HomeMy WebLinkAboutPre-AttachmentRFQ 03-04-107
City of Miami, Florida
Commercial Waste Hauling services
ATTACHMENT A
ATTESTATION OF QUALIFICATIONS
RFQ NO. 03oa ,
Commercial Solid Waste Hauling Services
FAILURE TO COMPLETE AND RETURN THIS ATTACHMENT WITH RESPONSE
SHALL DEEM PROPOSER NON -RESPONSIVE.
Name of Applicant:
7J oCi-hoid-
Address of Applicant:
Date:
y use
Proposers must answer and provide all required docum�ns Res onse�o this RFQpso longbelow. Proosers aas all
this format or may respond e same order as outlinin another format iedibelow.
information is provided
1. Identification Information on Applicant
A. Name of Applicant
the name, business address of the principal
If the applicant is a partnership or corporation,
officers and stockholders and any person having any financial or controlling interest in the
ver,
ration is a
partnership or cooperation shall be required. Provided, � holders that then only thenameand
publicly owned corporation having more than 2 shall be re
q wired. Detail information
business address of the local managing officer(s)sha
below or within submittedwill be unable to determine the
ethisnnformation not be provided with Response
qualifications of a Proposer should 1 em/p ;4100 .74
rr
B. Character of Applicant
The applicant, to determine qualifications for participation in the Franchise Agreement, if
an pp oration, partnership, association or organization,
individual, or in the case of a firm, Corp p interest therein, should be of
any person(s) having any
financial, controlling, or managing
good moral character. In making such determination, the following information submitted
by the applicant shall be considered:
(1) Penal History
If the applicant is an individual, a record of all convictions other than anendividual,ethen
fore
shall be provided by the applicant. If the applicant
19
City of Miami, Florida
Commercial Waste Hauling Services
RFQ 03-04-107
in the case of a publicly held
records of all convictions and the reasons therefore of the principal controlling
officeor applicant shall be provided. However,
corporati(s)on
pp
co oration having 25 or more shareholders, only chrequired. aforementioned lndicate convictions
ation
applicable to its local managing officer(s) shallity Crimes statute does
below, if applicable, and reasons. A11 be unableso confirm the o detelrmineic t the qualifications of a
not apply to Proposer. The City w
Proposer should this information not be provided with Response.
N P
(2) Fingerprints
The fingerprints of the persons mentioned in this subsection, tiee may be obtained from
each of such persons shall accompany response. Such is ro ided.
the City's police
departm t. Indic ate below fingerpripro ed. / t
(1(fi !�
(3) Business History applicant has operated a solid waste collection removal
Indicate whether such app or license, and if so, where
business in this or another state under a franchise, permit
and whether such franchise, permit or license has ever been revoked or suspended
and the reasons therefore. The City will be unable to determinethe qualifications of a
Proposer should this information not be provided with Response
5 ��� '
. "7G�.P a�,► ieari his w O
►a a S,i
s •55 'n r�
p'1d
(4) Existence of Business Entity
proof of incorporation and proof of that
If the applicant is a corporation, provide
corporation's good standing in the state of incorporation. If applicant is a foreign
ng
corporation, applicant should submit information or the mate of F aterial e r rtifydyi Ig that tt
applicant is allowed and qualified to do business inlicant should
an
is other than a corporation and sit operating
namensregistered undeer a fictitious names, ate law and held by
submit information that such fact to the City. The City will
applicant. Indicate below that such proof is being provided
be unable to determine the qualifications of a Proposer should this information not be
provided with Response
ll� Gejz
S
29
City of Miami, Florida
2. Equipment and Method of Operation
pp
ment
Theaapplicant, in order to qualify for participation in the Agreem such shall possess equip and
ation
capable of providing safe and efficient service. the Department of Solid Waste shall
approving the method of operation for each applicant,
require the following information:
to
by
A.
Provide the type, number and complete descriptionAgreement equipment
in the spa ee used or
the applicant for providing service pursuant tote g qualifications of a
on an attachment. The City will be unable to determine dt d q with Response.
