HomeMy WebLinkAboutSupplement to Bid Form00502. SUPPLEMENT TO BID FORM:
CUSTOMER REFERENCE LISTING (Page 1 of 2)
Contractors shall furnish the names, addresses, and telephone numbers of a minimum of five
(5) firms or government organizations for which the Contractor has provided services for
projects of similar size, scope and complexity over a five (5) year period.
1) Company Name Ceop r
Address in OUS Loco-+ o n S CSI Ca w )
Contact Person/Contract Amount earl 1-4 ct) IU r ZCto r.
Telephone No. /Fax No, (Cr504314 :2300 I@ A) 4- ]31/5
2) Company Name AOflLt�. Pau,ei'Wf-
Address 545S NE 2 1 -
w 3
Contact Person/Contract Amount Cra! Os '�--t � � Z.� � `` r25 14)
Telephone No. /Fax No. &6 i--.BUJ isz-- 317 S
3) Company Name 0' A C. C a t s&u Chi &Y
Address 1 ia5 {O o 1 ShuRs f
Contact Person/Contract Amount 0121 C ru 2- ( ;CDZ SSD "
Telephone No. /Fax No. 2Lr? -L1(.0 5 /3c � a55 '" 1 WLI
4) Company Name eyaCa.ciaz �1
Address 55.5a-
Contact Person/Contract Amount lati212m U" r1 I 2 0 G, v
Telephone No. /Fax No. ( *7-Oa-) /6�) dY?rt(.0,4
Orange Bowl Parking Lot Repairs —ADA, B-30521 Bid No.: 05-06-] 17
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00502. SUPPLEMENT TO BID FORM:
CUSTOMER REFERENCE LISTING (Page 2 of 2)
5) Company Name 4 e41r C1 ay.
Address bl W O Y`( n J €'
Contact Person/Contract Amount 0-Q r `Tills t oen g
Telephone No. /Fax No.`I�-II LIU J4Lt9 J91
6) Company Name
Address
Contact Person/Contract Amount
Telephone No. /Fax No.
7) Company Name
Address
Contact Person/Contract Amount
Telephone No. /Fax No.
8) Company Name
Address
Contact Person/Contract Amount
Telephone No. /Fax No.
Orange Bowl Parking Lol Repairs--ADA, B-30521 Bid No.: 05-06-117
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00510. SUPPLEMENT TO BID FORM:
OFFICE LOCATION AFFIDAVIT (Page 1 of 2)
Please type or print clearly. This Affidavit must be completed in full, signed and
notarized ONLY IF YOU MAINTAIN AN OFFICE WITHIN THE CORPORATE LIMITS OF THE
CITY OF MIAMI.
tovis..3 1*.Q3t - ! Yl G
Legal Nanit of Firm:
Entity Type; (Check One) ❑ Partnership ❑ Sole Proprietorship ❑ Corporation
CJO'2cIi
Corporation Document No:
a 1,1 Volk r a-
J a.n uk-Qc(1 . 19iq
Date Established
Occupational License No:
Date of Issuance
y7r3 1. _
PRESENT U
Street Address: 1-7i I N. v. ' 1 y
City: 1` "a
State: FL, How long at this location: k 6
PREVIOUS
Street Address:
City:
State How long'at this location:
According to Section 18-85 of the City of Miami Code, as amended:
The "City Commission may offer to a responsible and responsive local bidder, who maintains an
office in the City of Miami, the opportunity of accepting a bid at the low bid amount, if the original
bid amount submitted by the local bidder does not exceed 110 percent of the lowest other
responsible and responsive bidder."
The intention of this section Is to benefit local bona fide bidders/proposers to promote
economic development within the corporate limits of the City of Miami.
I (we) certify, under penalty of perjury, that the office location of our firm has not been
established with the sole purpose of obtaining the advantage granted bona fide local
bidders/proposers by this section.
Orange Bowl Parking Lot Repairs--ADA, B-30521 Bid No.: 05-06-] 17
Page4]
00510. SUPPLEMENT TO BID FORM;
OFFICE LOCATION AFFIDAVIT (loge 2 of 2)
.//t 6t' G 'el.-
Print Name
FLE4,4,4-
(Cur.
Authorized Signature
doe/tee/0 o(c' ..
Prriint Name
5�r�rr'
Title
ignature Authoriz-Signature
(Must be signe /•y the corporate secretary of a Corporation or one general partner of a
partnership or the proprietor of a sole proprietorship or all partners of a joint venture.)
NOTARIZATION
STATE OF FLORIDA, COUNTY OF DADE
That: yoN. . 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: \ tgl.con't.
Please submit with your bid copies of Occupational License, professional and/or trade
License to verify local status. The City of Miami also reserves the right to request a copy
of the corporate charter, corporate income tax filing return and any other documents(s)
to verify the location of the firm's office.
NOTARY PUBLIC -STATE OP FLORIDA
00"" Robert Alonso
Commission # DD383222
'.,„„,,,.' Expires: JAN. 03, 2009
BONDED MU ATLANr1C BONDING CO., INC.
Orange Bowl Parking Lot Repairs —ADA, B-30521 Bid No.; 05-06-117
Page 42