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Air Mechanical & Service Corp.
CITY OF SUNNY ISLES BEACH 18070 Collins Avenue Sunnv Isles Beach; Flonda 33160: . (-kir :305.947:0606. :, www.sibfl.net ^ L. FEB 2 2 2017 �� • ` • 022 • �, v. cif „ r►o�` Sir City of Sunny Isles Beach C.''Y or SO PX° Office of the City Clerk 'RIGINAL BID FORM 1 BID COVER Bid Title: New HVAC Chiller Systems for Pelican Community Park THE UNDERSIGNED BIDDER PROPOSES AND AGREES, IF THIS BID IS ACCEPTED, TO ENTER INTO AN AGREEMENT WITH THE CITY OF SUNNY ISLES BEACH 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 Bidder accepts all of the terms and conditions of the ITB and Instructions to Bidders, induding 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 Bidder agrees to sign and submit the Agreement and other documents required by this ITB within ten days after the date of the City's Notice of Award. IN SUBMITTING THIS BID, THE BIDDER REPRESENTS, AS MORE FULLY SET FORTH IN THE AGREEMENT,THAT: 4101 • The Bidder 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 Bidder 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 Bidder. • This Bid is genuine and not made in the interest of or on behalf of any undisdosed person, firm or corporation and is not submitted in conformity with any agreement or rules of any group, association, organization, or corporation; the Bidder has not directly or indirectly induced or solicited any other Bidder to submit a false or sham Bid; the Bidder has not solicited or induced any person, firm or corporation to refrain from Bidding; and Bidder has not sought by collusion to obtain for itself any advantage over any other Bidders or over the City. The Bidder 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 purpose 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 Bidder will establish completion times for each individual Work Item and the successful Bidder 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. Exact Legal Company Name: Air Mechanical & Service Corp Business Name (dba), if any: City of Sunny Isles Beach I Invitation to Bid No. 16-12-02 22 • CITY OF SUNNY ISLES BEACH 18070 Collins Avenue Sunny Isles Beach,Florida 33160 . 305.947.0606 °` A "1 www.sibil.net "kit © y V • O -14.Or sal�� Street Address: 2700 Avenue of the Americas, Englewood, FL 34224 Mailing Address(if different): Telephone No.: ( 9 41 ) 475-3715 Fax No.: ( 941 ) 475-3725 Email Address: bbyers@amsco-ac.corn 59-2158902 FEIN No.: *By signing this document the bidder agrees to all Terms Authorized Signature: Blaine Byers Print Name: Air Mechanical & Service Corp Service Sales Title: THE EXECUTION OF THIS FORM CONSTITUTES THE UNEQUIVOCAL OFFER OF BIDDER TO BE BOUND BY THE TERMS OF ITS BID. FAILURE TO SIGN THIS SOLICITATION WHERE INDICATED ABOVE BY AN AUTHORIZED REPRESENTATIVE SHALL RENDER THE BID NON- RESPONSIVE. THE CITY MAY, HOWEVER, IN ITS SOLE DISCRETION, ACCEPT ANY BID THAT INCLUDES AN EXECUTED DOCUMENT WHICH UNEQUIVOCALLY BINDS THE BIDDER TO THE TERMS OF ITS OFFER. City of Sunny Isles Beach I Invitation to Bid No. 16-12-02 23 Or S+Jhi1Y hIES ti(ACN I B0Iit 1;itt t}� lri iI <,ffn '3l;( s0t1u!94r vtwtiti siltll•nt,t / 1 y e c/h"W SUtt P"- BID FORM 2 Reference Questionnaire To Whom It May Concern Subject: Reference Letter for Bid No. 16-12-02 for New HVAC Chiller Systems for Pelican Community Park Name of Bidder/Proposer: Air Mechanical & Service Corp - The above referenced Contractor is submitting a bid for a solidtatlon that has been Issued by the City of Sunny Isles Beach.We require that the Contractor provide written references with their submission.By providing you with this document the Contractor is requesting that you provide the following reference Information.We would appreciate you providing the information requested below as well as any other Information your feel is pertinent. Title of Contract: Scope of work: Rep I a-cc_ret e w 4 csP 00 To N . C In, l ie_v5 5 Value of Contract$ O1000 40 Was the work performed timely No Was the work performed timely&to acceptable quality standards? Oa No Have there been any repairs required under the warranty? Yes ' ) Would you enter Into a contract with the Contractor in the future? e) No If no to any of the above,please provide details: Comments: . , • - - d--l• - WoNis sit , p rh'1S La As o... vaary Ned-4-1 0.nd o~de-4 rv►sloA-1a�.J Thank you for your assistance in helping us in valuating our bid soildtation. Name of individual completing this form: X/TD n.fG u � I Ni Agency: 1�A ni •ft Title: Propn.,r-1. MA,vw�E2 Telephone: i•— �- 3 E-mail: R�.l�-o rut Q . Berpa..F L' PNC. Can'` Signature t� Date: L/at/i-7 Sincerely, Genesis Cuevas Purchasing Agent City of Sunny isles Beach I Invitation to Bid No.16-12-02 g -• E _.._ - _-.. ...