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Legal Name of Firm:
Entity Type: Partnership, Sole Proprietorship, Corporation, etc.
COREOPIA i 1d -N
Year Established:
GS
Office Location: City of Miami, Miami -Dade County, or Other
U N 1 N c0 F-Fo-F,��--�Er� t A N -� �A�� CO(JL\M
Business Address:
400i- Ni.W. -51 kyf�
City, State, and Zip Code: ,{
Telephone Number:
(30.5) G -:5 - GIG
Fax Number:
(305) C 3-5- 0202
E-mail Address:
Occupational License Number:
7
J-0 JO413- 3
Occupational License Issuing Agency:
Occupational License Expiration Date:
- 3LP t . 30, 200q
Respondent certifies that (s) he has read and understood the provisions of City of Miami Ordinance No.
10032 (Section 18-105 of the City Code) pertaining to the implementation of a "First Source Hiring
Agreement.": ( eg or No)
Page 3 of 32
Do you expect to create new positions in your company in the event your company was awarded a
Contract by the City? (Yes or No)
YE-.
In the event your answer to question above is yes, how many new positions would you create to
perform this work?
j
t E.N
Please list the title, rate of pay, summary of duties, number of positions, and expected length or duration
of all new positions which might be created as a result of this award of a Contract.
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VEL1VrV-:f -a Pb -,Mo --- 11 WEEKS�knt EN rMPL-aYr-�-5--$ISkQ.-MEAL aSSEMSLY-Sky--mGvS alt �xs
Minorit
y/
Women Business Affairs Registration Status: Hispanic Female, Black or None,
t✓t L: S P;'A 4 -4 i t (815 -'AMC ELM ALT -5 C7WNt ttb S07--)
Please list and acknowledge all addendum/addenda received. List the addendum/addenda number and
date of receipt (i.e. Addendum No. 1, 7/1/07). If no addendum/addenda was/were issued, please insert
N/A. _
Ai: Dg N -DOT i �o a iAMIL 1(,,20D7, No.2 Anm iL-2-M9
Reference No. 1: Name of Company/Agency for which bidder is currently providing the services/goods
as described in this solicitation, or has provided such services/goods in the past:
C t `11 Off 'M I AN I --� *FA -,u5 as f E1R9ft-r1O1\L D4,Y aRLP 15(0-N1
Reference No. 1: Address, City, State, and Zip for above reference company/agency listed:
-3-50C) -Fat4 AmcxwD tyi�- , -N EAm (-) Vic., 33 3
Reference No. 1: Name of Contact Person and Telephone Number for above reference no. 1
Reference No. l: Date of Contract or Sale for above reference no. 1
cc--r1-j 2.00 --j >= v a slN c;F-:- IM 5
Reference No. 2: Name of Company/Agency for which bidder is currently providing the services/goods
as described in this solicitation, or has provided such services/goods in the past:
C I TY 05IN 14N I -i PA7KV STEEM;5� , CW t 0, C-Ao--- -Diy t S i DIS
Reference No. 2: Address, City, State, and Zip for above reference company/agency listed:
350Q A N Atv► 0?((s l4 R wE j1"A1 Aw i ,VL, , 33. 33
Reference No. 2: Name of Contact Person and Telephone Number for above reference no. 2
Page 4 of 32
Reference No. 2: Date of Contract or Sale for above reference no. 2
oy a 260 - n� R�CNT CC?N- A GTop,
Reference No. 3: Name of Company/Agency for which bidder is currently providing the services/goods
as described in this solicitation, or has provided such services/goods in the past:
as
{ rI t�i�A -- NiY� COMM o-wiY AcTiC�tJ A rjP-NGY., �AY CAm i)(VM ICI�,1
Reference No. 3: Address, City, State, and Zip for above reference company/agency listed:
Reference No. 3: Nameof Contact Person and Telephone Nurnber for above reference no. 3
Reference No. 3: Date of Contract or Sale for above reference no. 3
JA -0. I. ZOOS WAWE SCREb 5(NGS �9 --
Bidder has attached copy of current State or Local Health Certificate for Food Preparation Facilities?
Name of Governmental Agency that issued Health Certificate:
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P IN(51ON Or Uo -I-VS'U5 * R951A RANT 5
Bidder is registered with the State of Florida Department of3y�rOD—PIVj(i; Rt ,CCN NA-) ae+� i�t�lY i
and is included on the Registered Caterer List for by the bid opening
date? Ye or No?
Bidder filled out and attached the Florida Department of tW(A i tdnvitation to Bid, .Standard Contract
(ITB) FY 2009 document, found under the "Notes and Attachments" section of this bid in the
Oralce iSupplier system? es or No?
Bidder has attached documentation evidencing appropiate State approval to operate a food service
facility?Sor No?
Pad.- 5 of 32
Reference No. 4: Name of Company/Agency for which bidder is currently providing the
services/goods as described in this solicitation, or has provided such services/goods in the past:
Highland Food Resources
Reference No. 4: Address, City, State, and zip for above reference company/agency listed:
1011 Ives Dairy Road, Suite 105, Miami, F133179
Reference No. 4: Name of Contact Person and Telephone Number for above reference no. 4
Sandra Escobar (305) 655-0022
Reference No. 4: Date of Contract or Sale for above reference no. 4
October 1, 2005