 6
BID SUBMITTAL FORMS
OPENING: 10:00 A.M.
02/21/2012
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PLEASE QUOTE PRICES F.O.B. DESTINATION, LESS TAXES, DELIVERED IN
CITY OF SUNNY ISLES BEACH, FLORIDA
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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:
01/17/2012
This Bid Submittal Consists of
Pages 23 through 27
Sealed bids are subject to the Terms and Conditions of this Request for 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.
RFP 12-01-04
Beach Access Signs
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 Aaent:
Marcanthony Tulloch
Firm Name:
2 rewhve :1mf/'lt66/'D11!J
Commodity Coders}:
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RETURN ONE ORIGINAL AND FOUR COPIES OF BID SUBMIrrAL PAGES AND AFFIDA vrrs
FAILURE TO SIGN PAGE 27 OF SECTION 6 BID SUBMITTAL WILL RENDER YOUR BID NON-
RESPONSIVE
J
City of Sunny Isles Beach I Request for Proposal No. 12-01-04
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SECTION 6
BID SUBMITTAL FOR:
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ACKNOWLEDGEMENT OF ADDENDA
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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
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Addendum #2, Dated
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Addendum #3, Dated
Addendum #4, Dated
Addendum #5, Dated
Addendum #6, Dated
Addendum #7, Dated
Addendum #8, Dated
PART II:
~ NO ADDENDUM WAS RECEIVED IN CONNECTION WITH THIS BID
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FIRM NAME: (!V(!()I.hW Dnpr'MS10flS
AUTHORIZED SIGNATURE: ~d~
TITLE OF OFFICER: {JrtJ/tti 1YlaY1(J.f)er
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DATE: ';;/17 / -;l()ld
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City of Sunny Isles Beach I Request for Proposal No. 12-01-04
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BID SUBMITTAL FORM
Bid Title: Beach Access Signs
The undersigned Proposers proposes and agrees, if this Bid is accepted, to enter into an agreement with
The City of Sunny Isles Beach furnish all Work as specified or indicated in the Contract Documents for the
Contract Price and within the Contract 1ime 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 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 studied carefully all reports and drawings of subsurface
conditions and drawings of physical conditions.
· 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 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 andlor Notice to Proceed.
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Firm Name:
City of Sunny Isles Beach I Request for Proposal No. 12-01-04
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Street Address:
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'-h O'D S, Old Pe.~_h.fr.ee ,ed.
Mailing Address (if different):
SUi-h; 600 ,f; tJon;.(I/SS, G& oDO"1/
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Telephone No. -l'T70) Z> '3J - cV13 <0
Email Address:6fevel1eCi-Si3\.\~.com
Fax No. -c ~/'3) 42./ -0'7&2-
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* "By signing this document the bidder agrees to all Terms
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Signature:
(~ut~gent)
Print Name: 6kv-tll Mid1
1itle: fJ'tj'R?i nk7r
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.
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City of Sunny Isles Beach I Request for Proposal No. 12-01-04
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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
The undersigned being first duly sworn as provided by law, deposes, and says:
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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.
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The undersigned is authorized to make this Affidavit on behalf of,
We)5.5,U fDk( (J(',sesD'B.1 - Cr.w.,tive I,r.p~S$11J1.S
(Name of Corporation, Partnership, Individual, etc.)
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(Type of Business)
, formed under the laws of
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(State)
of which he is
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(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 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.
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AFFIANT'S NAME
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AFFIANT'S TITLE
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TAKEN, SWORN AND SUBSCRIBED TO BEFORE ME thisa~ay of k,h/'..t "I-y
Personally Known V or Produced Identification .
, 20~.2.
Type of identification
DECEMBER 28,2010
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(Affix seal here)
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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.)
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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.
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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.
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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 TW02Y' CHANGE IN THE INFORMATION CONTAINED IN THIS FORM.
By. .~~
( ign ture)
tluic.l Wi.i,Sscf
(PrinJ.ed Name)
?wner
(Title)
(j Sworn to and subscribed before me this
. r~h(;ol f:111PWJ(IMJ
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(AFFIX NOTARY STAMP HERE)
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\\\\"""111'/ ~~tze: Nit{! Public - State of Florida
,,\ SCOTT C. II;; PI': (;~ (J;l f-r t"TJr-Q..,
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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.
Signed:
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Title:
Firm:
G (pv..-h V+' Em press1on.J
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Address:
4705 6. old' ~ac-?rIret' rY SI/i.b 60l),8
Norc.l1S.s 611 3~O-J I
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DECEMBER 28,2010
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CONFLICT OF INTEREST
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
BEFORE ME, the undersigned authority, personally appeared
deposes, and states:
1Javl'd (,Velsse (
, who was duly sworn,
18.1. I am
C)Jo live J:mptltSl./OVlS
orct"(I$s, GIlT .
the tt){,JI1U
with a local office in ;r.!O(cOSS I t7lf
of
and principal office in
18.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No. 12.- 0 I ~oLI described
as: Landscape Maintenance Services. 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 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.
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18.81 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.
18.91n 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 n
AFFIANT
day of
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Print or Type Name and Title
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Sworn to and subscribed before me this _ day of
D Personally Known OR
D Produced Identification ; Type of Identification
,2010.
NOTARY PUBLIC STATE OF FLORIDA
DECEMBER 28,2010
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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
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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?
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YES
NO f
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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?
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YES NO lC 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.
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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.
(Jta.hw ]:mtJ/1tJO/PI1S
Firm f
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Aut orized Ignature
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Pri~t or Type Name and Title v t/
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DECEMBER 28,2010
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ANTI-KICKBACK
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City of Sunny Isles Beach
18070 Collins Avenue
Sunny Isles Beach, FL 33160
Telephone: (305) 947-0606 Fax: (305) 949-3113
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ANTI-KICKBACK AFFIDAVIT
COUNTY OF
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STATE OF FLORIDA
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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.
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The foregoing
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of person], as
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",\ SCOTT III;
AFFIX NOTf1.tN-~~MP.W~.:"'''''
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Type of Identification Produced
instrument was acknowledged before me this
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day of
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DECEMBER 28,2010
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