__. _ _ ., - ..a. l =fit 0. BID FORM 2 Reference Questionnaire To Whom It May Concern Subject: Reference Letter for Bid No. 16-12-02 for New HVAC Chiller Systems for Pelican Community Park Name of Bldder/Proposer: Air Mechanical & Service Corp The above referenced Contractor Is submitting a bid for a solicitation that has been Issued by the City of Sunny Isles Beach. We require that the Contractor provide written references with their submission. By providing you with this document the Contractor is requesting that you provide the following reference information. We would appreciate you providing the Information requested below as well as any other Information your feel is pertinent. Title of Contract: Scope of work: /1 4.c€f o2 7C)1 Thk- C,kd <s p`-Dv:�t/J S Value of Contract$ a �, ut D y 9 Was the work performed timely No Was the work performed timely to acceptable quality standards? Tes No Have there been any repairs required under the warranty? 46211 No Would you enter Into a contract with the Contractor in the future? No If no to any of the above, please provide details: Comments: 1111 Thank you for your assistance in helping us in evaluatingtiour bid ssoiidtation. Name of Individual completing this form: �;.�1 eze"6 /'/idl Agency: �PSvt4v Title: Telephone: Fey ,9o-<2 c7 E-mail: Signature: Date: Sincerely, Genesis Cuevas Purchasing Agent City of Sunny Isles Beach Invitation to Bid No. 16-12-02 `' S CIT'CO SUNNY 151ES 6F.,ACH 1'5070 Culims ft yvnue 5ututy Wet Boric fividtt 3316Cs ,- , NQS 947 trb s9 c.• , rix°r.31611 tt4 ink '•tic* f �pb� t:~OF SUN BID FORM 2 Reference Questionnaire To Whom It May Concern Subject: Reference Letter for Bid No. 16-12-02 for New HVAC Chiller Systems for Pelican Community Park Name of Bidder/Pry: Air Mechanical & Service Corp The above referenced Contractor Is submitting a bid for a solicitation that has been issued by the city of Sunny Isles Beath.We require that the Contractor provide written references with their submission. By providing you with this document the Contractor Is requesting that you provide the following reference Information.We would appredate you providing the Information requested below as well as any other information your feel Is pertinent Title of Contract: I r hal/ Scope of work: Re (Qct- /. 6j b^ 1 Orr &!Z'C f-WDA livid nsdri O Value of Contract$ `ig , `# Was the work performed ti - 1Z No Was the work performed timely& .. acceptable quality standards? 41iP t Have there been any repairs required under the warranty? (� Would you enter into a contract with the Contractor In the future? No If no to any of the above, please provide details: Comments: " in g.((ems r.�S� °� - `nh s 541-4 n e Thank you for your assistance in helping us in evaluating our bid solicitation. Name of Individual completing this form: D4I)n qJ d Ytt)n n e r- . Agency:�t 01F3tnCiert Je i Title:6vv`r n� idemi t c a I+c c .� rr Telephone: f- `/._5- `19153 E-mail: Ic�l. bct.�n/v/►�#fig E,SIde )1°4 .tfl __ 't- Date: G+. -Z i- Genesis Cuevas Purchasing Agent n_ • City of Sunny Isles Beach I Invitation to Bid No.16-12-02 Jan Donoho .rom: Chua, Alan <AIan.Chua@dot.state.fl.us> ent: Monday, February 20, 2017 4:05 PM To: Jan Donoho Subject: RE: bid reference - AIR MECHANICAL FYI. Original Message From: Chua,Alan Sent: Monday, February 20, 2017 4:04 PM To: 'jhines@sibfl.net' Cc:Thomas,Trisa Subject: FW: bid reference-AIR MECHANICAL Good afternoon Ms. Hines, Attached please find completed Reference Questionnaire as requested by Air Mechanical. Let me know if you have any questions.Thank you. Thanks, flan Chua Capital Improvements Procurement Administrator-JACOBS Traffic Engineering and Maintenance General Consultant to Florida's Turnpike Physical Address: Mile Post 65, Florida's Turnpike -Turnpike Operations Center, Pompano Beach, FL 33069 US Mail: P.O. Box 9828, Ft. Lauderdale, FL 33310 Office: 954-934-1258 I Cell: 954-790-8902 I Fax: 954-934-1352 Email: alan.chua@dot.state.fl.us Original Message From: Chua,Alan Sent: Monday, February 20, 2017 3:17 PM To: 'Jan Donoho' Subject: RE: bid reference No, per our guidance from Central Office Procurement. Original Message From:Jan Donoho [mailto:jandonoho@amsco-ac.com] Sent: Monday, February 20, 2017 3:10 PM To: Chua, Alan Subject: RE: bid reference Importance: High ,Alan That would be Jane Hines, MMC City clerk 1 (305)-947-0606 jhines@sibfl.net would that include a copy back to us Jan Original Message From:Chua, Alan [mailto:Alan.Chua@dot.state.fl.us] Sent: Monday, February 20, 2017 2:41 