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Home My WebLink AboutGraphplex SignsIMPORTANT BID ENCLOSED Bid No. 12-01-04 Beach Access Signs D ORIGINAL RECETvED'- FEB 2 1 2012 City 01 Sunny is!€lS Bwdl Oft!c~ c:t ii18 C!t-I Clerk .~~~~J . Opening Date and Time: Tuesday, 02/21/2012, 10:00 A.M. Proposal Submitted by: GRAPHPLE~SIGNS Contact: Jack Gervais: 954.549.5566 2830 North 28th Street Hollywood, FL 3302 954.549.5566 Fax: 954.239.6872 E-Mail: jack@graphplex.com GRAPHPLE~SIGNS February 17,20]2 City of Sunny Isles Beach ] 8070 Collins Avenue Sunny Is]es Beach, FL 33 ]60 GraphPlex Signs, an S-Corporation, is pleased to submit the enclosed proposal. We have taken into consideration all logistics in the pre-planning phase to complete these signs in a professional and timely manner. Our in-house staff of fabricators have the ability to interpret and fabricate the intended finished signs. In fact, we have manufactured and installed a replacement Beach Access unit in the past. GraphPlex has the purchasing power and the ability to fabricate your signs on time and within budget. Manufacturing nine signs is an efficient way to not only manufacture, but install due to the fact there are economies of scale. Signs should be installed within a 3-4 business day time frame once fabricated. GraphP]ex works continuously with the City of Weston, Town of Golden Beach, Bay Harbour Islands and the City of Sunny Isles Beach. We have provided a tremendous number of signs for the City of Sunny Isles Beach. Monument signs, street signs, beach access signs, parking signs, to name a few. Sincerely, ~ ;,~ C9y~ating Officer 2830 North 28th Terrace, Hollywood, FL 33020 954.549.5566 F: 954.239.6872 jack@graphpIex.com www.graphplex.com m:t.....4I.. ._~~....- GRAPHPLE~IGNS 2830 N. 28th Terrace Hollywood, FL 33020 Date 2/17/2012 City of Sunny Isles Beach ] 8070 Collins Avenue Sunny Isles Beach, FL 33160 BEACH ACCESS SIGNS> PROPOSAL NO. 12-01-04 GraphPlex will fabricate and install nine "Beach Access" signs. Sign units consist of] 9.125" diameter x ]" deep Wateljet cut aluminum top with vinyl color details. Double face signs are 27.75" wide x 31.25" tall with painted "Beach Access" and "City of Sunny Isles Beach". Post is 4" diameter with 4.5" diameter collar at the base. Tank' for providing GraphPlex the opportunity to fabricate and install your signs. S: Payment due within 30 days of installation. DELIVERY: Approximately five weeks from approved conceptual drawings. NOTE: 1.5% per month (18% per annum) finance charge will be added to all past due accounts. Please pay promptly to avoid finance charges. Subtotal Proposal # 2]941 14,460.00 $14,460.00 Sales Tax (6.0%) $0.00 Phone # 954.920.0905 Total Fax# 954.920.0906 E-mail jack@graphplex.com Web Site www.graphplex.com f$113460.00 www.sunbiz.org - Department of State Home Contact Us E-Filing Services Previous on List Next on List Return To List No Events No Name History Detail by Entity Name Florida Profit Corporation LLSJ CORP 7 Filing Information Document Number P02000012602 FEI/EIN Number 010621774 Date Filed 02/04/2002 State FL Status ACTIVE J I I Principal Address 2830 N. 28TH TERRACE HOLLYWOOD FL 33020 Changed 02/21/2011 Mailing Address 2830 N. 28TH TERRACE HOLLYWOOD FL 33020 Changed 02/21/2011 Registered Agent Name & Address SCHWARTZ, CARL I 2830 N. 28TH TERRACE HOLLYWOOD FL 33020 Address Changed: 02/21/2011 Officer/Director Detail Name & Address Title P SCHWARTZ, CARL I 2830 N. 28TH TERRACE HOLLYWOOD FL 33020 Title COO GERVAIS, JOHN P 2830 N. 28TH TERRACE HOLLYWOOD FL 33020 Annual Reports Report Year Filed Date 2009 04/13/2009 Page 1 of2 Document Searches Forms Help Entity Name Search Submit http://www.sunbiz.org/scripts/cordet.exe?action=DETFIL&inCL doc _ number=P020000 126... 