HomeMy WebLinkAboutSupplemental to Bid Form00500. SUPPLEMENT TO BID FORM:
QUESTIONNAIRE
THIS COMPLETED FORM SHOULD BE SUBMITTED WITH THE BID, HOWEVER,
SUBMISSION OF THE FORM OR ANY ADDITIONAL INFORMATION NOT INCLUDED IN
THE SUBMITTED FORM AS DETERMINED IN THE SOLE DISCRETION OF THE CITY,
MAY BE SUBMITTED WITHIN SEVEN (7) CALENDAR DAYS OF THE CITY'S REQUEST.
FAILURE TO SUBMIT THE FORM OR ADDITIONAL INFORMATION UPON REQUEST BY
THE CITY SHALL RESULT IN THE REJECTION OF THE BID AS NON -RESPONSIVE.
The undersigned authorized representative of the Bidder certifies the truth and accuracy of all statements
and the answers contained herein.
1. How many years has your organization been in business while possessing one of the licenses,
certifications, or registrations?
License/Certification/Registration Name and Number
Electrical contractor Michael. A. McClaskey EC13004619
# Years
1
1A. What business are you in? Pump and Motor, Service, repair and Rewinding
2_ What is the last project of this nature that you have completed?
N/A
Have you ever failed to complete any work awarded to you? If so, where and why?
-N/A_.
Give owner names, addresses and telephone numbers, and Surety and project names, for all
projects for: which you :.have -.performed work, where your Surety has intervened to :assist in
completion of theprojeci, whetheror-nota claim wasmade. .
-N/A __—_"_
Give names, addresses and telephone numbers of three individuals, corporations, agencies, or.
institutions for which you have performed work:
Atlas Paper Mills Hialeah, FL
(name) (address)
Miami Dade Water & Sewer Miami, FL
305-835-8046
(phone #)
305-827-9703
(name)
Johnson Controls/York
(address)
Mimai, FL
(phone #)
954-444-3705
(name)
(address)
(phone #)
Bid No. 11-12-018
Page 47
6. List the following information conceming all contracts in progress as of the date of submission of
this bid. On case of to -venture, list the information for all co -venturers.)
TOTAL DATE OF % OF
NAME OF OWNER & CONTRACT COMPLETION COMPLETION
PROJECT PHONE # VALUE PER CONTRACT TO DATE
Motor & Pump Miami -Dade Co.
Repairs 786-552:8196 $1,000,000.00 2017 50%
Motor & Pump City of Miami Beach
Repairs 305-416-1600 Open $
2013
(Continue list on insert sheet, if necessary.)
Has a representative of the Bidder completely inspected the proposed project and does the Bidder
have a complete plan for its performance?
No
Will you subcontract any part of this Work? If so, provide the following details for each
subcontractor(s) that will perform work in excess of ten percent (10%) of the contract amount.
(Attach additional sheets if necessary)
Subcontractor Approx. M/WBE Description of Work
Name Percentage Status
Triangle -Fire __ ..:i.0 a
inspection of CO2 Systems
The foregoing -list of Subcontractors) may not be amended after award of the Contract without '.
the prior written approval of the Contract Administrator, whose approval shall not be
unreasonably withheld_
What equipment do you own that is available for the Work?
We -have a facility fully equipped to handle any
repair, test, project, and the personnel needed.
We have a,complete machine shop, lathes vibration
analysis equipment, thermography equipment, VPI tank.
youpurchaseproposed ' What�equipment will for the Work?
None
Bid No. 11-12-018 Page 48
11. What equipment will you rent for the proposed Work?
Miami transfer for crane services as needed.
12. State the name of your proposed project manager and superintendent and give details of his or
her qualifications and experience in managing similar work.
Luis Valdes, mechanical engineer with 15 years
of field service experience.
1.3. State the true, exact, correct and complete name of the partnership, corporation or trade name
under which you do business and the address of the place of business. (If a corporation, state
the name of the president and secretary. If a partnership, state the names of all partners. If a
trade name, state the names of the individuals who do business under the trade name).
13.1 The correct name of the Bidder is TAW Miami Service Center, Inc.
13.2 The business is a (Soic Proprictorship) (Partnership) (Corporation)_
CoL poration
13.3. The address of principal place of business is
9930 N W. 19th Avenue, -Miami, FL 33178
13.4 The names of the corporate officers, or partners, or individuals doing business under a
trade name, are as follows:
N/A
Bid No. 11-12-018 Page 49
13.5 List all organizations which were predecessors to Bidder or in which the principals or
officers of the Bidder were principals or officers.
N/A
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. -
N/A
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 organization(s).
N/A
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
dex-i 1ption of the subject matter of the dispute; and the final outcome of the claim.
N/A
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.
N/A
Bid No. 11-12-018
Page 50
13.10. Has the Bidder, its principals, officers or predecessor organizations) been debarred or
suspended from bidding by any government during the last five (5) years? If yes,
provide details.
N/A
13.11. Under what conditions does the Bidder request Change Orders?
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?
N/A
Bid No. 11-12-018 Page 5I
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 three (3) year period.
1)
Company Name Atlans Paper Mills
Address
3725 E.,10th St., Hialeah, FL
Contact Person/Contract Amount Jose a . Avilan
Telephone No. /Fax No. 3 0 5- 8 3 5- 8 04 6
-Company Name
Address
Johnson - Controls/York
15901 S.W. 29th St., Miramar, FL
Contact Person/Contract Amount Alto Furionq, III
Telephone No. /Fax No. 954 -444 - 3 705
Company Name
Address
Miami -Dade Water & Sewer
4801 S.W. 117th Avenue, Miami, FL
Contact Person/Contract Amount Susan Turner
Telephone No. /Fax No. 7 8 6- 2 6 8- 5 5 3 5
Company Name
Address
City of Homestead.
790 N. Homestead Blvd., Homestead, FL
Contact Person/Contract Amount Malia Rivera
Telephone No. /Fax No. 305 -224 -462 0
Bid No. 11-12-018 Page 52
00502. SUPPLEMENT TO NO row -
CUSTOMER REFERENCE LISTING (Page 2 of 2)
5) Company Name City of Miramar
Address 13900 Pembroke Rd. Miramar, FL
Contact Person/Contract Amount Robert L . Jackson
Telephone No. /Fax No. 954 -704 -1721
Company Name Williams Island
e 7000" Island �BIv-d , �Eventura, PL
ss Addrdress
Contact Person/Contract Amount "Henry Naranl o
Telephone No. /FaxNo. -305=931�3975
Company Name Miami -Dade Aviation :Dept ."
Address 4331 N.W. 22nd St. , Bldg. 3040
Miami, FL
Contact PersonlContract Amount Glen Pl a
Telephone No. No. 305-876-0566
Company Name
Address
Florida 'International 'University
11200 S.W. 8th St. , Miami, FL
Contact-Person/Contract Amount -Walter Conklin
Telephone No. !Fax No. - .-305-3.48-7499
Bid No. 11-12-018
Page 53