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: RECYCLING BINS DIMENSIONS 261/4" x 16 3/8" x 13 3/4"
WEIGHT 5.1 lbs.
CAPACITY 18.6 gallons
Payment Terms: 2% 10 daysNet 30 days X 1 % 10 days X
Delivery or Completion of project will be made within 30-45 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: Otto Environmental Systems (NC) , LLC
ADDRESS: 12700 General Drive, Charlotte, NC 28273
PHONE: 800/227-5885 FAX: 704/588-5250
EMAIL: sbowlingBotto-usa. com BEEPER: 904/669-3791
SIGNED BY: . L'��1.,'gg eUhen Stradtman
TITLE: CEO DATE: August 7, 2006
FAILURE TO COMPLETE, SIGN, AND RETURN THIS FORM SHALL DISQUALIFY THIS BID.
City of Miami Page 22
Bid No. 05-06-D98
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
Otto Environmental Systems (NC) , LLC , a corporation organized and existing under
the laws of the State of Delaware , held on the 30 day of May , 2006 , a
resolution was duly passed and adopted authorizing (Name) Stephen Stradtman as
(Title) CEO 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 7 , day of
20 06.
Secretary:
Print: Jo
August
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. 06-06-088
Bid Response Form - Certification Statement (Page 2 of 3)
CERTIFICATE OF AUTHORITY
IIF INDIVIDUAL1
I HEREBY CERTIFY that, l (Name) , individually and doing
business as (d/b/a) (1f 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
Bld No. 05-06-098
4.2. BID FORM
Est. Annual
Item No. Description: quantity: Unit Price: Extended Amount:
1. Litter Container as or equal to 400 $ lea $
Wausau Tile, Inc. Model #MF3021
meeting the specifications.
Manufacturer/Model No,
Warranty:
No. of calendar days for delivery after receipt of Purchase Order: days
2. Recycling Bin as or equal to 4800
Rehrig Pacific Co., Huskylite #RB-18
meeting the specifications.
Manufacturer/Model No. RC-180-051
Warranty: 5 years
$ 6.59 /ea $ 31, 632.00
No. of calendar days for delivery after receipt of Purchase Order: 30-45 days
Authorized Signature: �.("����� Date: August 7, 2006
Stephen Stradtman, CEO
FAILURE TO COMPLETE, SIGN AND RETURN THIS FORM SHALL DISQUALIFY THIS BID.
City of Miami
Bid No. 05-06-098
Page 25
4.3. Qualification Statement
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: Otto Environmental Systems (NC) , LLC
COMPANY OFFICERS:
President Stephen Stradtman
CFO
XYIUMNRXICK William Lassell
Secretary John D. Orleans Treasurer
COMPANY OWNERSHIP:
Otto Industries North America, Inc.
LICENSES:
100
% of ownership
% of ownership
% of ownership
% of ownership
1. County or Municipal Occupational License No.
(attach copy with bid)
2, Occupational License Classification
3. Occupational License Expiration Date:
4. Metro -Dade County Certificate of Competency No.
(attached copy if requested in Bid or RFP)
5. Social Security or Federal I.D. No. 76-0721498
EXPERIENCE:
b. Number of Years your organization has been in business: 22 years
7, Number of Years experience BIDDER/PROPOSER (person, principal of firm, owner) has had in operation
of the type required by the specifications of the Bid or RFP: 22 years
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: 22 years
City of Miami Page 26
B1d No. 06-06-098
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:
FIRM NAME/ADDRESS
City of Groveland
156 South Lake Avenue
Groveland, FL 34736
DATE OF SALE DESCRIPTION OF SALE
2005 & 2006 Recycling bins
CONTACT PERSON: Kathy Cotton PHONE NO.: 352-429-2141
FIRM NAME/ADDRESS
City of Tampa
DATE OF SALE DESCRIPTION OF SALE
2005 & 2006 Recycling bins
4010 W. Spruce Street
Tampa, FL 33607
CONTACT PERSON: Barbara Heineken
FIRM NAME/ADDRESS
Waste Pro
P. 0. Box 6862
Longwood, FL 32791
CONTACT PERSON: Tim Dolan
FIRM NAME/ADDRESS
PHONE NO.: 813- 348-1165
DATE OF SALE DESCRIPTION OF SALE
3/2006 Recycling bins
PHONENO.: '171-731-2544
DATE OF SALE DESCRIPTION OF SALE
Waste Services for City of Deltona 2005 & 2006 Recycling bins
925 Clyde Morris Blvd.
Daytona Beach, FL 32114
CONTACT PERSON: Dan Burroughs
PHONE NO.: 386-527-2719
FAILURE TO FULLY COMPLETE, AND RETURN THIS FORM MAY DISQUALIFY YOUR BID.