2/14/2012 www.sunbiz.org - Department of State Page 1 of 1 Home Contact Us E-Filing Services Document Searches Forms Help Previous on List Next on List Return to List Fictitious Name Search No Filing History Submit Fictitious Name Detail Fictitious Name GRAPH PLEX SIGNS- Filing Information Registration Number G09000164469 Status ACTIVE Filed Date 10/13/2009 Expiration Date 12/31/2014 Current Owners 1 County BROWARD Total Pages 1 Events Filed NONE FEI/EIN Number 01-0621774 Mailing Address 2301 N. 21ST AVENUE HOLLYWOOD, FL 33020 Owner Information LSJ CORPORATION 2301 N. 21ST AVENUE HOLLYWOOD, FL 33020 FEI/EIN Number: 01-0621774 Document Number: P02000012602 Document Images 10/13/2009 -- CANCELLATION/RE-REGISTRATION View image in PDF format Note: This is not official record. See documents if question or conflict. Previous on List Next on List Return to List Fictitious Name Search No Filing History Submit I Horne I Contact us I Document Searches I E-Filinq Services I Forms I Help I Copyriqht@ and Privacy Policies State of Florida, Department of State http://www.sunbiz.org/scripts/ficidet.exe?action=DETREG&docnum=GO9000 164469&rd... 2/14/2012 2011 FOR PROFIT CORPORATION ANNUAL REPORT DOCUMENT# P02000012602 Entity Name: lSJ CORP. FILED Feb 21, 2011 Secretary of State Current Principal Place of Business: New Principal Place of Business: 2301 N. 21 AVENUE HOLLYWOOD, Fl 33020 2830 N. 28TH TERRACE HOllYWOOD, Fl 33020 Current Mailing Address: New Mailing Address: 2301 N. 21 AVENUE HOllYWOOD, Fl 33020 2830 N. 28TH TERRACE HOllYWOOD, Fl 33020 FEI Number: 01-0621774 FEI Number Applied For ( ) FEI Number Not Applicable ( ) Certificate of Status Desired ( ) Name and Address of Current Registered Agent: Name and Address of New Registered Agent: SCHWARTZ, CARL I 2301 N. 21 AVENUE HOllYWOOD, Fl 33020 US SCHWARTZ, CARL I 2830 N. 28TH TERRACE HOllYWOOD, FL 33020 US The above named entity submits this statement for the purpose of changing its registered office or registered agent, or both, in the State of Florida. r''''----'''''''' SIGNA TUR~.~.....__.- Electronic . gna OFFICERS AND DIRE 02/21/2011 Date Title: Name: Address: City-St-Zip: P SCHWARTZ, CARL I 2830 N. 28TH TERRACE HOllYWOOD, Fl 33020 Title: Name: Address: City-St-Zip: COO GERVAIS, JOHN P 2830 N. 28TH TERRACE HOllYWOOD, Fl 33020 I . I hereby certify that the information indicated on this report or supplemental report is true and accurate and that my electronic signature shall have the same legal effect as if made under oath; that I am an officer or director of the corporation or the receiver or trustee empowered to execute this report as required by Chapter 607, Florida Statutes; and that my name appears above, or on an attachment with all other like empowered. SIGNATURE: CARL I SCHWARTZ Electronic Signature of Signing Officer or Director p 02/21/2011 Date GRAPHPLEx'"SIGNS Firm Qualifications> Founded in 1974, GraphPlex has been providing quality signs at affordable prices. GraphP]ex specializes in the fabrication and installation of interior and exterior signs; either illuminated or non-illuminated. Our staff of 15 fabricators and installers are capable of either responsibility. Should we have the opportunity to work together, the proposed signs will be manufactured at the GraphPlex facility in Hollywood, FL. We