PM To:Jan Donoho<jandonoho@amsco-ac.com> Subject: RE: bid reference Jan, We can fill out this form however, we need to submit this form directly to the requesting agency. Please provide the contact information or email address of the representative of City of Sunny Isle Beach. Thanks, Alan Chua Capital Improvements Procurement Administrator-JACOBS Traffic Engineering and Maintenance General Consultant to Florida's Turnpike Physical Address: Mile Post 65, Florida's Turnpike-Turnpike Operations Center, Pompano Beach, FL 33069 US Mail: P.O. Box 9828, Ft. Lauderdale, FL 33310 Office: 954-934-1258 I Cell: 954-790-8902 I Fax: 954-934-1352 Email:alan.chua@dot.state.fl.us Original Message From:Jan Donoho [mailto:jandonoho@amsco-ac.com] Sent: Monday, February 20, 2017 2:17 PM To:Chua,Alan Subject: bid reference Hello Alan Would you mind completing the attached and returning by 3PM tomorrow,Tues. Feb.21st. Thanks Jan Your message is ready to be sent with the following file or link attachments: Amh ref quest 2 CITY OF SUNNY ISLES BEACH 18070 Collins Avenue Sunny Isles Beach, Florida 33160 solo,qt. 305.947.0606 ° www.sibfl.net zika 0 O Cf.) Of SUN Pa • BID FORM 3 Minimum Requirements LICENSES,TRAININGS AND CERTIFICATIONS OF CONTRACTOR AND SUBCONTRACTORS Please indude in this section. Will provide addtional documents if awarded the fore mentioned project Bid No 16-12-02 - new HVAC chiller system for Pelican Community Park. IP 40 City of Sunny Isles Beach I Invitation to Bid No. 16-12-02 25 Aco® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 12/21/2016 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 ELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED EPRESENTATIVE 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 CONTACT BetsyCrawford NAME: Lassiter-Ware Insurance of Jacksonville IAfC N Exu: (800)845-8437 FAX No: (888)883-8680 8659 Baypine Rd aDpRess:Betsyc@lassiter-ware.com Suite 100 INSURER(S)AFFORDING COVERAGE NAIC 8 Jacksonville FL 32256 INSURERA:Amerisure Insurance Company 19488 INSURED INSURERB:Amerisure Partners Insurance 11050 Air Mechanical & Service Corp. INSURERC: 2700 Ave of The Americas INSURERD: INSURER E: Englewood FL 34244 INSURER F: COVERAGES CERTIFICATE NUMBER:17/18 Master 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 POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER (MMIDD/YYYY) (MM/DD/YYYY) GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 300,000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ A CLAIMS-MADE n OCCUR X CPP2095042 1/1/2017 1/1/2018 MED EXP(Any one person) $ 10,000 X Contractural Liability PERSONAL BADV INJURY $ 1,000,000 X XCU Included GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 -I POLICY 51 Tei Ti LOC - ,_ $ 0 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ X ALL OWNED SCHEDULED X CA2095041 1/1/2017 1/1/2018 BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS x AUTO WNED PROPERTY(Per accident)DAMAGE $ X $10,000 PIP UNisured Motorists $ 20,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAB CLAIMS-MADE CU2095043 1/1/2017 1/1/2018 AGGREGATE $ 5,000,000 _ DED X RETENTION$ 10,000 $ WORKERS COMPENSATIONWC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N X TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 A OFFICER/MEMBER EXCLUDED? N/A 12/31/2016 12/31/2017 WC2095044 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS 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 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION ATE THEREOF, NOTIC InformationACCORDANCE WITH THE POLICY PROVIS ONSE WILL BE DELIVERED IN 11111 AUTHORIZED REPRESENTATIVE only _ Kirk Bramlett/BETSYC — — ` ELS ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(201005).01 The ACORD name and logo are registered marks of ACORD ish State of Florida Department of State I certify from the records of this office that AIR MECHANICAL & SERVICE CORP. is a corporation organized under the laws of the State of Florida, filed on January 27, 1982. The document number of this corporation is F64810. I further certify that said corporation has paid all fees due this office through December 31, 2017, that its most recent annual report/uniform business report was filed on January 13, 2017, and that its status is active. I further certify that said corporation has not filed Articles of Dissolution. 