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: A140G"�
Payment Terms: 2% 10 days__Net 30 days
Delivery or Completion of project will be made within q 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 e:
NAME OF BIDDER: __0"L ObJETR
ADDRESS: j' 1 I §° • - 4
F 7 AX: �.
cz
BEEPER:
PHONE:
EMAIL:
SIGNE
TITLE: "/I
DATE: _7
7e,
FAILURE TO COMPLETE, SIGN, AND RETURN THIS FORM SHALL DISQUALIFY THIS BID.
City of Miami
Bid No. 05-06-028
Page 18
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
, a corporation organized and existing under
the laws of the State of , held on the _day of
resolution was duly passed and adopted authorizing (Name) as
(Title) 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 , day of
20
Secretary:
Print:
,a
CERTIFICATE OF AUTHORITY
(IF PARTNERSHIP)
HEREBY CERTIFY that at a meeting of the
, a partnership orga
the laws o - - - e of _ , held on the
resolution was duly pass- • - die adopted authorizi
(Title) of the
that his/her execution thereof, attes - = •y
partnership.
I further certify tha
20
Board of R=c ors of
and existing under
yof ---- _, a
me) as
ids on behalf of the partnership and provides
r, shall be the official act and deed of the
d partnership agreement remains in full force an
I • TNESS WHEREOF, I have hereunto set my hand this ___, day of
artner:
Print:
CERTIFICATE OF AUTHORITY
(IF JOINT VENTURE)
Joint venturers must subm : '•int venture agreeme - g at the person signing this bid
is authorized to sign bid documen - • b= • . • e joint venture. If there is no joint venture
agreement each member of t ven - •gust sign the bid and submit the appropriate
Certificate of Authority • . • rate, partnership, or in • i ► • - -
City of Miami Page 19
BId No. 05-06.028
Bid Response Form - Certification Statement (Page 2 of 3)
CERTIFICATE OF AUTHORITY
(IF INDIVIDUAL)
1 H. REBY CERTIFY that, I (Name) , individually and doing
bus ess as (d/b/a) (If Applicable) have
exec ed and am bound by the terms of the bid to which this attestation is - ched.
IN WI ESS WHEREOF, I have hereunto set my • d this , day of
, 20_—.
Signed:
Print:
STATE OF
COUNTY OF
)
)
The foregoing instr ent was acknowledged before me
20_____, by , who is
produced as identification
oath.
SIGNAT RE OF NOTARY PUBLIC
STAT OF FLORIDA
NTED, STAMPED OR TYPED
NAME OF NOTARY PUBLIC
Is
City of Mlamf Page 20
Bld No. 05-06-028
,
rsonally known to me or who has
nd who (did / did not) take an
day of