HomeMy WebLinkAboutExhibit 3(Page 1of 8)
Section 4 - BID FORM
Submitted:
City of Miami, Florida
Office of the City Clerk
City Hall, 1st Floor
3500 Pan American Drive
Miami, Florida 33133-5504
Date
The undersigned, as Bidder, hereby declares that the only persons interested in this Bid
as principal are named herein and that no person other than herein mentioned has any
interest in this bid or in the Contract to be entered into; that this Bid is made without
connection with any other person, firm, or parties making a Bid; and that it is, in all
respects, made fairly and in good faith without collusion or fraud.
The Bidder further declares that it has examined the site of the Work and informed itself
fully of all conditions pertaining to the place where the Work is to be done; that it has
examined the Contract Documents and all addenda thereto furnished before the opening
of the bids, as acknowledged below; and that it has satisfied itself about the Work to be
performed; and that it has submitted the required Bid Guaranty; and all other required
information with the Bid; and that this Bid is submitted voluntarily and willingly.
The Bidder agrees, if this Bid is accepted, to contract with the City, a political subdivision
of the State of Florida, pursuant to the terms and conditions of the Contract Documents
and to furnish all necessary materials, equipment, machinery, tools, apparatus, means of
transportation, and all labor necessary to construct and complete within the time limits
specified the Work covered by the Contract Documents for the Project entitled:
Bid No: 07-08-018
Title: City Hall Emergency Structural Repairs, B- 30121
The Bidder also agrees to furnish the required Performance Bond and Payment Bond or
alternative form of security, if permitted by the City, each for not Tess than the total Bid
price plus alternates, if any, and to furnish the required Certificate(s) of Insurance.
The undersigned further agrees that the Bid guaranty accompanying the Bid shall be
forfeited if Bidder fails to execute said Contract, or fails to furnish the required
Performance Bond and Payment Bond or fails to furnish the required Certificate(s) of
Insurance within fifteen (15) calendar days after being notified of the award of the
Contract.
In the event of arithmetical errors, the Bidder agrees that these errors are errors which
may be corrected by the City. In the event of a discrepancy between the price Bid in
figures and the price Bid in words, the price in words shall govern. Bidder agrees that
any unit price listed in the Bid is to be multiplied by the stated quantity requirements in
order to arrive at the total.
BID FORM: (Page 2 of 8)
Note: Bidders must bid on all line items. Bidders are bidding on a lump sum
basis for the purpose of determining the lowest responsive and responsible
Bidder. Hourly rates will not be included in determining the lowest responsive
and responsible bidder
Our LUMP SUM BID, includes the total cost for the Work specified in this solicitation,
consisting of furnishing all materials, labor, equipment, supervision, mobilization,
overhead & profit required, in accordance with the Bid Specifications.
Item # Description Price
1. Column Repairs $
2. Load Bearing Walls & Foundation $
3. Slab on Grade $
4. Spalling Repairs $
Lump Sum for all Items: $
Lump Sum Written Amount
Hourly Rates (Rates are to be include overhead and profit)
Classification Hourly Rate
Electrician $
Apprentice Electrician $
Plumber $
Apprentice Plumber $
Carpenter $
Apprentice Carpenter $
Laborer $
The total value of the contract is for an amount not to exceed $418,000, which includes the base
bid of $298,000 plus $120,000 for time and material work and additional work. The $120,000 for
the additional time and material work will be used at the sole discretion of the City.
Consultant's Initials City's Initials
BID FORM: (Page 3 of 8)
DIRECTIONS: COMPLETE PART I OR PART II, WHICHEVER APPLIES, AND PARTS
III AND IV.
Part 1: Listed below are the dates of issue for each Addendum received in connection
with this Bid:
Addendum No. 1, Dated
Addendum No. 2, Dated
Addendum No. 3, Dated
Addendum No. 4, Dated
Part 11: No addendum was received in connection with this Bid.
Part III; Certifications
The Bidder, by virtue of signing the Bid Form, affirms that the Bidder is aware of the following,
and shall comply with all the stated requirements.
1. Affirmative Action Plan
Successful bidder(s) shall establish an Affirmative Action Plan or an Affirmative Action Policy
pursuant to Ordinance #10062 as amended. Effective date of implementation must be
indicated on the policy: and
2. First Source Hiring
Bidder certifies that it has read and understood the provisions of City of Miami Ordinance
Section 18-110, pertaining to the implementation of a "First Source Hiring Agreement".
