HomeMy WebLinkAboutBid Response Form4.0 BID RESPONSE FORM
4.1. Certification Statement (Page 1 of 3)
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 (!) 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 t/
Delivery or Completion of project will be made within _30_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 (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:
t,r /3 _.1...�
NAME OF BIDDER: ,I ' " ) C_) r' �;' t, t 11
I L 1,
ADDRESS:
PHONE: ) (-o I .-1 g).3
FAX: �..�� .. C(
EMAIL:-_1..--..,C /..tt^<..`-C,. J..) r.�,) 7 e 1:)Cii;� r&tti(.1:''BEEPER:
•
SIGNED BY: (""-- e , J:)
TITLE: I°rf CIL-t r3 ac.,
DATE:
FAILURE TO COMPLETE, SIGN, AND RETURN FORM SHALL DISQUALIFY THIS BID.
City of Miami Page 24
Ekd No. 05.06.006
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
TA e ia(-; 6 r'e't-t.0 L. L. C__ , a corporation organized and existing under
the laws of the State of /-�16 e r o fi _, held on the day of I °>. Al , .� e 3 , a
resolution was duly passed and adopted authorizing (Name) Ear/ (ctr� ,La.caas
(Title) j1(il6E1.. 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 WITNES iiIHERfOF, I have hereunto set my hand this 2.Li, day of it'cif"c�.l-,
20(
Secretary:
Print: r.A9 r-,- C (,, to c,Lr4..
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,
1 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 25
Bid No. 05-06.006
Bid Response Form ~Certification Statement (Page 3of3)
CERTIFICATE OFAUTHORITY
(|F/ND|V|DUAL}
| HEREBY CERTIFY that, | (Name) . indiOdually and doing
business as (d/b/a) (J Applicable) have
exeCLIted and am bound by the terms of the bid to which this attestation is attached.
|N WITNESS WHEREOF, | have hereunto set my hand this . day of
20
Signed:
Print
1 /,
STATE OF //yP/0A
COUNTYOF
)
)SS:
The foregoing mstrument was acknowledged before mu this day of
20[~L,�.by /--�jr< /"�``/ /-n��C .vvhuisp meorwhu --
produced ' as identification and who (did /did not) take an
oath.
SIGNATURE OF NOTARY PUBLIC
STATE OFFLORIDA
NOV 17' 2'.003
n.��xr�oAu'u'icuvu0oucu.,1o�.
PR|NTED. �TA�PEO OR TYPED
NAME OF NOTARY PUBLIC
City mWam|
Bid No, 05-06-006
mooeu
4.2. BID FORM
BIDDERS MUST BID ON ALL OF THE ITEMS LISTED BELOW. AWARD SHALL BE MADE ON AN
AGGREGATE BASIS TO THE PRIMARY AND SECONDARY LOWEST MOST RESPONSIVE AND
RESPONSIBLE BIDDER(S). PERMIT FEES AND TIPPING FEES ARE NOT TO BE FACTORED IN
YOUR BID AS THESE ITEMS ARE TO BE BILLED AS A SEPARATE LINE ITEM WITH PROOF OF
COST SUBMITTED WITH INVOICE. CURRENT FUEL COST MUST BE FACTORED INTO YOUR BID
PRICING, HOWEVER, FUTURE FUEL COST FLUCTUATIONS WILL BE BILLED SEPARATELY
BASED ON THE CONSUMER PRICE INDEX (SEE SECTION 2.23., FUEL COST INDEX)
SAMPLE EXTENDED
ITEM # DESCRIPTION UNIT PRICE QUANTITIES** AMOUNT
1 Residential one (1) story frame / stucco, $ /sq. feet X 1200 sq ft = $1 f1 -ICI.
CBS Structure (INCLUDES SLAB)
2 Residential two (2) story frame / stucco, $ I ''SC' /sq, feet X 2400 sq ft = $? ((C''0 (i(1
CBS Structure (INCLUDES SLAB)
3
4
Commercial one (1) story / frame stucco, $
CBS Structure (INCLUDES SLAB)
Commercial two (2) & three (3) story $ 1.
frame/stucco, CBS Structure (INCLUDES SLAB)
a Commercial Structure four (4) story or $
6
7
8
l, 5- /sq. feet X 3000 sq ft=$ 1.1 j � s i 1•
/sq. feet X 6000 sq ft= $ I(), 2. C'C"
C '' /sq. feet X101000sq ft= $ 2,C)/ e0(), OC,
40 feet in height or more (INCLUDES SLAB)
Walls $ 1 t. 00 /linear feet X100 lin.ft= $ 1 00r.
