HomeMy WebLinkAboutExhibit 15City of Miami, Florida
Commercial Waste Hauling Services RFQ 03-04-107
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6.3. LocaI Office Affidavit
Please type or print clearly. This Affidavit must be completed la full, signed and notarized ONLY if your office is located within the
corporate limits of the City of Miami.
Legal Name of Firm:
Entity Type: (check one box only) [] Partnership
[] Sole Proprietorship [] Corporation
Corporation Doc. No:
Date Established: Occupational License No:
Date of Issuance:
rittfj:€
PRESENT
Street Address:
City:
State:
How long at this location:
PREVIOUS
Street Address:
City:
State
How long at this location:
According to Ordinance No. 12271 (Section 18-85):
The City Commission may offer to a responsible and responsive local bidder, who maintains a Local Office, the oppommity of accepting a bid at
the low bid amount, if the original bid amount submitted by the local vcador is not more than ten percent (101/4) in excess 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/pmposers by this section.
Authorize Signature
Print Name
(Corporate Seal) Title
Authorize Signature
Print Name
Title
(Must be signed by 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.)
STATE OF FLORIDA, COUNTY OF MIAMI-DADE
Subscribed and Sworn before me that this is a truo statement this day of 200. l l Produced identification:
Notary Public, State of Florida My Commission expires
[l Personally known to me; or
(Seal)
Printed name of Notary Public
Please submit with your Response 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 location.
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City of Miami, Florida
Commercial Waste Hauling Services RFQ 03-04-107
(a)
6.4. Debarment and Suspension
CITY OF MIAMI CODE SEC. 18-56.4
Authority and requirement to debar and suspend:.
After reasonable notice to an actual or prospective contractual party, and after reasonable opportunity to such
party to be heard, the City Manager, after consultation with the Chief Procurement Officer and the City
Attorney, shall have the authority to debar a contractual party for the causes Iisted below from consideration
for award of city contracts. The debarment shall be for a period of not fewer than three (3) years. The City
Manager shall also have the authority to suspend a contractor from consideration for award of city contracts if
there is probable cause for debarment. Pending the debarment determination, the authority to debar and
suspend contractors shall be exercised in accordance with regulations which shall be issued by the Chief
Procurement Officer after approval by the City Manager, the City Attorney, and the City Commission.
(b) Causes for debarment or suspension include the following:
1. Conviction for commission of a criminal offense incident to obtaining or attempting to obtain a public
or private contract or subcontract, or incident to the performance of such contract or subcontract;
2. Conviction under state or federal statutes of embezzlement, theft, forgery, bribery, falsification or
destruction of records, receiving stolen property, or any other offense indicating a lack of business
integrity or business honesty;
3. Conviction under state or federal antitrust statutes arising out of the submission of bids or proposals;
4. Violation of contract provisions, which is regarded by the Chief Procurement Officer to be indicative of
nonresponsibility. Such violation may include failure without good cause to perform in accordance
with the terms and conditions of a contract or to perform within the time limits provided in a contract,
provided that failure to perform caused by acts beyond the control of a party shall not be considered a
basis for debarment or suspension;
5. Debarment or suspension of the contractual party by any federal, state or other governmental entity;
6. False certification pursuant to paragraph (c) below; or
7. Any other cause judged by the City Manager to be so serious and compelling as to affect the
responsibility of the contractual party performing city contracts.
(c) Certification:
All contracts for goods and services, sales, and leases by the City shall contain a certification that neither the
contractual party nor any of its principal owners or personnel have been convicted of any of the violations set
forth above or debarred or suspended as set forth in paragraph (b) (5).
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 set forth above, or debarred or suspended as set forth in
paragraph (b) (5).
Company name: 14)A5i
Signature:
Date: 3 (iL/a
FAILURE TO COMPLETE, SIGN, AND RETURN THIS FORM MAY DISOUALIFY YOUR RESPONSE
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City of Miami, Florida
Commercial Waste Hauling Services RFQ 03-04-107
6.5. STATEMENT OF' COMPLIANCE WITH ORDINANCE NO. 10032
Proposer certifies that (s)he has read and understood the provisions of City of Miami Ordinance No. 10032 (Section
18-105 of the City Code) pertaining to the implementation of a "First Source Hiring Agreement."
Proposer will complete and submit the following questions as part of the RFQ Proposal.
Violations of this Ordinance may be considered cause for annulment of a Contract between the Qualified Proposer(s)
and the City of Miami.
A. Do you expect to create new positions in your company in the event your company was awarded a Contract by
the City?
Yes X. No
B. In the event your answer to Question "A" is yes, how many new positions would you createto perform this
work?
C. Please list below the title, rate of pay, summary of duties, number of positions, and expected length or duration
of all new positions which might be created as a result of this award of a Contract.
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1)
2)
3)
4)
5)
6)
7)
8)
(Use additional sheets if necessary)
PROPOSER NAME: a) C7e , dell,'
SIGNATURFJTITLE:
/1-44 DATE: -a /t', 4.
FAILURE TO COMPLETE, SIGN, AND RETURN THIS FORM MAY D!SOUALIFY PROPOSAL.
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