40 Given under my hand and the Great Seal of the State of Florida at Tallahassee, the Capital, this the Thirteenth day of January, 2017 41*' 1-1 16111% atai4A • Secretary of State Tracking Number: CC9232177896 To authenticate this certificate,visit the following site,enter this number,and then follow the instructions displayed. https://services.su nbiz.org/Filings/CertificateOfStatus/CertificateAuthentication • I - . RICK SCOTr,GOVERNOR KEN LAWSON,SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION dint-, CONSTRUCTION INDUSTRY UCENSING BOARD h,k10 ik.. ,a84.isg*filoptyin ,,,, :v., erir,--; CFC1429223 The PLUMBING CONTRACTOR -,:.:,-;',6-7S-',; Named below IS CERTIFIED ...„— Under the provisions of chapter 489 FS. ExplraTion date:.AUG 31,2018 EIC STANTON_ ,•HOWARD _ AI _ ,.?,...;:4S-1- - •q-,'- R MECHANICAL 8 S:7' Qe'cORP -''t, • -,y 'i 4311 WEST mu D It-4-t7 '1 11 '' tj '-'- 4' , ,..--,/ _ ,-- 1:--. ..,,,. ,.,.__....,,_4, , 411 SD 0725/2171B "4 "--"OlGpik-.Y AS REQUIRED BY LAW me L1007260001154 RICK SCOTT,GOVERNOR ICEN UVNSCIN,SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD ,4iliiklA scagesaaseaskia CGC1522709 v 0., the GENERAL CONTRACTOR • Named below IS CERTIFIED ---,-. Under the prim/felons of Chapter 489 FS. Explishon date: AUG 31,2018 ...rd..< 0 .. .l.-Ki. 0 .., ...,: BYERS,JOHN JOHN L . 7._ AIR MECHANICAL 8 SERVICE CORP --,..,, ,.. _,,• 4108 WALVA STREET ".•',7";'.-", :'n''''•'-:'•-,-- .*: ..••‘ :•-•-•'';--)-7•:•-7, -- - TAMPA FL 33614 , 7--- - •• ft", - x •\. .7fr...i a_ 0 - ISSUED 011/1412018 DISPLAY AS REQUIRED BY LAW Mee L156111130002389 0 0 ----- • • RICK SCOTT,GOVERNOR ' I KEN LAWSON,SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION . CONSTRUCTION INDUSTRY LICENSING BOARD 44%44;1% imodcMatezZatr .. E.li The MECHANICAL CONTRACTOR 0 Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiratk3n date: AUG 31,2018 - -- -, , '_----- ' --r---,3•:--ht7..-...„' •••,...;_,_ -.,, •,--- 0 . ':.. .. 0 __--x---,-- SPAW HAROLD 1140tdA8, „,v-*.,. , AIR MECHANICAL&SERWC,CORP. r.?Li' 2808 W MCA ST _ ''------*_:4':•:4,tr----"'','.,:. ---;:r----.:;'-`,--,-'',,‘Y, TAMPA FL 33814 - 1:% --..`: - ow ...., ....•-• .,..,..._' , -;`, L'...,5,., ,,•-•.,.4''.... ...-'' ''?'' '-'' ''4.' ' ''i-' r ', :- 0 r, , ,-„__, --...'.--,a1..o...'---...-•;-: .:_ja. ...2-3 ...1.'= ...-77:,• .' -4 :::+ • ISSUED: UEV15/21318 DISPLAYAS REQUIRED BY LAW 8E00 1-11:46/1:4001417 0 2016/2017 CHARLOTTE COUNTY • LOCAL BUSINESS TAX RECEIPT ACCOUNT 15222 MUST BE OtSPI.AYEO IN A CONSPICUOUS MACE EXPIRES SEPTEMBER 30,2017 TYPE OF 342 CONTRACTOR(MECHANICAL CONTRACTOR) RENEWAL BUSINESS BUSINESS VARIOUS LOCATIONS ADDRESS CHARLOTTE CO,FL 00000 BUSINESS AIR MECHANICAL&SERVICE CORP. NAME AMOUNT 35.00 PENALTY 0.00 OWNER HAROLD W SPAW TOTAL 35.00 MAIUNG 2700 AVENUE OF THE AMERICAS Vickie L.Potts ADDRESS ENGLEWOOD.FL 34224 Charlotte County Tax Collector This receipt does not constitute a franchise,an agreement.or permission or aurhoritn THIS FORM BECOMES RECEIPT ONLY WtrEN VAUDATEO to perform the scrvikrs or operate rhe business described hereon when a franchise. Paid 09/12/2016 Receipt •772—OOD03953 35•DO agrecmern.oroth rcountyycommission.swuurfederal p.'missionorauthority is P required by count).state or fedend law. CITY OF SUNNY ISLES BEACH 18070 Collins Avenue Sunny Isles Beach, Florida 33160 Sotato $ 305.947.0606 ° - www.siblInet 01 - • i G Or e • D'• con'OF SUN P� BID FORM 4 ADDENDA ACKNOWLEDGEMENT INSTRUCTIONS: COMPLETE PART I OR PART II, WHICHEVER APPLIES PART I: UST BELOW ARE THE DATES OF ISSUE FOR EACH ADDENDUM RECEIVED IN CONNECTION WITH THIS ITB Addendum #1, Dated February 10, 2017 Addendum #2, Dated 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 RFQ Air Mechanical & Service Corp FIRM NAME: SIGNATURE: _,=Xl"' Blaine Byers Service Sales TITLE: February 21 , 2017 DATE: City of Sunny Isles Beach I Invitation to Bid No. 16-12-02 26 SJNNY ,SZe de, et V 4 i P 46 1* FLOWN c,rY OF SUN NOV Addendum No. 1 CITY.OF SUNNY ISLES BEACH New HVAC Chiller Systems for Pelican Community Park CITY ITB NO. 16-12-02 To All Bidders: Bidders for the above-referenced project shall take note of the following changes, additions, deletions, clarifications, etc. to the Plans and Specifications, which in accordance with the Contract Documents shall become a part of and have precedence over anything shown or described otherwise. Clarification: • Q1: Is the warranty bond required? Al: The following language from section - 2.17.1 Type of Warranty Coverage Required has been removed (Note: Changes to document language are both underlined and crossed-ems} Contractor's warranties shall be one (1) year from final completion, basked-by-a war-r-antybend and shall include all delivery, labor, material, and equipment for the correction, replacement, reinstallation, and/or removal of defective and/or unacceptable work. The Contractor shall provide a copy of its written warranty certificates at contract closeout. END OF SECTION 411 Friday, February 10, 2017 CITY OF SUNNY ISLES BEACH 18070 Collins Avenue Sunny Isles Beach, Florida 33160 . Nr 144. 