Slabs
Fences
$ •7) /sq. feet X 1000 sq ft= $ 0
$ 1. t)C3 / foot X 200 ft = $ CC,
(Any additional slab and/or fence not appurtenant at additional cost)
Sewer Capping Services $ �Z1• 00 /project X 1 = $ 10), o C)
OPTIONAL, SERVICES:
9 Minimum charge per project
(Not to exceed $1000.00)
$ !?L/' rq,; /project X 1 = $ 4oe). oc.)
10 Asbestos Survey $ `7 . C' L g /project X 1 = $ 1/ L'' "-'
11 Asbestos Supervisor, if needed $ 0 /hour X 8 = $ ,,210,. oC.->
12 Abandonment of Septic Tanks $ 300. 00 /tank X 1 = $ CFCs, OC)
(will be utilized in conjunction with #1-#5 above)
13 Machine Inaccessible (Demolition by Hand) $ e)0/sq, feet X 250 sq ft = $ � 2-.5Z' CtC'
SUM TOTAL (ITEMS 1-13) $
**Note: Sample quantities are for evaluation purposes only.
City of Miami Page 27
Bid No. 05-06-006
Certificate of Competency OR State of Florida Demolition License
No. Cie 6.?.-; (,) Expires:
(to be provided with Bid Form Response)
If no Subcontractors are to be used, insert the word 'Self' in the spaces under "Name of Subcontractor,
Subcontractor's
County -Municipal
Name of Occupational
Type of Work Subcontractor License Number
1.
2.
3.
C
Subcontractor's Appropriate License No. 7)
(Current copy to bo submitt d with bid)
Expiration Date: 0 7 BIDDER:
d.?-
Signature:
DATE:
.8 1.• C--
(company name)
FAILURE TO COMPLETE, SIGN, AND RETURN THIS FORM SHALL DISQUALIFY BIDDER,
City of Miami Pago 28
Bid No. 05-06-006
43. Qualification Statement (Page lof 2)
INSTRUCTIONS:
This questionnaire is to be included with your bid. Do not leave any questions unanswered, When the question
does not apply, write the word(s) "None", or "Not Applicable", as appropriate. Please print.
COMPANY NAME:
771
41(1
�..(7i (.. �. C..
COMPANY OFFICERS:
President ?' -/ ' : 1 Vice President ".f (1,I1(t i (.
Secretary Treasurer
COMPANY OWNERSHIP: I
•
1 I
LICENSES:
1 % of ownership
`-( % of ownership
_ 7}_%ofownership
% of ownership
1. County or Municipal Occupational License No,
(attach copy with bid)
] +
2, Occupational License Classification �.) <:'r`1 ('.=r f !-1( i-1- r 1
3. Occupational License Expiration Date:
4. Metro -Dade County Certificate of Competency No. Wart
(attached copy if requested in Bid or RFP)
5. Social Security or Federal I,D, No.
EXPERIENCE:
6. Number of Years your organization has been in business:
7. Number of Years experience BIDDER/PROPOSER (person, principalof firm_ , owner) has had in operation
of the type required by the specifications of the Bid or REP: _ _ 7
8, Number of Years experience BIDDER/PROPOSER (firm, corporation, proprietorship) has had in
operation of the type required by the specifications of the Bid or RFP: ; a
City of Miami Page 29
Bid No. 05-06-006
Bid Response Form — Qualification Statement (Page 2 of 2)
9. Experience Record: List references who may be contacted to ascertain information on past and/or present
contracts, work, jobs, that BIDDER/PROPOSER has performed of a type similar to that required by
specifications of the City's Bid or RFP with whom you have done business with in the past three (3) years:
AGENCY/FIRM NAME/ADDRESS DATE OF JOB DESCRIPTION OF JOB
CONTACT PERSON:
AGENCY/FIRM NAME/ADDRESS DATE OF JOI
CONTACT PERSON:
PHONE NO.:
DESCRIPTION OF JOB
PHONE NO.:
AGENCY/FIRM NAME/ADDRESS t1) DATE OF 10B DESCRIPTION OF J013
CONTACT PERSON:
PHONE NO,:
AGENCY/FIRM NAME/ADDRESS DATE OF JOB DESCRIPTION OF JOB
CONTACT PERSON: PHONE NO,:
FAILURE TO FULLY COMPLETE, AND RETURN THIS FORM MAY DISQUALIFY YOUR BID.
City of Miami Page 30
Bid No. 05-06-006