are truly a "one stop shop". Personnel> Jack Gervais - Chief Operating Officer - facilitates client liaison/relations for over six years. Jack has an extensive background in graphic arts and owned his own company, LaidlawGervais for 15 years. He will be your lead contact for this project. Bob Webster - Project Manager - started GraphP]ex architectural signage over 35 years ago, building our company into a diversified and respected supplier of high-end signage in the south Florida market. Webster typically oversees quality control. Ed Usher - Chief Designer of interior and exterior signage and lead fabricator of interior signage for five years. Mr. Usher worked with Interstate Signcrafters in the same capacity from 2003-2005. For 23 years at Sungraf, Ed prepared graphics for sign fabrication and supervised 5-6 Graphic Artists. Tom Drissel- Chief Fabricator/Shop Manager at GraphPlex for over seven years. Mr. Orissel is an expert in metal, including welding, woodwork and plastic fabrication. At Sign-A-Rama's for two years, Tom learned to design, and fabricate signs. Tom worked at USA Signs for over a year in the same capacity . Elbert Fleming - Head Fabricator - Earl started his sign career with Sun Plastics and worked there for 19 years. He has been with our company for over 11 years. Earl specializes in metal, woodwork and plastic fabrication. GraphP]ex has 8 - 10 installers, nine fabricators and seven office employees (these duties sometimes overlap). Roughly 25 employees total. 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 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: 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 Frsjc;pN~U1A dh~ 4v~rllv tfs. Commoditv Codets}: RETURN ONE ORIGINAL AND FOUR COPIES OF BID SUBMITTAL PAGES AND AFFIDA VITS 'FAI~URE"TO~SIGN~PAGE.27;OF:SECTI()N:-6:Eii:D. SUBM-frTALWIlrRENbErYOUR-Bi~NbN~ t::RESPb"NSIVEJ City of Sunny Isles Beach I Request for Proposal No. 12-01-04 ,19'"'~ ~,' '. . '. ~ ~ ~ t, SECTION 6 BID SUBMITTAL FOR: ACKNOWLEDGEMENT OF ADDENDA INSTRUCTIONS: COMPLETE PART I OR PART II, WHICHEVER APPLIES PART I: LIST BELOW ARE THE DATES OF ISSUE FOR EACH ADDENDUM RECEIVED IN CONNECTION WITH THIS BID Addendum #1, Dated Addendum #2, Dated Addendum #3, Dated Addendum #4, Dated Addendum #5, Dated Addendum #6, Dated Addendum #7, Dated Addendum #8, Dated PART II: o NO ADDENDUM WAS RECEIVED IN CONNECTION WITH THIS BID FIRMNAME:L-<;o- Cvrll4t;rVt d/oA- 0wfVltx: ~~ AUTHORIZEDSIGNATUR ~ DATE:~'!' ('). DfAc to( ,/ City of Sunny Isles Beach I Request for Proposal No. 12-01-04 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 Time indicated in this Bid and in accordance with the other terms and conditions of the Contract Documents. The Proposers accepts all of the terms and conditions of the Advertisement or Invitation to Bid and Instructions to Proposers, including without limitation those dealing with the disposition of Bid Security. This Bid will remain subject to acceptance for 90 days after the day of Bid opening. The Proposers agrees to sign and submit the Agreement with the Bonds and other documents required by the Bidding Requirements within ten days after the date of the City's Notice of 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 and/or Notice to Proceed. Firm Name: Lr<;j WI Wdll1 d~ 6n City of Sunny Isles Beach I Request for Proposa~ Street Address: \ L . J l' 'Y~ UJ-N I f!: Mailing Address (if different): I JfJUJ 'N, Pp~ WV4VL- '1'?O)A? Telephone No. qt;!{. 9f1. 