Evaluation of bidder's responsiveness to Ordinance Section 18-110 may be a consideration
in the award of a contract.
3. Non -Collusion
Bidder certifies that the only persons interested in this Bid are named herein; that no other
person has any interest in this Bid or in the Contract to which this Bid pertains; that this Bid
is made without connection or arrangement with any other person; and
4. Drug Free Workplace
The undersigned Bidder hereby certifies that it will provide a drug -free workplace program
by:
(1) Publishing a statement notifying its employees that the unlawful manufacture,
distribution, dispensing, possession, or use of a controlledsubstanceis prohibited in the
Bidder's workplace, and specifying the actions that will be taken against employees for
violations of such prohibition;
(2) Establishing a continuing drug -free awareness program to inform its employees
about:
(i) The dangers of drug abuse in the workplace;
BID FORM: (Page 4 of 8
(ii)The Bidder's policy of maintaining a drug -free workplace;
(iii )Any available drug counseling, rehabilitation, and employee assistance programs;
and
(iv) The penalties that may be imposed upon employees for drug abuse violations
occurring in the workplace;
(3) Giving all employees engaged in performance of the Contract a copy of the statement
required by subparagraph (1);
(4) Notifying all employees, in writing, of the statement required by subparagraph (1), that
as a condition of employment on a covered Contract, the employee shall:
(i) Abide by the terms of the statement; and
(ii) Notify the employer in writing of the employee's conviction under a criminal drug
statute for a violation occurring in the workplace no later than five (5) calendar days after
such conviction;
(5) Notifying the City in writing within ten (10) calendar days after receiving notice under
subdivision (4) (ii) above, from an employee or otherwise receiving actual notice of such
conviction. The notice shall include the position title of the employee;
(6) Within thirty (30) calendar days after receiving notice under subparagraph (4) of a
conviction, taking one of the following actions with respect to an employee who is convicted
of a drug abuse violation occurring in the workplace:
(i) Taking appropriate personnel action against such employee, up to and including
termination; or
(ii) Requiring such employee to participate satisfactorily in a drug abuse assistance or
rehabilitation program approved for such purposes by a federal, state, or local health,
law enforcement, or other appropriate agency; and
(7) Making a good faith effort to maintain a drug -free workplace program through
implementation of subparagraphs(1) through (6); and
5. Lobbying
The undersigned certifies to the best of his or her knowledge and belief, that:
(1) No Federal appropriated funds have been paid, or will be paid, by or on behalf of the
undersigned, to any person for influencing or attempting to influence an officer or employee
of any agency, a Member of Congress, an officer or employee of Congress, or an employee
of a Member of Congress in connection with the awarding of any Federal contract, the
making of any Federal grant, the making of any Federal loan, the entering into of any
cooperative agreement, and the extension, continuation, renewal, amendment, or
modification of any Federal contract, grant, loan, or cooperative agreement.
(2)If any funds other than Federal appropriated funds have been paid to any person for
influencing or attempting to influence an officer or employee of any agency, a Member of
Congress, an officer or employee of Congress, or an employee of a Member of Congress in
connection with this Federal contract, grant, loan, or cooperative agreement, the
undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report
Lobbying," in accordance with its instructions.
BID FORM: (Page 5 of 8)
(3)This undersigned shall require that the language of this certification be included in the
award documents for "All" sub -awards at all tiers (including subcontracts, sub -grants, and
contracts under grants, loans, and cooperative agreements) and that all sub -recipients shall
certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when
this transaction was made or entered into. Submission of this certification is a pre -requisite
for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code.
Any person who fails to file the required certification shall be subject to a civil penalty of not
less than $10,000 and not more than $100,000 for each such failure; and
* Note: In these instances, "All" in the Final Rule is expected to be clarified to show that it
applies to covered contract/grant transactions over $100,000 (per QMB).
6. Debarment, Suspension and Other Responsibility Matters
The Bidder certifies to the best of its knowledge and belief, that it and its principals:
a. Are not presently debarred, suspended, proposed for debarment, and declared ineligible
or voluntarily excluded from covered transactions by any Federal department or agency.
b. Have not within a three-year period preceding this proposal been convicted of or had a
civil judgment rendered against them for commission of fraud or a criminal offense in
connection with obtaining, attempting to obtain, or performing a public (Federal, State, or
local) transaction or contract under a public transaction; violation of Federal or State
antitrust statutes or falsification or destruction of records, making false statements, or
receiving stolen property;
c. Are not presently indicted for or otherwise criminally or civilly charged by a government
entity (Federal, State, or local) with commission of any of the offenses enumerated in
paragraph 1.b of this certification; and
d. Have not within a three-year period preceding this application/proposal had one or more
public transactions (Federal, State, or local) termincit&i for cause -or default.