305.947.0606 °� f m, www.sibfl.net :k., o 'yf D . F`O', 4.. c"}'of so PaO Air Mechanical & Service Corp BID FORM 5 BID PRICING BIDDER AGREES TO PERFORM ALL THE WORK DESCRIBED IN THE CONTRACT DOCUMENTS INCLUDING ALL LABOR, EQUIPMENT, SUPERVISION,TESTING AND PERMITTING TO PROVIDE A COMPLETE TURN-KEY PROJECT CONFORMING TO THE REQUIREMENTS DETAILED BY THE SPECIFICATIONS, MANUFACTURER, OWNER, STATE, FEDERAL AND LOCAL AGENCIES FOR THE FOLLOWING LUMP SUM AND/OR UNIT PRICES.WORK INCLUDES BUT IS NOT LIMITED TO GENERAL, ELECTRICAL AND MECHANICAL CONSTRUCTION. BID DESCRIPTION UNIT EST. UNIT EXTENDED ITEM# QUANTITY COST COST Temporary Chiller System 0 Temporary Chiller service required during the o 1 replacement period of the existing chillers LS 1 $o $ 24, 000. 00 • (including installation,operation, and removal) N • Subtotal of Temporary Chiller St tem / 2 4, 0 0 0.C 0 Demolition of Existing HVAC Chiller Systems o o 0 2 Removal of existing modular Air Cooled Chiller LS 1 $co o $ 1 8, 000. 00 •3 Removal of existing Pumps LS 1 $ o $ 4, 000. 00 Subtotal of New HVAC Chiller Systems 22, 000.00 New HVAC Chiller Systems New Chiller CH-1 (see schedule notes on M-2)to installed on a new modified structural concrete pad including but not limited too new two 0 4 alternate chilled water pumps, piping, and the LS 1 $ oo $ 233, 700. 00 upgrade of the 200A service of existing panel to N a new 250A service new chiller load(see rn rn schedule notes on E-1) Subtotal of New HVAC Chiller Systems 2 3 3, 7 0 0.0 0 4111 City of Sunny Isles Beach I Invitation to Bid No. 16-12-02 27 CITY OF SUNNY ISLES BEACH 18070 Collins Avenue Sunny Isles Beach, Florida 33160 soµ"YcF, 305:947.0606 o _ e www.sibll.net (� n • „ „'y'. '• ` 44e Cin or sut 04c' New Air Conditioning vent in PCP Gymnasium for recently converted storage room which 5 will ultimately house an office for 2 full-time LS 1 $ $4, 200. 00 and several part time personnel. (currently no AC in unit) Subtotal of New PCP Gymnasium Office 14, 2 0 0. 0 0 PROJECT CLOSE OUT As-built record drawings (electronicLS 1 $ $1 500. 00 6. AutoCAD&PDF format and hard copy) Subtotal of Project Close Out 11 , 5 0 0.0 0 BIDSUBTOTAL(1-6) /285, 400. DO CONTINGENCIES Project Contingency(To be used at the sole 1 15% $ 4 2, 81 0. D 0 411 7• discretion and direction of the Owner) • 8. Permit Allowance 1 $15,000 $15,000 BIDTOTAL(1-8): 343, 210. D0O Air Mechanical & Service Corp City of Sunny Isles Beach I Invitation to Bid No. 16-12-02 28 CITY OF SUNNY ISLES BEACH 1 - 18070 Collins Avenue Sunny Isles Beach, Florida 33160 `ss""Y 0.,_ 305.947.0606 o m wwv+.sibfl.net O n ° eO r C++Y OF 5 JFI AFFIDAVITS SONNY 'SAF ,...,<< � s O6'a, .; ' - 7 U '--.--- - '\.*'.L.,, '_.4.-----7„ ,„___,.4., . ..,-__ : • ,, - ,-. - . -... 4, /9 .i.„,„, _., * T y< 91 * F L_ 0 'C 0 P c7 O C/T Y SUS U N PC 0 . City of Sunny Isles Beach I Invitation to Bid No. 16-12-02 29 `osNY/$CF ~o�` "1,JY Z NON - COLLUSION AFFIDAVIT ill . __ _ `r : City of Sunny Isles Beach r ,DD t'''. o� 18070 Collins Avenue sr '•v L o' 0%..., %° Sunny Isles Beach,FL 33160 cr',"or sue'' Telephone:(305)947-0606 Fax:(305)949-3113 STATE OF FLORIDA ) COUNTY OF Charlotte ) • 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, Air Mechanical & Service Corp (Name of Corporation,Partnership,Individual,etc.) a, Corporation Florida formed under the laws of (Type of Business) (State) ' Service Sales of which he is . (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 III 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. Blaine Byers .444-, S vice Sales AFFIANT'S NAME AFFIANT'S TITLE TAKEN,SWORN AND SUBSCRIBED TO BEFORE ME this 21 S y of February �d0�. 2 p1 7 Personally Known X or Produced Identification ,• Type of identification NA (Affix seal here) L -40: _ NO'A-PUBLIC(name printed or typed) ••''� �``O� arry Dalton ; • e,:, LARRY DALTON y: MY COMMISSION#FF115182 .';.?oFF. ' EXPIRES June 26,2018 (407)398-0153 Ftoridallotaryservice.com 1111 DECEMBER 28,2010 1 of 10 ss.04NY ISi F,f l.O r.