'J!]p(p Fax No. qlS t. 7"5'1. b '672- Email Address: ~ <WI--~ ~luG ~ No. 0LMJ1Jli.Ji.1J-f * "By signing this document the bidder agrees to all Terms Signature: (Signatu e Olaut,..~rized agent) . printN~e' vl~ ~V4-(S lllle C/;ud 0 ~ '* t1 c5 off, W 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. City of Sunny Isles Beach I Request for Proposal No, 12-01-04 OF SU~ City of Sunny Isles Beach I Request for Proposal No. 12-01-04 NON-COLLUSION AFFIDA VIT 01 :\Ul'l 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 t(UU,,)(k.(U The undersigned being first duly sworn as provided by law, deposes, and says: This Affidavit is made with the knowledge and intent that it is to be filed with the City of Sunny Isles Beach City Commission and that it will be relied upon by said County, in any consideration which may give to and any action it may take with respect to this Bid. The undersigned is authorized to make this Affidavit on behalf of, of which he is a,~M~lN\ .L Li .. ( e of BUSiness) [)( ,iW , formed under the laws of =Y ~ (State) ~<; (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. ~t TAKEN, SWORN AND SUBSCRIBED TO BEFORE ME this', 11 day of ~&( lA..fH'1 Personally Known V or Produced Identification AFFIANT'S TITLE ofnw (wdD , 20~J J. Type of identification (Affix seal here) "":11 "UII" ..1>"i(I..rt::'".. VICKIE L HEROLD N"A~.i MY COMMISSION H EE 08211( , ~'~~'l EXPIRES: April 10,2015 f "~.;;"!i.::r.;., Bonded Thru Notary Public Underwriters t- """ ~ l~'~ WkA.L ~. gQ;jM.(n NOTARY PUBLIC (name printed or typed) DECEMBER 28. 2010 1 of 7 PUBLIC ENTITY CRIMES Of ~\..ll.j City of Sunny Isles Beach 18070 Collins Avenue Sunny Isles Beach, FL 33160 Telephone: (305) 947-0606 Fax: (305) 949-3113 SWORN STATEMENT PURSUANT TO SECTION 287.133(3)(a) FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES PUBLIC ENTITY CRIMES Pursuant to the provisions of paragraph (2) (a) of Section 287.133, Florida State Statutes - "A person or affiliate who has been placed on the convicted vendor list following a conviction for a public entity crime may not submit a Bid on a Contract to provide any goods or services to a public entity, may not submit a Bid on a Contract with a public entity for the construction or repair of a public building or public Work, may not submit Bids on leases of real property to a public entity, may not be awarded to perform Work as a Contractor, supplier, Sub-Contractor, or Consultant under a Contract with any public entity, and may not transact business with any public entity in excess of the threshold amount Category Two of Sec, 287.017, FS for thirty six months from the date of being placed on the convicted vendor list". THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICIAL AUTHORIZED TO ADMINISTER OATHS. 11.1. Thiss by for whose business address is: and (if applicable) its Federal Employer, dentification number (FEIN) is () 1 (If the entity had no FEIN, include the Social Security Number of the individual statement: .) 11.2. I understand that a "public entity crime" as defined in Paragraph 287.133(1 )(g), Florida Statutes, means a violation of any state or federal law by a person with respect to and directly related to the transaction of business with any public entity or with an agency or political subdivision of any other state or with the United States, including, but not limited to, any Bid or Contract for goods or services to be provided to any public entity or an agency or political subdivision of any other state of the United States and involving antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material misrepresentation. 