Proposer should this information not be ! p G g
gS
RFQ 03-04-107
Commercial Waste Hauling Services
B. Provide a statement / attestation that the applicant shall use only City and/or County -
approved disposal sites for disposing of all garbage, garden trash, industrial waste,
and solid waste material which applicant collects and
ree ofFlorida exceptoves, partme sites
f
which heretofore have been approved by the State
Environmental Protection. The City will be unable to determine
the
a qualifications of
a Proposer should this information not be provided with Response
.e
3. Insurance Requirements
Proposer must submit a Statement attesting that proof of insurance he City Ce provided
rov ded, in ana
pdays of approval y
d
form acceptable by the City within five (5) y ppin current
tus
shall maintain its insurance, with the City listed as Addiwill be unable tional , to determine athe
throughout the duration of the Agreement. The City
qualifications of a Proposer should this information not be provided with Response
It should be noted that the City will be unable to determine Proposer's qualifications
should all required information requested above not be provided with Response.
the above will not be able to provide
Therefore, any Proposer who fails
f to provide
Pany
r red by the City.
services unless deemed fully 9
certify that the above information provided, and its corresponding documentation, r information nots
I hereby fY false or misleading information,
true and correct. I fully understand that any
as requested by the City for the purposes of deceit or deception, that be groundsl e for
providedg
no
the determination of being deemed "not qualified"and that I understand
recourse in the finding by the City.
21
Waste Disposal information:
Thunder Demolition Inc. will dispose of all garbage and solid waste
that is collected in the City of Miami in a facility designated for
disposal of garbage and solid waste and which meets all requirements
of law. These facilities include Miami -Dade County's Solid Waste
Management System as well as. other Florida DEP approved and
permitted sites.
City of Miami, Florida
Commercial Waste Hauling Services
RFQ 03-04-107
I further certify that the undersigned is legally authorized to sign this statement on behalf of the
applicant for participation in the Agreement.
Signed :
Telephone No: C'-5` �9Q1 "Z O Fax Number:^
Beeper No.:
Cell Number:
N
Email Address:
,, er�'e..e
Witnessed by: / i� . �� Print Name:
Date:
Print Name:
&og - q7U
a41
4-10
22
RFQ 03-04-107
City of Miami, Florida
Commercial Waste Hauling Services
6.1. RFQ Information Form
Issue Date: June 14 2004 Buyer: Pamela Burns CITE{
RFQ No.:
03-04-107 Email: burns ci.miami.fl.us
Responses must be received by: Wednesday, July 7, 2004 at 200 P.M.
at th
e Office of the City Clerk, 3500 Pan American Drive, Miami, Florida 33131-5504
926-76; 929-6�;
Commodity Codes: 906-82; 910-27; 926-45;929-66; 962-39; 968-71; 988-8; 998-48
TERM CONTRACT
COMMERCIAL SOLID WASTE
HAULING SERVICES
RFQ NO. 03-04-107
I certify that any and all information contained in this Proposal is true;
t ens d with yerccertify
that this
Proposal is made without prior understanding, agreement, or
rm
or person submitting a Proposal for the same materials, supplies, equipment, or services and conditions anft he RFQ,
is in all
respects fair and without collusion or fraud. I agree to abide by
all termsand certify that I am authorized to sign for the Proposer. Please print the following and sign your
name:
I propose to provide one or both of the following services:
Indicate "x"
Commercial Solid Waste Haulin Services
Specialized Waste Handlin Services
Firm's Name:
Principal Business Address:
tf1E`, 1,15 ST
f7043? L 33 16
Mailing Address:
//b
34c Telephone: so s - gqq
E-mail address:
Name: ./
Title: ri —
Authorized Signature: �+
t
Ou
23
RFQ 03-04-107
City of Miami, Florida
Commercial Waste Hauling Services
6.2
CERTIFICATE OF AUTHORITY
(IF CORPORATION)
STATE OF I Dn.ea )
) ``SSS:
COUNTY OF PI ja4-YU Drtae d
I HEREBY CERTIFY that a meeting of the Board of Directors of the
a corporation existing under the laws of the State of
�ii� ,held on
the following resolution was duly passed and adopted:
o
the
sal dated,
"RESOLVED, that, as President of the Corporation, C of Miami and this corporation and tthat their eexcut onotheeof, attested by
�s2 k?� , 20,-� , to the ty
the Secretary of the Corporation,and with the Corporate Seal affixed, shall be the official act and deed of this
Corporation."
I further certify that said resolution is now in full force and effect.
IN WITNESSWHEREOF,1 have hereunto set my hand and affixed the official seal of the corporation this
day of , 20 0_ .