•� 'y' 4SY PUBLIC ENTITY CRIMES . Z City of Sunny Isles Beach 4 ` "= • •,DD a.. 18070 Collins Avenue sr '•s s.o a' 4' Sunny Isles Beach,FL 33160 ''or sos'�� Telephone:(305)947-0606 Fax:(305)949-3113 SWORN STATEMENT PURSUANT TO SECTION 287.133(3)(a) FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES PUBLIC ENTITY CRIMES Pursuant to the provisions of paragraph (2) (a) of Section 287.133, Florida State Statutes - "A person or affiliate who has been placed on the convicted vendor list following a conviction for a public entity crime may not submit a Bid on a Contract to provide any goods or services to a public entity, may not submit a Bid on a Contract with a public entity for the construction or repair of a public building or public Work, may not submit Bids on leases of real property to a public entity, may not be awarded to perform Work as a Contractor, supplier, Sub-Contractor, or Consultant under a Contract with any public entity, and may not transact business with any public entity in excess of the threshold amount Category Two of Sec. 287.017, FS for thirty six months from the date of being placed on the convicted vendor list". THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICIAL AUTHORIZED TO ADMINISTER OATHS. 11.1. This sworn statement is submitted to City of Sunny Isles Beach by Blaine Byers, Service Sales ]print individual's name and title) for Air Mechanical & Service Corp [print name of entity submitting sworn statement] whose business address is: 2700 Avenue of the Americas Englewood, FL 34224 and (if applicable) its Federal Employer Identification number(FEIN) is 59-2158902 (If the entity had no FEIN, include the Social Security Number of the individual signing this sworn statement: NA .) 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 10 Air Mechanical & Service Corp 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 1111 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 entityorganized under the laws of anystate or of the United States with the legal power to 9 9 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.) X 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 Ill 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: 4.,.....- Signature) Blame Byers (Printed Name) Service Sales (Title) Sworn to and subscribed before me this 21st day of February 201 by Blaine Byers . (AFFIX NOTAR SW4D ki.6R.la+ 4...A --- ,. . .,••,",pr nj�+,,:=_� �_�t� LARRY DALTON. MY COMMISSION#FF115182 Signature: Notary Public—State of Florida `••?? of EXPIRES June 26, 2018 Larry Dalton ) 398-0153(007FloridallotaryService.com Print or Type Commissioned Name Personally Known X OR Produced Identification NA ® NA Type of Identification Produced 10/1998 3of 10 SJpNY/SEJ - •= EQUAL OPPORTUNITY / ® , AFFIRMATIVE ACTION A � O s• DD FLo % City of Sunny Isles Beach 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: Blaine Byers Title: Service Sales Air Mechanical & Service Corp Firm: Address: 2700 Avenue of the Americas Englewood, Fl 34224 • 4110 DECEMBER 28.2010 4.of 10 S,$NY rsrE � . 9 CONFLICT OF INTEREST uAr `t = • City of Sunny Isles Beach 18070 Collins Avenue tit,9D1•Lp 9.°) S4' Sunny Isles Beach,FL 33160 or sot+ 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 CHARLOTTE Blaine Byers BEFORE ME, the undersigned authority, personally appeared , who was duly sworn, deposes, and states: 18.1. I am the Service Sales Rep of Air Mechanical & Servicevith a local office in Englewood, FL and principal office in Tampa, Fl ori da. Corp 18.2. The above named entity is submitting a Bid for the City of Sunny Isles Beach, Bid No. 16-12-02 described as: 011460g6/lV)'ajfijehfi¢gilefv/c)6V/*The Affiant has made diligent inquiry and provides the information contained in this Affidavit based upon his own knowledge. *new HVAC Chiller Systems for Pelican Community Park 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. 18.7 I certify that no member of the entity's ownership or management is presently applying for any employee position or actively seeking an elected position with the City of Sunny Isles Beach. 18.8 I certify that no member of the entity's ownership or management,or staff has a vested interest in any aspect of the City of Sunny Isles Beach. 18.9 In the event that a conflict of interest is identified in the provision of services, I, on behalf of the above named entity, will immediately notify the City of Sunny Isles Beach. Dated his 21st of February aow 2017 Dated Blaine Byers, Service Sales A FIANT Print or Type Name and Title Swom to and subscribed before me this 21 stday of February ,21V0/. / 2017 Xl Personally Known OR Produced Identification NA ;Type of Ide ratio NA NOTARY PUBLIC STATE OF FLORIDA Larry Dalton LARRY DALTON ® MY COMMISSION#FF115182 e.y .Af °••„!roF�,d; ;r EXPIRES June 26, 2018 (407)398-0153 FloridallotaryService.COm DECEMBER 28,2010 5 of 10 4 S' 4 I SC FJ , Z DISPUTE DISCLOSURE ® y City of Sunny Isles Beach 18070 Collins Avenue �I 9''••,Lo' s` Sunny Isles Beach,FL 33160 c">o, SUN 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. Air Mechanical & Service Corp February 21 , 2017 Firm Date Blaine Byers, Service Sales Authorized Signature Print or