11.3. I understand that "convicted" or "conviction" as defined in Para. 287.133(1)(b), Florida Statutes, means a finding of guilt or a conviction of a public entity crime, with or without an adjudication of guilt, in any federal or state trail court of record relating to charges brought by indictment or information after July 1, 1989, as a result of a jury verdict, non-jury trial, or entry of a plea of guilty or nolo contendere. 11.4. I understand that an "affiliate" as defined in Para. 287.133(1 )(a), Florida Statutes, means: a.) 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. 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.) v 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. ~::~~U? (Title) ] U -I' Sworn to and subscribed before me this 'l..v.!l. day of (-e.b rv...J1J'i .Ju.( k G eIY(,1..r-s. , 20~, by "t'tl I" '~~IoF'~ I'P~. VICKIE L HEROLD N . :*~ MY COMMISSION N EE 082114 '~'......,...~.; EXPIRES: April 10, 2015 '~Rf,,~~ Bonded Thru Notary Public Underwriters .'ltuU( ll, Y(. I-Lo'J\1}UQ Si]nature: Notary Public- State of Florida \ iLk l'-d_ L. 1-\ e.. (f.ll d Print or Type Commissioned Name Personally Known V' OR Produced Identification Type of Identification Produced 10/1998 3 of 7 EQUAL OPPORTUNITY / AFFIRMATIVE ACTION Of ~)~ City of Sunny Isles Beach 18070 Collins Avenue Sunny Isles Beach, FL 33160 Telephone: (305) 947-0606 Fax: (305) 949-3113 EQUAL OPPORTUNITY I AFFIRMATIVE ACTION STATEMENT The contractors and all subcontractors hereby agree to a commitment to the principles and practices of equal opportunity in employment and to comply with the letter and spirit of federal, state, and local laws and regulations prohibiting discrimination based on race, color, religion, national region, sex, age, handicap, marital status, and political affiliation or belief. Firm: Signed: Title: Address: DECEMBER 28, 2010 4 of? 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 -tA COUNTY OF 1 V , who was duly sworn, BEFORE ME, the undersigned authority, personally appeared deposes, and states: ~J 1&~1l-Y ~,. ./ the I of ~ ::::::, with a local office in and principal office in 18.2. The above amed entity is submitting a Bid for the City of Sunny Isles Beach, Bid No. rt .61.4--:---7 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. 18.71 certify that no member of the entity's ownership or management is presently applying for any employee position or actively seeking an elected position with the City of Sunny Isles Beach. 18.8 I certify that no member of the entity's ownership or management, or staff has a vested interest in any aspect of the City of Sunny Isles Beach. 18.9 In the event that a conflict of interest is identified in the provision of services, I, on behalf of the above named entity, will immediately notify the City of Sunny Isles Beach. Dated this "1-\1...).. day of r~( LlJt I Y . . , 20W ( J. -:.)CLlk ('"'t'rv(l.;-~ CJ\It:~ C~rMltlV\l~ nJi.'7i.Rr AFFIANT Print or Type ame and 'tle Sworn to and subscribed before me this If'\~ day of r-elXu (I 1"\/ , 20'I,D. I J. 9"" Personally Known OR , D Produced Identification ; Type of Identification A1iku: ~. tI.tJVJ..LifJ NOTARY PUBLIC STATE OF FLORIDA VICKIE L. HEROLD MY COMMISSION N EE 082114 EXPIRES: April 10, 2015 Bonded Thru Notary Public UndelWrilers DECEMBER 28.2010 5 of 7 DISPUTE DISCLOSURE City of Sunny Isles Beach 18070 Collins Avenue Sunny Isles Beach, FL 33160 Telephone: (305) 947-0606 Fax: (305) 949-3113 DISPUTE DISCLOSURE FORM Answer the following questions by placing a "X" after "Yes" or "No". If you answer "Yes", please explain in the space provided, or on a separate sheet attached to this form. 19.1. Has your firm or any of its officers, received a reprimand of any nature or been suspended by the Department of Professional Regulations or any other regulatory agency or professional associations within the last five (5) years? YES NO '/. 