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 governin determining the
quoted prices.
We (l) 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 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:
NAME OF BIDDER: A .1,A 7R.A>c'S/'O4T7i-r/O , ,NCB- •
ADDRESS: 1.5151 lV w 3 3 f)/_ . IL'UN 4 I
PHONE: (30_0 G 86~ gO ttO FAX: (30'6) 6 ST — 6 g q
EMAIL: E to -I A ,4Torivaber lolu, dam BEEPER: (3O) c7a3 f5 OV -
SIGNED BY: C464-61145 12.14A-tv-4
TITLE: V r °_ /QE25 007 DATE: /0-0
FAILURE TO COMPLETE, SIGN, AND RETURN THIS FORM SHALL DISQUALIFY THIS BID.
City of Miami Page 22
Bid No. 05-06-046
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
i4 4 i2441),4/4o 74-nati, .14.)d. , a corporation organized and existing under
the laws of the State of FL-04 )bA , held on the day of A Pi)) L , 2006, a
resolution was puly passed and adopted authorizing (Name) E.bwr' bo lia-P4 t,2L as
(Title) VR E P Qatir b T 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 /0 , day of .A??It-
Secretary..
Print:
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. 05-06-046
Bid Response Form - Certification Statement (Page 2 of 3)
CERTIFICATE OF AUTHORITY
(IF INDIVIDUAL)
I HEREBY CERTIFY that, I (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, 1 have hereunto set my hand this , day of
, 20
Signed:
Print:
STATE OF ibrid01
1 ) SS:
COUNTY OF �IJ c ml Dade- )
The foregoing instrument was acknowledged before me this I 0 day of Ac P r i I ,
20 00 , by Ec[u.arc1d Her rionc ez- , who is personally known to me or who has
produced peYSor c 1 E\ 14 nOvJn as identification and who (did / did not) take an
oath.
a( -
SIGNATUR F NOTAR PUBLIC
STATE OF FLORIDA
PRINTED, STAMPED OR TYPED
NAME OF NOTARY PUBLIC
,__y
ototi p,,,,y DENISE RODR1GUEZ
t Notary Public - State of Florida
8. ,1My Commission Expires Mar 10, 2009
Commission # DD 405667
' 8. iv, Bonded By National Notary Assn.
City of Miami Page 24
Bid No. 05-06-046