Type Name and Title DECEMBER 28.2010 6 of 10 • 4 s,rig Y'SFl e9 ANTI - KICKBACK . n • u z City of Sunny Isles Beach 18070 Collins Avenue sr'D91•FLOW' +° Sunny Isles Beach,FL 33160 or suo'•c Telephone:(305)947-0606 Fax:(305)949-3113 ANTI-KICKBACK AFFIDAVIT STATE OF FLORIDA ) COUNTY OF CHARLOTTE ) 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. A/ • �., By: i Blaine Byers Title: Service Sales The foregoing instrument was acknowledged before me this 21st day of February , 20 17 • by Blaine Byers [name of person], as service Sales [type of authority], for Air Mechanical & Service corp[name of party on behalf of whom instrument was executed]. AFFIX NOTARY STAMP HERE: / (4/. LARRY DALTON y Public — State of Florida MY COMMISSION#FF115182 ‘`'>' J• Larry Dalton i,t,0 EXPIRES June 26,2018 (4071 398-0153 FloridallotaryService.com Print or Type Commissioned Name Personally Known X OR Produced Identification NA Type of Identification Produced NA DECEMBER 28,2010 7 of 10 .4': • SVNN•Jsr f 0 ,::). 4.-.,"'.0- ,I, BID BOND 'I'`:'- __ City of Sunny Isles Beach ;'ems-/a1' 18070 Collins Avenue '`. )•/,:,-310 �` Sunny Isles Beath,FL 33180 e'4 a,sni' Telephone:(305)947-0608 Fax(305)949-3113 STATE OF FLORIDA ) COUNTY OF Miami-Dade) KNOW ALL MEN BY THESE PRESENTS, that we Air Mechanical& Service Corp. as Principal, and Westfield Insurance Company , as Surety, are held and firmly bound unto the City of Sunny Isles Beach, a municipal corporation of the State of Florida in the sum of Five Percent of the Amount Bid Dollars($ 5% ),lawful money of the United States,for the payment of which sum well and truly to be made,we bind ourselves,our heirs,executors,administrators and successors jointly and severally,firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH that whereas the Principal has submitted the accompanying Bid dated, February 22,201720(!O for: New HVAC Chiller Systems For Pelican Community Park; ITB-16-12-02-D-2016/mb WHEREAS,it was a condition precedent to the submission of said Bid that a cashier's check or Bid Bond in the amount of five percent(5%)of the Base Bid be submitted with said Bid as a guarantee that the Proposers would,if awarded the Contract,enter into a written Contract with the City for the performance of said Contract,within ten(10)consecutive calendar days after written notice having been given of the Award of the Contract NOW, THEREFORE, the conditions of this obligation are such that if the Principal within ten (10)consecutive calendar days after written notice of such acceptance,enters into a written Contract with the City of Sunny Isles Beach and furnishes the Performance Bond,satisfactory to the City,each In an amount equal to one hundred percent(100%)of the Contract Price,and provides all required Certificates of Insurance, then this obligation shall be void;otherwise the sum herein stated shall be due and payable to the City of Sunny Isles Beach and the Surety herein agrees to pay said sum Immediately,upon demand of the City,in good and lawful money of the United States of America,as liquidated damages for failure thereof of said Principal. IN WITNESS WHEREOF, the above bonded parties have executed this instrument under their several seals this 22nd day of February 20 17 the name and the corporate seal of each corporate parry being hereto affixed and these presents 0 being duly signed by its undersigned representative. DOCUMENT CONTINUES ON NEXT PAGE IN -- ENCS OF J Air Mechanical& Service rp. A•d/ iiliL! Indivi<tjal or Partne hip Principal Affix Corp to Seal 2 _10/Avenue of the Americas Business Address ,ut::iu:rr;r Englewood, FL 34224 .•''� �•)t.C tS' t- City,State,and Zip Code .,,I; `�,�'••-i ' " s,•mp r- 941-475-3715 941-475-3725 •J:p 'v`a � Business Telephone Business Facsimile - •�t ; o t.Y �� lIN .",,,, /ye cy.1- ecretary VI Nf WV- fer, a ay (Corporate Surety)' n R.Neu,Att rrFact "%,,; ,,,,i�: ..•Witness• ",, and FL Licensed Agent t. ), : • '� By: f. - *Impress Corporate;Seal J 'F'›` i Z IMPORTANT Surety'cbm arnei:executing bonds must appear on the Treasury Department's most current list(circular 570 as amended)and be authorized . to transact'business in the State of Florida. i DECEMBER 2a.2010 '. B of 10 j EM 1 1 J• THIS POWER OF ATTORNEY SUPERCEDES ANY PREVIOUS POWER BEARING THIS SAME ROWER#AND ISSUED PRIOR TO 12/18/14, FOR ANY PERSON OR PERSONS NAMED BELOW. General POWER NO. 0994782 00 Power Westfield Insurance Co. of Attorney Westfield National Insurance Co. 1 CERTIFIED COPY Ohio Farmers Insurance Co. Westfield Center, Ohio Know All Men by These Presents, That WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, corporations, hereinafter