HomeMy WebLinkAboutcertification statement4.0 BID RESPONSE FORM
4.1. Certification Statement
Please quote on this form(s) net prices for the item(s) listed. Retum signed original and retain a copy for your
files. Prices should include all costs, including transportation to destination. The City reserves the right to
accept or reject all or any part of this bid. Prices should be firm for a minimum of 120 days following the time
set for opening of the bids.
In the event of errors in extension of totals, the unit prices shall govern in determining the quoted prices.
We (I) certify that we have read your Invitation for Bids, completed the necessary documents, and propose to
furnish and deliver, F.O.B. DESTINATION, the items or services specified herein.
The undersigned hereby certifies that neither the contractual party nor any of its principal owners or personnel
have been convicted of any of the violations, or debarred or suspended as set in section 18-107 or Ordinance
No. 12271.
All exceptions to this bid have been documented in the section below (refer to paragraph and section).
EXCEPTIONS:
Payment Terms: 2% 10 days Net 30 days it?
Delivery will be made within % calendar days after receipt of purchase order.
We (I) certify that any and all information contained in this bid is true; and we (I) further certify that this bid is
made without prior understanding, agreement, or connection with any corporation, firm, or person submitting a
bid for the same materials, supplies, equipment, or service, and is in all respects fair and without collusion or
fraud. We (1) agree to abide by all terms and conditions of this IFB and certify that I am authorized to sign this
bid for the bidder, Please print the following and sign your name:
NAME OF BIDDER: £i£,v66'T evoeRISoN
ADDRESS: /ag ? 5, r.O, /2; - rat
PHONE:yo; "' ^bf?' FAX: £ ) O'S'it
EMAIL:€EX}ie 9'r ,dervw_eil oL.. Cosy BEEPER() ,3a7.- AO3v
SIGNED BY
f
TITLE: eteiNegi
DATE: /O/d yt
FAILURE TO COMPLETE, SIGN. AND RETURN THIS FORM SHALL DISOUALIFY THIS BID.
City of Miami
BId No. 03-04-012
Bid Response Form - Certification Statement (Page 2 of 3)
CERTIFICATE OF AUTHORITY
(IF CORPORATION)
1 HEREBY CERTIFY that at a meeting of the Board of Directors of
efa'i0: T7..02s4v rt/gMe'1r Asigi.tri1'Otc , a corporation organized and existing under the laws of the
State of 11 , held on the Al day of .v"awrr4,4Ay , c+ r , a resolution was duly passed and
adopted authorizing (Name) dW' u r .0evo.¢ig &ca as (Title) ,a w+ of the
corporation to execute bids on behalf of the corporation and providing that his/her execution thereof, attested by
the secretary of the corporation, shall be the official act and deed of the corporation. I further certify that
said resolution remains In full force and effect.
IN WITNESS WHEREOF, I have hereunto set my hand this ,f', day of Yr r , 20/6
Secretary. �,� 4' .
�
Print: - igi '
CERTIFICATE OF. AUTHORITY
( PARTNERSHIP)
I HEREBY CERTIFY that at a meeting of the Board of Directors of
, a partnership organized and existing under the laws of the
State of , held on the _day of , a resolution was duly passed and
adopted authorizing (Name) as (Title) of the to execute
bids on behalf of the partnership and pr•. ides that his/her execution thereof, attested by a partner, shall be the
official act and deed of the partnership.
I further certify that said partnership a • eement remains in full force and effect.
IN WITNESS WHEREOF, I
Partner
Print:
ve hereunto set my hand this , day of
g
, 20
CERTIFICATE OF AUTHORITY
(IF JOINT VENTURE)
Joint venturers must submit a joint venture agreement indicating that the person signing this bid is authorized to
sign bid documents on behalf of the joint venture. If there Is no Joint venture agreement each member of the
joint venture must sign the bid and submit the appropriate Certificate of Authority (corporate, partnership, or
Individual).
N/A
City of Miami Bid No. 03-04012