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 \f 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"" 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 f~;- ~:s~ {y4j1t~(,2(-tJ J. 10,I?-- Firm U ~te C~_. - &4iVd1? uth~' pc:~eo/;,;; ~ DECEMBER 28. 2010 6 of 7 ANTI-KICKBACK <>f ~ J t4 City of Sunny Isles Beach 18070 Collins Avenue Sunny Isles Beach, FL 33160 Telephone: (305) 947-0606 Fax: (305) 949-3113 ANTI-KICKBACK AFFIDAVIT STATE OF FLORIDA ) COUNTY OF ~ ~ 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. ~ 'J:JiS Lt,t[ Cj1r~J rfI);u- The foregoing instrument was acknowledged before me this 'I -Ul day of ~ Wnl cuy , 20lL, by T(,uk Ge..rvQ\,; [name of person], as ~\'\(cc 01lLNt.'li-{\~ O.c..c.-U_I [type of authority], for WJ L()(? d-b.L~ CbrUphPl€.lG S>ro@"-s [n me of party on behalf of whom instrument was executed] . By. AFFIX NOTARY STAMP HERE: i~J...-:r.~'ftiif:, VICKIE L HEROlD i*/:''K~ :*E MY COMMISSION ~ EE 082114 ~'~':Q'.? EXPIRES: April 10, 2015 ---7f,iif.'/;;*'" Bonded Thru Notary Public Underwriters '(l~U0..L ~, 'I*~ Notary Public - State of Florida \/i cL-( L. I--t€-(o(~ Print or Type Commissioned Name Personally Known / OR Produced Identification Type of Identification Produced DECEMBER 28. 2010 7 of 7 ....-....-...-. .-.. -," ..-.'.-.---.&.-.'.-.'" -.' .. , BROWARD COUNTY. FLORIDA : CERTlFICATE.oF COMPETENCY SIGN ERECTION (NONELECTRIC) : CCII 81~4716-SE.X . WEBSTER, ROBERT L. - QUALIFYING GRAPH PLEX CORP 5240 95 ST SEBASTIAN Fl 32958 EXPIRES 08/31/2013 ;" -- --.----..--..-----.-----.--.----.--------------.--- -.---.----.-- --- -...~~~------------_._-~..,.....-.--.~-'_._~~~.---------~-------~~-~- BROW ARDCOU NTY-l:OCAL --- BUSIN ESS--TAX-RECEI PT--------- 115 S. Andrews Ave;, Rill. A-100, Ft. Lauderdale, FL 33301-1895 - 954-831-4000 - VALID OCTOBER 1,2011 THROUGH SEPTEMBER 30,2012 -..-. ____.u...~. ___.. DBA: Business Name: GRAPH PLEX CORP Receipt #: 189 - 5819 . T .ALL OTHER TYPES CONTRACTOR Busmess ype. (SIGN ERECTION CONTRACTOR) Business Opened:02/10/1999 State/County/CertlReg:87 -4 716 -BE-X Exemption Code:NONEXEMPT Owner Name: ROBERT L WEBSTER/QUAL Business Location: 2830 N 28 TER HOLLYWOOD Business Phone: Rooms Seats Employees 5 Machines Professionals For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 0.00 0.00 0.00 27.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is non-regulatory in nature. You must meet all County and/or Municipality planning and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. WHEN VALIDATED Mailing Address: GRAPH PLEX CORP 2830 N 28 TER HOLLYWOOD, FL 33020 Receipt #031-10-00004606 Paid 09/26/2011 27.00 :2011 - 2012 ----- _ n____ .___ ....___ ___._ ____..__. _.._..__ ___u __._... - n __ -._ n.____ _.____. -_..__.___.____________________________._____.____.____..____._._._.._.~_~_n~.~____~....~__..._._..y.~..~~,...........~_~_'""~~,......~_.....__~.-.