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HomeMy WebLinkAboutCertificationCertification Statement Please quote on this form, if applicable, 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 submission. Prices should be firm for a minimum of 120 days following the time set for closing of the submissions. 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 solicitation, 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 submission have been documented in the section below (refer to paragraph and section). EXCEPTIONS Please see attached Exceptions page. We (I) certify that any and all information contained in this submission is true; and we (I) further certify that this submission is made without prior understanding, agreement, or connection with any corporation, fum, or person submitting a submission 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 solicitation and certify that I am authorized to sign this submission for the submitter. Please print the following and sign your name: SUPPLIER NAME• Microwave Networks Incorporated ADDRESS• 4000 Greenbriar, Stafford, TX 77477 PHONE• 281-263-6500 FAX- 281-263-6406 EMAIL: billk@microwave etwor ., ;EEPER- SIGNED BY• TITLE: Chief Financial Office DATE: May 2, 2008 FAILURE TO COMPLETE. SIGN. AND RETURN THIS FORM SHALL DISOUALIFY THIS BID. Pane 2 of 35 Certifications Legal Name of Firm: Microwave Networks Incorporated Entity Type: Partnership, Sole Proprietorship, Corporation, etc. Corporation Year Established: 1998 Office Location: City of Miami, Miami -Dade County, or Other Stafford, TX Occupational License Number: Not Applicable Occupational License Issuing Agency: Occupational License Expiration Date: Respondent 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.": (Yes or No) Ye s Do you expect to create new positions in your company in the event your company was awarded a Contract by the City? (Yes or No) No In the event your answer to question above is yes, how many new positions would you create to perform this work? Please list 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. Minority/Women Business Affairs Registration Status: Hispanic, Female, Black or None, Page 3 of 35 Nrile Will Subcontractor(s) be used? (Yes or No) Ye s If utilizing sub -contractors, please indicate name and the scope of their work under this contract. Radian Communications Services Corp — All Services Does the City of Miami Living Wage Ordinance apply to this formal solicitation? ( See Section 1.40 of the General Terms and Condtions) (Yes or No) No Service Total Contract Amount( which includes base term and renewal options): Not Applicable Is this service contract a citywide contract? (Yes or No) Not Applicable If the above answer is no, please indicate the name of the city (end user) department that your contract will' serve: Not Applicable Provide brief description of the project or service to be provided City of Miami Microwave Infrastructure Adjustment I/We hereby state compliance with the City of Miami Living Wage Ordinance, Section 18-556 through Section 18-559 as summarized in Section 1.40 of the General Terms and Condtions? (Yes or No) Ye s Reference #1 - Municipality name, contact person, and phone number: Please see attached MNI Reference page. Reference #1 - Scope of work for reference #1 above: Reference #2 - Municipality nacre, contact person, and phone number: Reference #2 - Scope of work for reference #2 above: Page 4 of 35 Reference #3 - Municipality name, contact person, and phone number: Reference #3 - Scope of work for reference #3 above: Reference #4 - Municipality name, contact person, and phone number: Reference #4 - Scope of work for reference #4 above: Reference #5 - Municipality name, contact person, and phone number: Reference #5 - Scope of work for reference #5 above: Number of calendar days required to commence work, after receipt of Purchase Order: 30 Number of calendar days required for completion of work after commencement: 15 Have you attached copies of the required license(s) to perform under this contract? No Page 5 of 35 Line: 1 Description: Implementation and Execution of planned microwave system infrastructure adjustments, as per Bid Specifications. Category: 90728-00 Unit of Measure: Dollar Unit Price: $ 80 , 939 Number of Units: 1 Total: $ 80, q 3q Page 6 of 35