Secretary:
(SEAL)
FAILURE TO COMPLETE SIGN AND RETURN THIS FORM MAY DIS UALIFY YOUR RESPONSE.
24
City of Miami, Florida
Commercial Waste Hauling Services
RFQ 03-04-107
6.3. Local Office Affidavit
Please type or print clearly. Thls Affidavit must be completed in full, signed and notarized ONLY if your office is located within the
Entity Type: (check one box only) [] Partnership
[] Sole Proprietorship )Corporation
Occupational License No: Date of Issuance:
corporate limits of the City of Miami.
Legal Name of Firm:
De4rnol 014
Corporation Doc. No: Date Established:
Office Location :
PRESENT
Street Address: e. IA
City: State:
iv_
PREVIOUS
Street Address:
City:
According to Ordinance n o. 12271 (Section 18-85):
f
ting a
The CityCommissionantif the offer to a
bidamountsubmitted and responsive local by the local bidder, who
somaintains eaaLocal Office, th 0°PPin opportunity
theplowest otherId at
the low bid amount, g
responsible and responsive bidder.
The intention of this section is to benefit focal bona fide bidders/proposers to promote economic development within the corporate limits
of the City of Miami.
t (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 tide local bidders/proposers by this section.
How long at this location:
rg
Print ame
Pc-eS,,
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
Personally known to me; or
Subscribed a Sworn.before me that this is a true statement this
day of .Q 200. ] Produced identification:
OI-�3- 011
„sno„ ANNIABA8S
Y oU���i
Wiry Public - stMit of Ftorla.
maroon
A
4
a ,n of
Printed name of yourNotary Public P P professional and
Please submit with Res Dose copies of Occupational l License,
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.
. My Comet Expire Jul 23, 2011
/tea bass '� " I commiuion a DD 3324$1
+I �` �� g� rt �'e wad Through NMioiWl
ty fL Public, S of Florida
„�" My Commission expires
ry �
28
City of Miami, Florida
Commercial Waste Hauling
Services RFQ 03-04-107
6.4. Debarment and Suspension
CITY OF MIAMI CODE SEC. 18-56.4
(a) Authori and re uirement to debar and sus end:
After reasonable notice to an actual or prospective contractual party, and after reasonable opportunity to such
cer and the City
party toa be heard, City
Manager,
debarafter
a contractual party for theChief
cau es listed below from consideration
Attorney, shall have the authority to years. The City
r ward ofa city contracts. avthe authority to suspend barment lbe a contras orr a riod of not fewer than threefrom consideration for award of city contracts if
Manager shall also
there is probable cause for debarment. Pending the debarment determination, the authority to debar and
suspend contractors shall be exercised th accManager the City Attorney,which
and the City Commissiony .
(b) Chief
Procurement Officer after approve by City
(b) Causes for debarment or sus ension include the followin
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;
to be
4. Violation of contract provisions, which is e include faluregarded bye without e Chief Pgoodremeeause O pterform in accordance
cative of
nonresponsibility. Such violation may
h the termshatand conditionsperform caused ract or to perform within the time by acts beyond the control of a limits provided
not betconsidered ta
provided that failurep
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) Certifi ^cation:
hall
All contracts for goods and its s
ervices,
erslorses by the City pe personnel have sbeen convicted of any of the violations set
ontain a certification that neither the
contractual party nor any of its prtnc p
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:
Signature:
Date:
oar6S-,20o7
FAILURE TO COMPLETE SIGN AND RETURN THIS FORM MAY DIS UALIFY YOUR RESPONSE
29
City of Miami, Florida
6.5. STATEMENT OF COMPLIANCE WITH ORDINANCE NO. 10032
Proposer certifies ifies that (s)he has read and understood the provisions of City of Miami Ordinance No. 10032 (Section
18-105 of the City Code) pertainingthe implementation of a "First Source Hiring Agreement."
to p
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
Commercial Waste Hauling Services
RFQ 03-04-107
No
B. in the event your answer to Question "A" is yes, how many new positions would you create to 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.
(Use additional sheets if necessary)
PROPOSER NAME:
SIGNATURE/TITLE:
FAILURE TO COMPLETE SIGN AND RETURN THIS FORM MAY DIS UALIFY PROPOSAL.
DATE: 0 - 0 S -- 00 7
30