Where the prospective Bidder is unable to certify to any of the statements in this certification,
such Bidder shall submit an explanation to the City of Miami.
Part IV; Certification — Trench Safety Act
The Bidder, by virtue of signing the Bid Form, affirms that the Bidder is aware of the Trench
Safety Act, and will comply with all applicable trench safety standards. Such assurance shall be
legally binding on all persons employed by the Bidder and subcontractors.
The Bidder is also obligated to identify the anticipated method and cost of compliance with the
applicable trench safety standards.
Bidder acknowledges that included in the various items of the proposal and in the total Bid price
are costs for complying with the Florida Trench Safety Act. These items are a breakout of the
respective items involving trenching and will not be paid separately. They are not to be
confused with bid items in the schedule of prices, nor be considered additional Work.
BID FORM: (Page 6 of 8)
The Bidder further identifies the costs and methods summarized below:
Quantity Unit
Description Unit Price Price Extended . Method
Total $
Attached is a Bid Bond [ ], Cash [ ], Money Order [ ], Unconditional/Irrevocable Letter of
Credit [ ], Treasurer's Check [ ], Bank Draft [ ], Cashier's Check [ ], Bid Bond Voucher [ ] or
Certified Check [ ] No. Bank of
for the sum of
Dollars ($ ).
The Bidder shall acknowledge this Bid and certifies to the above stated in Part III and IV by
signing and completing the spaces provided below.
Firm's Name:
Signature:
Printed Name/Title:
City/State/Zip:
Telephone No.:
Facsimile No.: E-Mail Address:
Social Security
No. or Federal Dun and
I.D.No.: Bradstreet No.:
(if applicable)
If a partnership, names and addresses of partners:
BID FORM: (Page 7 of 8)
CERTIFICATE OF AUTHORITY
(IF CORPORATION)
I HEREBY CERTIFY that at a meeting of the Board of Directors of
, a corporation organized and existing under the laws
of the State of , held on the day of , a resolution was duly
passed and adopted authorizing (Name) as
(Title) of the corporation to execute bids on behalf of the corporation and
providing that his/her execution thereof, attested by the secretary of the corporation, shall be the official
act and deed of the corporation. I further certify that said resolution remains in full force and effect.
IN WITNESS WHEREOF, I have hereunto set my hand this , day of 20
Secretary:
Print:
CERTIFICATE OF AUTHORITY
(IF PARTNERSHIP)
I HEREBY CERTIFY that at a meeting of the Board of Directors of
a partnership organized and existing under the laws
of the State of , held on the day of , a resolution was duly passed
and adopted authorizing (Name) as (Title) of the to
execute bids on behalf of the partnership and provides that his/her execution thereof, attested by a
partnershall-be-the official act and deed of the partnership.
I further certify that said partnership agreement remains in full force and effect.
IN WITNESS WHEREOF, I have hereunto set my hand this , day of , 20
Partner:
Print:
CERTIFICATE OF AUTHORITY
IF JOINT VENTURE)—.
Joint ventures must submit a joint venture agreement indicating that the person signing this Bid is
authorized to sign bid documents on behalt of the joint venture. it there is no joint venture agreement
each member of the joint venture must sign the Bid and submit the appropriate Certificate of Authority
(corporate, partnership, or individual).
CERTIFICATE OF AUTHORITY
(IF INDIVIDUAL)
I HEREBY CERTIFY that, I (Name) , individually and doing business
as (d/b/a) (If Applicable) have executed and am bound
by the terms of the Bid to which this attestation is attached.
IN WITNESS WHEREOF, I have hereunto set my hand this , day of , 20
Signed:
Print:
BID FORM: (Page 8 of 8)
NOTARIZATION
STATE OF )
SS:
COUNTY OF )
The foregoing instrument was acknowledged before me this day of
20 , by , who is personally known to me or who has
produced as identification and who (did / did not) take an oath.
SIGNATURE OF NOTARY PUBLIC
STATE OF FLORIDA
PRINTED, STAMPED OR TYPED
--NAME-OF-NOTARY-NOTARY