~""'-.... ... ... BROWARD-COUNTYLC>CAL'-BUSINESSTAXRECEIP'T---- ~- ::~:~~--~-- 115 S. Andrews Ave:, Rrn. A-100, Ft. Lauderdale, FL 33301-1895 - 954-831-4000 . VALID OCTOBER '1,2011 THROUGH SEPTEMBER 30,2012 DBA: Business Name: GRAPH PLEX SIGNS Receipt #: 3 79-12969 Business Type:ALL OTHERS (SIGN SALESM~) Owner Name: GRAPH PLEX SIGNS Business Location: 2830 N 28 TER HOLLYWOOD Business Phone: Business Opened:09/30/2002 State/Cou nty/CertlReg: Exemption Code:NONEXEMPT Rooms Seats Employees Machines Professionals For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 45.00 0.00 0.00 0.00 0.00 0.00 45.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BlISINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is non-regulatory in nature. You must meet all County and/or Municipality planning and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. WHEN VALIDATED Mailing Address: GRAPH PLEX SIGNS 2830 N 28 TER HOLLYWOOD; FL 33020 Receipt #031-10-00004612 Paid 09/26/2011 45.00 20.:tl__ ~__~O:J.,:~___ ~ ACORD@ CERTIFICATE OF LIABILITY INSURANCE I DA TE (MMIDD/VYYY) ~ 3/31/2011 THIS CERTIFICATE IS ISSUED AS A 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 certificate holder in lieu of such endorsement(s). PRODUCER ~2~~~CT Jaclyn Stamper Corporate Insurance Advisors rA~gN~o. Exll: (954) 315-5000 I FAX lAIC No\: (954) 315-5050 100 NE 3rd Avenue E-MAIL ADDRESS: Suite 1000 ~RODUCER D#00002239 Ft. Lauderdale FL 33301 INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A :New Hampshire Ins CO 23841 INSURER B :Philadelohia Indemnity Ins Co. 18058 LSJ Corp, DBA: Graph Plex Signs INSURERC :FCCI Insurance Company 10178 2830 N. 28th Terrace INSURER D : INSURER E : Hollywood FL 33020 INSURER F : COVERAGES CERTIFICATE NUMBER:CL1l33106222 REVISION NUMBER: 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 PAID CLAIMS. INSR ADDL SUBR ~aM~~1 I r~2T6~M-~1 LIMITS LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER GENERAL LIABILITY X EACH OCCURRENCE $ 1,000,000 - ~~~~~~~?E~~~~~?ence) ~ COMMERCIAL GENERAL LIABILITY $ 100,000 A tJ CLAIMS-MADE [i] OCCUR 01-LX-027561402-0 4/1/2011 4/1/2012 MED EXP (Anyone person) $ 5,000 ~ PERSONAL & ADV INJURY $ 1,000,000 r-- GENERAL AGGREGATE $ 2,000,000 ~'L AGGRE@E LIMIT APAS PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X ~~8T LOC $ AUTOMOBILE LIABILITY X COMBINED SINGLE LIMIT $ 1,000,000 - (Ea accident) X ANY AUTO - PHPK702321 4/1/2011 4/1/2012 BODILY INJURY (Per person) $ B ALL OWNED AUTOS - BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE - $ - HIRED AUTOS (Per accident) NON-OWNED AUTOS Uninsured motorist combined $ 1,000,000 - Medical payments $ 5,000 X UMBRELLA L1AB H OCCUR EACH OCCURRENCE $ 3,000,000 - EXCESS L1AB CLAIMS-MADE AGGREGATE $ 3,000,000 - DEDUCTIBLE $ A X RETENTION $ 10 000 01-UD-012856515-0 4/1/2011 4/1/2012 $ C WORKERS COMPENSATION X X I T~~$'ItJI~S I IO~-~- AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE D N/A E.L. EACH ACCIDENT $ 500 000 OFFICER/MEMBER EXCLUDED? 0001WC10A64507 6/10/2011 6/10/2012 (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ 500 000 ~m,;~rt-H~~ 'g'~'i)PERATlONS below E.L. DISEASE - POLICY LIMIT $ 500 000 DESGRIPTION OF DPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Addlllonal Remarks Schedule, if more space Is required) CERTIFICA TE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL. BE DELIVERED IN City of Sunny Isles Beach ACCORDANCE WITH THE POLICY PROVISIONS. 18070 Collins Avenue Sunny Isles Beach, FL 33160 AUTHORIZED REPRESENTATIVE Mark Schwartz/DEBBFL i/ll(u~,I:: /!