HomeMy WebLinkAboutBid Response Form4.0 BID RESPONSE FORM
4.1. Certification Statement
Please quote on this form(s) net prices for the item(s) listed. Return 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
Delivery or Completion of project will be made within a. calendar days after receipt of
purchase order.
We (I) certify that any and ail 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 (I) 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: c ' fr. 9_c..4L Ekte dy SFLGiALI LS) NC
ADDRESS: goo 4.1\404-rem pkLt. OIL, d SLA rE JJ uprte2) FL 33-.5$
PHONECoo) d14oFAX: ( .074b- E21$
.cew►
EMAIL::w.%-ccur.i at ciaswertertru,AVci BEEPER: tov
SIGNED BY:
TITLE: i1.P. DATE:
FAILURE TO COMPLETE, SIGN, AND RETURN THIS FORM SHALL DISOUALIFY THIS BID.
City of Miami Page 22
Bid No. 05-06-024
Bid Response Form - Certification Statement (Page 2 of 3)
CERTIFICATE OF AUTHORITY
(IF CORPORATION)
I HEREBY CERTIFY that at a meeting of the Board of Directors of
co+M+M I;d.l ,iea,y SPir+lc M..► l , a corporation organized and existing under
the laws of the State of Fwit..t0.4 , held on the 7 day of i"4kR t-1 ociA. a
resolution was duly passed and adopted authorizing (Name) J®4"..ms . C3• o rcitee..i as
(Title) V1 c.t Puri ocJ-r of the corporation to execute bids on behalf of the corporation
and providing that hislher 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 in ,day of . kNLAMLY
20 Or!v .
Secretary:
Print: Jirq;
a OA . Grtut:La
CERTIFICATE OF AUTHORITY
(IF 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 provides
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 agreement remains in full force and effect.
IN WITNESS WHEREOF, I have hereunto set my hand this , day of
20
Partner:
Print:
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).
City of Miami Page 23
Bid No. 05-06-024
Bid Response Form - Certification Statement (Page 2 of 3)
CERTIFICATE OF AUTHORITY
(IF INDIVIDUAL)
I HEREBY CERTIFY that, l (Name) , individually and doing
business as (d/b/a) (If Applicable) have
executed and am bound by the terms of the bid to which this attestation is attached.
IN WITNESS WHEREOF, I have hereunto set my hand this , day of
, 20
Signed:
Print:
STATE OF )
SS:
COUNTY OF
The foregoing instrument was acknowledged before me this day of
20 , by , who is personally known to me or who has
produced as identification and who (did / did not) take an
oath.
SIGNATURE OF NOTARY PUBLIC
STATE OF FLORIDA
PRINTED, STAMPED OR TYPED
NAME OF NOTARY PUBLIC
City of Miami Page 24
Bid No. 05-08-024
4.2. BID FORM and SPECIFICATIONS
Item
1.
Description
Calcium Hypochlorite Pulsar Bricquettes
No substitution.
Packaged: 50 lb. pail
Estimated Unit of Unit
Annual Otv. Measure Price
2. Calcium Hypochloride-Dry Granular
70% available C12
Packaged: 1001b. drums
Brand Name or Product No. A- H '3 055+
3. Muriatic Acid 20 Baume
Packaged: 4 (1 gal.) jugs/case
Brand Name or Product No. 1! AC t O-G.S
400 pails $ eq-75/ea
A 81.7 S i -E C-ta s - -L-•wA 13
10 drums $ Wea
200
cases $ q-$7 /ea
4. Diatomaceous Earth Filter Powder 200 bags
Packaged: 50 lb. bag
Brand Name or Product No. 1~ kv% 5K O'j
5. Sodium Bicarbonate
Packaged: 466-1b-beg+ Sep OD . bag •
Brand Name or Product No. A e Sg 00
$ I to.7'y /ea
t 00
.58- bags $ %S•S$ /ea
10o
6. Calcium Chloride hB— bags $ 1ir•$S /ea
Packaged: 1139-ib.-hag• GO t b. loge•y
Brand Name or Product No.A
7. Trichloro-s-Trazinetrionc 25 pails $1O$.75 lea
Packaged: 401b. or 50 lb. Pail
Specify: 401b. Pail [ 1 or 50 lb. Pail [,/1
Brand Name or Product No. PrR GS$
po
8. Cyanuric Acid or pool stabilizer .46- drums $S10.71 /ea
Packaged: 100 ib.gym ssib. tact es, ' -- (41-4.A ck. of syotviz)
Brand Name or Product No. ,¢E 7 77
TOTAL (Items 1-8):
Extended
Price
$ 3S'3cO /yr
pet i 1s'(
$ I) 0,14.?O/yr
$ 1,4114.00/yr
$ 3,3Sg.00/yr
$ 1553,00/yr
$ 11to$B.00/yr
$a�Z I$ .167yr
$ `f � cas..' O/yr
$ SID) 14(07.7"
Authorized Signature: _., . Date: 1 2•1-- piP
FAILURE TO COMPLETE, SIGN AND RETURN THIS FORM SHALL DISQUALIFY THIS BID.
City of Miami Page 25
Bid No. 05.05-024