referred to individually as a "Company" and collectively as "Companies," duly oorganized and existing under thppeppoint laws of the State of Ohio, and having its principal office in Westfield Center, Medina County, Ohio, do by these KEesents make,constitute and VIN WOJTOWICZ,JENNIFER aSTEPHENS,JOHN R. NEU,JOINTLY OR SEVERALLY of ST PETERSBURG and State of FL its true and lawful Attorney(s)-in-Fact,with full power and authority hereby conferred in Its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings, or other instruments or contracts of suretyship LIMITATION: THIS POWER OF ATTORNEY CANNOT BE USED TO EXECUTE NOTE GUARANTEE, MORTGAGE DEFICIENCY, MORTGAGE GUARANTEr, OR BANK DEPOSITORY BONDS. and to bind any of the Companies thereby as fully and to the same extent as if such bonds were signed by the President,sealed with the corporate seal pof the applicable Company and dullby authority g theSaid duly de by itsSecretary, hereby ratifying and confirming all that the said Attorney(s)-in-Fact may do In WESTFIELD INSURANCPointment Is maE COMPANY,WESTFIELD NATIONAL INSURANCE COMPANY eand OHIO FAsolution PRMERSO FARMERSted by the Board COM ANYDirectors�f each of the "Be It Resolved,that the President,any Senior Executive,any Secretary or any Fidelity&Surety Operations Executive or other Executive shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attorneys)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: • The Attorney-in-Fact. may be given full power and authority for and In the name of and on behalf of the Company,to execute,acknowledge and deliver, any and all bonds, recognizances, contracts, agreements of indemnity and other conditional or obligatory undertakings and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such Attorney-in-Fact shall be as binding upon the Company as if signed bythe President and sealed and attested by the Corporate Secretary." "Be it Further Resolved,that the signature of any such designated person and the seal of the Company heretofore or hereafter affixed to any sower of attorney or any certificate relating thereto by facsimile,and any power of attorney or certificate bearing facsimile signatures or facsimile eal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached." (Each adopted at a meeting held on February 8,2000). In Witness Whereof, WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY have caused these presents to be signed by their National Surety Leader and Senior Executive and their corporate seals to be hereto affixed this 18th day of DECEMBER A.D., 2014 . wan ..puluq,,, Corporate „•` �,„,....,,,,, Seals �asg '4c 40•ONAL iZ.1,6%. s•'% ••' �su�o�,�• WESTFIELD INSURANCE COMPANY 0Affixed / �v�•''• .au 0 ;•`a`'P•''• •• .sr,:; ��f ••���"!;fp�*� WESTFIELD NATIONAL INSURANCE COMPANY pyx ;W.9 SEAL OHIO FARMERS INSURANCE COMPANY W •7 �' •`'3 -SrsA I *MTERED•41 •r s .aw •�.. ....04: '�y {. 19% 48 •.�; '''".,..„,',7„„,.‘,.'" State 4'/i•••pIgIWN••••�, BY: ? If. State of Ohio Dennis P. Baus, National Surety Leader and County of Medina ss.: Senior Executive On this 18th day of DECEMBER A.D., 2014 , before me personally came Dennis P. Baus to me known, who, being by me duly sworn, did depose and say, that he resides in Wooster, Ohio; that he is National Surety Leader and Senior Executive of WESTFIELD INSURANCE COMPANY,WESFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY,the companies described in and which executed the above instrument;that he knows the seals of said Companies;that the seals affixed to said instrument are such corporate seals;that they were so affixed by order of the Boards of Directors of said Companies;and that he signed his name thereto by like order. Notarial CI. Seal SAffixed C3)Zgied40.44°` State of Ohio - • David A. Kotnik, Attorney at Law, Notary Public County of Medina ss.: • yMy Commission Does Not Expire(Sec• 147.03 Ohio Revised Code) ..,, e 0 F I, Frank A.Carrino, Secretary of WESTFIELD INSURANCE COMPANY,WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS' INSURANCE oce rotrue ieof a Power of ArxyCmpeshih is stll infull foand effect; and furthermore, ththe above and e resolutions the Boards of Directors, out inhePowerof Attorney said are in full force and effect. d In Witness Whereof, I have hereunto set my hand and affixed the seals of said Companies at Westfield Center, Ohio, this?"h day of "te,(jr , A.D of 01 :,. ....:„..0...4. 4 IiitA _414... laSE.--AL. ...)4b SEAL •�itel :c�rt►aTE�Eo•31 ,�( '• r V. r4 ! :y :n: 4... leas :* Secretary ....,-,z--. . '-�'.. V.'.° , ,•.,• �•••••„ Frank A. Carrino, Secretary •••,,11111.1.1•,`••' I.,,,,,,,,,..U`•`N ' • BPOAC2 (cc,enbined) (06-02)