~ A~AtVr:('~- ACORD 25 (2009/09) INS025 (200909) @ 1988-2009 ACORD CORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD . ~ ACORD@ CERTIFICATE OF LIABILITY INSURANCE J DA TE (MM/DD/VYYY) \".,---- 3/31/2011 THIS CERTIFICATE IS ISSUED AS A 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 certificate holder in lieu of such endorsement(s), PRODUCER ~~AA~~CT Jaclyn Stamper COI:porate Insurance Advisors rA~gNJo ~vll' (954) 315-5000 I r~~ No): (954)315-5050 100 NE 3rd Avenue E-MAIL ADDRESS: Suite 1000 PRODUCER 00002239 Ft. Lauderdale FL 33301 INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A New Hampshire Ins CO 23841 INSURER B :Philadelphia Indemni ty Ins Co. 18058 LSJ Corp, DBA: Graph Plex Signs INSURER C :FCCI Insurance Company 10178 2830 N. 28th Terrace INSURER D : INSURER E : Hollywood FL 33020 INSURER F : COVERAGES CERTIFICATE NUMBER:CLl133106222 REVISION NUMBER: 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 PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR ~m-J%Myy) ~2~J%Yv~) LTR INSR WVD POLICY NUMBER LIMITS GENERAL LIABILITY X EACH OCCURRENCE $ 1,000,000 - ~~~~~~J?E:~~~ir~nce) X OMMERCIAL GENERAL LIABILITY $ 100,000 ~ CLAIMS-MADE [i] OCCUR 4/1/2011 4/1/2012 A 01-LX-027561402-0 MED EXP (Anyone person) $ 5,000 I- PERSONAL & ADV INJURY $ 1,000,000 1- GENERAL AGGREGATE $ 2,000,000 - ~'L AGGR~E LIMIT APAS PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X ~~8T LOC $ AUTOMOBILE LIABILITY X COMBINED SINGLE LIMIT $ 1,000,000 -:-::::- (Ea accident) X ANY AUTO - HPK702321 4/1/2011 4/1/2012 BODILY INJURY (Per person) $ B ALL OWNED AUTOS - BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE .- $ - HIRED AUTOS (Per accident) NON-OWNED AUTOS Uninsured motorist combined $ 1,000,000 I- Medical payments $ 5,000 X UMBRELLA L1AB H OCCUR EACH OCCURRENCE $ 3,000,000 t- EXCESS L1AB CLAIMS-MADE AGGREGATE $ 3,000,000 X DEDUCTIBLE $ A RETENTION $ 10 000 01-UD-012856515-0 4/1/2011 4/1/2012 $ C WORKERS COMPENSATION X X I T~~$mI~s I IOJ~- AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE 0 E.l. EACH ACCIDENT $ 500 000 OFFICER/MEMBER EXCLUDED? N/A 6/10/2011 6/10/2012 (Mandatory In NH) 0001WC10A64507 E.L. DISEASE - EA EMPLOYE $ 500 000 ~~~~~~f~~ ~~'6PERATIONS below E.l. DISEASE - POLICY LIMIT $ 500 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) CERTIFICATE HOLDER CANCELLA TION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Sunny Isles Beach ACCORDANCE WITH THE POLICY PROVISIONS. 18070 Collins Avenue Sunny Isles Beach, FL 33160 AUTHORIZED REPRESENTATIVE Mark SChwartz/DEBBFL f/ifl~l:~ ~~ ~./I!r,C~k'(~/ j ,") -- ACORD 25 (2009/09) INS025 (200909) @ 1988-2009 ACORD CORPORATION, All rights reserved The ACORD name and logo are registered marks of ACORD . GRAPHPLE~SIGNS February 17,2012 City of Sunny Isles Beach 18070 Collins Avenue Sunny Isles Beach, FL 33 ]60 References> City of Weston > Remove and dispose of existing PVC street signs. Design, engineer, fabricate and install replacement "hurricane-resistant" custom aluminum street signs. Jeff Skidmore 954.2]4.7015 City of Sunny Is]es Beach> Remove and dispose of existing u-channel street signs. Design, engineer, fabricate and install replacement "hurricane-resistant" custom aluminum street signs. Helena Forbes (originally Jorge Vera) 305.792.1772 Town of Bay Harbour Islands> Remove and dispose of existing u-channel street signs. Design, engineer, fabricate and install replacement "hurricane-resistant" custom aluminum street signs. J.e. Jimenez 305.866.6241 Town of Golden Beach> Remove and dispose of existing u-channel street signs. Design, engineer, fabricate and install replacement "hurricane-resistant" custom aluminum street signs. Paul Abbott 305.773.6255 2830 North 28th Terrace, Hollywood, FL 33020 954.549.5566 F: 954.239.6872 jack@graphplex.com www.graphplex.com