City of Miami Page 27
Bid No. 06-06-098
4.4. MINORITY/WOMEN BUSINESS AFFAIRS REGISTRATION AFFIDAVIT
Please Check One Box Only [ ] Hispanic [ ] Female [ ] Black [Not Applicable
If business is not 51% minority/female owned , affidavit does not apply. If not applicable, notarization is not required.
I (We), the undersigned agree to the following conditions:
1) that we have read Section 2.25 of the General Terms and meet the fifty-one percent (51%) ownership and
management requirement for minority/women registration status and will abide by all of the policies and
regulations governing the City of Miami Minority and Women Business Enterprise Procedures;
2) that if at any time information submitted by the undersigned applicant in his/her Bidder Application should
prove to be false, inaccurate, or misleading, applicant's name will be struck from the City of Miami's
Master Bidder list with no further consideration given to this applicant;
3) that the City of Miami maintains the right, through award of bid/contract, to revoke the award, should it be
found that false, inaccurate or misleading information or a change in the original information have
occurred;
4) to notify the City of Miami within thirty (30) days of any change in the firm's ownership, control,
management or status as an ongoing minority/women business concern as indicated on the Bidder
Application, and that the City of Miami, upon a finding to the contrary, may render a firm's registration
with the City null and void and cease to include that firm in its registered list of minority and women -
owned businesses;
5) that the City of Miami has a right to diligently verify all information submitted by applicant in his/her
Bidder Application to monitor the status of the Minority/Women Business Enterprise, once registered;
6) that the City of Miami may share a firm's registration information concerning its minority/women status
and its capability with other municipal or state agencies for the sole purpose of accessing the firm to their
procurement opportunities, unless otherwise specified by the firm in writing.
I (We) certify under the penalties of perjury that the information contained in any and all application documents
submitted to the City of Miami is correct as per Ordinance No. 10062 as amended.
Firm Name:
(If signing as a corporate officer, kindly affix corporate seal)
(Name, Title & Date) (Name, Title & Date)
This application must be signed by at least one general partner of a partnership or the proprietor of a sole
proprietorship or all partners of a joint venture.
COUNTY, SS
COUNTY OF DADE
That:
NOTARIZATION
Date:
personally appeared before me and
acknowledged the foregoing instrument as his/her act and deed.
That he/she has produced as identification.
NOTARY PUBLIC:
My Commission Expires:
FAILURE TO COMPLETE, SIGN, AND RETURN THIS FORM MAY DISOUALIFY THIS BID.
City of Miami Pogo 28
Bid No. 06.06-098
4.5. SAMPLE OF AFFIRMATIVE ACTION POLICY for EQUAL EMPLOYMENT
OPPORTUNITY
AFFIRMATIVE ACTION/
EQUAL EMPLOYMENT OPPORTUNITY - POLICY STATEMENT
It is the policy of (Company Name) to base its hiring and promotions on merit, qualifications and competency and
that its personnel practices will not be influenced by an applicant's or employee's race, color, place of birth,
religion, national origin, sex, age, marital status, veteran and handicapped status.
One of the management duties of all principals at (Company Name) is to ensure that the following personnel
practices are being satisfied:
I. Take every necessary affirmative action to attract and retain qualified employees, regardless of race, color,
place of birth, religion, national origin, sex, age, marital status, veteran and handicapped status.
2. Maintain equitable principles in the recruitment, hiring, training, compensation and promotion of employees.
3. Monitor and review personnel practices to guarantee that equal opportunities are being provided to all
employees, regardless of race, color, place of birth, religion, national origin, sex, age, marital status, veteran
and handicapped status.
(Company Name) is committed to take affirmative action and aggressively pursue activities that will serve to
enable all employees and applicants opportunities available throughout this organization.
Clearly, the above actions cannot be accomplished as a secondary duty for any individual, despite the full support of
management. And so, to monitor our efforts, (Company Name) has assigned one of its principals as the
Affirmative Action Director to monitor all activities of this program.
Employees may contact (Name of assigned principal) at (telephone number) regarding this Affirmative Action
Policy.
DATE: August 7, 2006
(SIGNATURE/TITLE;, / I 4x 1 L2EO
PLEASE SEE OTTO'S ENCLOSED POLICY STATEMENT.
FAILURE TO COMPLETE, SIGN, AND RETURN THIS FORM MAY DISQUALIFY THIS BID.
City of Miami Page 29
Bld No. 06-06-098