HomeMy WebLinkAboutExhibit913.5 List all organizations which were predecessors to Bidder or in which the
principals or officers of the BiElder were princip is or officers.
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13.6. List and describe all bankruptcy petitions (voluntary or involuntary) which have
been filed by or against the Bidder, its parent or subsidiaries or predecessor
organizations during the past five (5) years. Include in the description the
disposition of each such petition.
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13.7. List and describe all successful Performance or Payment Bond claims made to
your surety(ies) during the last five (5) years. The list and descriptions should
include claims against the bond of the Bidder and its predecessor
orga n ization(s).
13.8 List all claims, arbitrations, mediations, civil actions, administrative hearings
and lawsuits brought by or against the Bidder or its predecessor organization(s)
during the last five (5) years. The list shall include all case names; case,
arbitration or hearing identification numbers; the name of the project over which
the dispute arose; a description of the subject matter of the dispute; and the
final outcome of the claim.
13.9. List and describe all criminal proceedings or hearings concerning business
related offenses in which the Bidder, its principals or officers or predecessor
organization(s) were defendants.
Flagami West End Phase II and Fairlawn Phase IIB Sewer Improvements Bid No.: 06-07-012
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13.10. Has the Bidder, its principals, officers or predecessor organization(s) been
debarred or suspended from bidding by any government during the last five (5)
years? If yes, provide details.
13.11. Under what conditions does the Bidder request Change Orders?
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13.12. What is the nature and amount of the three largest change orders submitted by
the bidder within the past five years, and their disposition?
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Flagami/West End Phase II and Fairlawn Phase IIB Sewer Improvements Bid No.: 06-07-012
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3) Company Name
Address
00502. 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 6 o141 al -ea in
5(001 _si- t dioLcothift, 327013
Address
Contact Person/Contract Amount -Nett f( rl 7 . - * 218 L40J09 I $ 5
Telephone No. /Fax Not'30S1 o�'rl — -(o (..53 (---ri-K)CC 30S) (!1
2) Company Name
Address
r; LI DC. rJo1m orr l OracLi
rl 050 NE f °I4'-' Ave IQ. r) -0 fit.
Contact Person/Contract Amount ¶+ ee 1- n h -- 1; 1D2-l) 12(o 0
Telephone No. /Fax No.C20519`4a-942C( 43° i or Si— 3Sta.
" c
c q1 JE2(dM. riz Marri` Ies;l 1.
Contact Person/Contract Amount5}rd(; (nCo, Y9-I a 27 g
Telephone No. /Fax No DS) )OC (-61N6)Jij en -6l 2 !
4) Company Name C' Li (- I L)
Address L4( ( au.' LM /T` 1. m iclrni; 7)SD
Contact Person/Contract Amount (g-of-i --"I'V‘72) 0S,9.
Telephone No. /Fax No() 41(p )'1Np C-f 643 051 N J (p' 2IS
Flagami/Wes1 End Phase II and Fairlawn Phase IIB Sewer Improvements Bid No.: 06-07-012
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00502. SUPPLEMENT TO BID FORM:
CUSTOMER REFERENCE LISTING (Page 2 of 2)
5) Company Name
Address
cA.0
11401 SU-) Q(4` $ Lf 2 1 i)G/Yll Jl'C ) (06-
Contact Person/Contract Amount 77II..G'9V 0(5dc1;:r) d gjOAC30 (0 •
Telephone No. /Fax No. c3)651— -U.L O (fr'>f30S) 1 —SCni
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.
Flagami/West End Phase 11 and Fairlawn Phase 116 Sewer Improvements Bid No.: 06-07-012
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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.
City:
Legal Name of Firm:1Entity Type: (Check One) ❑ Partnership ❑ Sole Proprietorship ❑ Corporation
Corporation Document No:
Date Established
Occupational License No:
Date of Issuance
Office ocatio.r (Esfabiislim nt of th'e bidder/Btd+?ler .
PRESENT
Street Ac9 WCS+"
W-d AP t cdrah "z 2)2W
State: How long at tAis location:
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/Bidders 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/Bidders by this section.
Flagami/West End Phase II and Fairlawn Phase IIB Sewer Improvements Bid No.: 06-07-012
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00510. SLIPPLEII f 1' TO BID FORM:
OFFICE OC TION AFFIDAVIT (Page 2 of 2)
i-ize Signatur
,Nc 2
Print Name
V i Ce 17,2(S! clui 4—
:...:.......:.i- .3e .,!. Title
ized Signature
OS Sia/14
Print N me
Title
Authorized Signature Authorized Signature
(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.)
NOTARIZATION
STATE OF FLORIDA, COUNTY OF DADE
That: v OJe- M • .5G}A) e personally appeared
before me and acknowledged the foregoing instrument as his/her act and deed.
That he/she has produced --- ljf /.01�-1
NOTARY PUBLIC: .-
as identification,
;... j;n ° 0D450254
My Commission Expires: `:' _ ' 14. 2009 5
Co.
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.
Flagami/West End Phase II and Fairlawn Phase IIB Sewer Improvements Bid No.: 06-07-012
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