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Bid Response - Sudden Service, LLC
Quote: 2216352 (RFQ 616407,2) Page 1 of 12 Sourcing It Navigator Favorites Requisition s i Negotiations " Intelligences{ Negotiations > Simple Search > RFQ: 616407,2 > Quote: 2216352 (RFQ 616407,2) Title Time Left Quote Style Quote Currency Contact Suppliers' Quote Number Quote Status Note to Buyer Attachments Requirements Invitation For Bid for Forklift & Other Hydraulic Lifts Maintenance & Repairs 0 seconds Sealed USD Paradela, Alberto 25690 Active We are an authorized Taylor and Wiggins dealer, our techs have many years of experience with forklifts and other hydraulic lifts. ,Title City of Miami Local ;Office Certification (Occupational License 1W9 Type File Horne Logout Preferences Help Award by Quote (RFQ 616407,2) > Actions Online Discussions Close Date Ranking Supplier Supplier Site Quote Valid Until Purchase Order Shortlist Status Description Category From Supplier File From Supplier File Invitation For Bid ;File Show All Details I Hide All Details Details Section Hide General Re uirements Requirement 26-3ul-2016 14:00:00 Price Only Sudden Service, Inc 31-Dec-2016 Included Last Updated Usage UpdateiDelete 26-Jul- One- 2016 Time 26-Jul- One- 2016 Time From 26-Jul- One - Supplier 2016 Time From 26 Jul- One - Supplier 12016 Time From 126 Jul- One - Supplier 2016 xx Time Maximum Score Target Value 0; uote Value Score 0 Maximum; Score`Score http://iinap 1.riverside.ctngov.net:8003/OA HTML/OA.j sp?OAFunc=PONRESENQ_VIE... 7/26/2016 vote: 2216352 (RFQ 616407,2) Page 2 of 12 !Legal Name of Firm: Sudden Service, Inc. !Entity Type: Partnership, Sole Proprietorship, Corporation, !Corporation Year Established:;1,927 Office Location: City of Miami, Miami Dade County, or Other I Miami Dade Count !Business Tax Receipt / Occupational License Number: 2014010054 Business Tax Receipt / Occupational License Issuing !Agency Business Tax Receipt / Occupational License Expiration Date: Will Subcontractor(s) be used? (Yes or No If subcontractor(s) will be utilized, provide their name, address and the the portion of the work they will be !responsible for under this contract (a copy of their license(s)f ,must be submitted with your bid response): !Please list and acknowledge all addendum/addenda !Addendum No. received. List the addendum/addenda number and date of 11, 7/8/16; !receipt (i.e. Addendum No. 1, 7/1/07). If no !Addendum No. ;addendum/addenda was/were issued, please insert N/A. 2, 7/19/16 Yes !If Bidder has a Local Office, as defined under Chapter `18/Articlle III, Section 18-73 of the City Code, has Bidder filled out, notarized, and included with its bid response the "City of Miami Local Office Certification" form? YES OR NO? (The City of Miami Local Office Certification form is located lin the Oracle Sourcing system ("iSupplier"), under the Header/Notes and Attachments Section of this solicitation !Reference No. 1: Name of Company/Agency for which !bidder is currently providing the services/goods as described fin this solicitation, or has provided such services/goods in !the past: Reference No. 1: Address, City, State, and Zip for above reference company/agency listed: ;Reference No. 1: Name of Contact Person and Telephone !Number for above reference no. 1 !Reference No. 1: Date of Contract or Sale for above reference no. 1 Reference No. 2: Name of Company/Agency for which bidder is currently providing the services/goods as described in this solicitation, or has provided such services/goods in ;the past: !Reference No. 2: Address, City, State, and Zip for above reference company/agency listed: Reference No. 2: Name of Contact Person and Telephone !Number for above reference no. 2 Reference No. 2: Date of Contract or Sale for above !reference no. 2 Reference No. 3 Name of Company/Agency for which !Miami -Dade !County 25-Nov-2023 N/A ITNT Marine Center 11940 NW 135 'St. North Miami, FL 33181 !Ron Goldberg, ;John Carrington f(305) 944-2118 12010 (Eller hT.O. lSteverdoring Co. 1007 North American Way Miami, FL 33132 !Domingo Diaz 1(305) 910 7842 2010 South Florida http://imapl.riverside.cmgov.net:8003/OA HTML/OA.jsp?OAFune=PONRESENQ_VIE... 7/26/2016 Quote: 2216352 (RFQ 616407,2) Page 3 of 12 !bidder is currently providing the services/goods as described! 'in this solicitation, or has provided such services/goods in ithe past: Reference No. 3: Address, City, State, and Zip for above reference company/agency listed: Reference No. 3: Name of Contact Person and Telephone Number for above reference no. 3 'Reference No. 3: Date of Contract or Sale for above [reference no. 3 Total! Contract Terms Variables DetailsSection No variables found Deliverables Indicates deliverable is overdue deliverable Deliverable Name No deliverables found. Lines !Clause 1Due Date Variable 'Container Terminal 2299 Port Blvd. !Miami FL 33132 ;Frank Fernandez 1(305) 347- 38161 2010 Description Value X Indicates responsible party failed to perform the c'erTIP All prices are in USD. Quote Total (USD) 4,060.55 how All Details Hide All Details Details !Line 0 Hide 1 Group 1: Hourly Labor Rate Weekdays (Monday -Friday, 7AM - 6PM) for Wiggins, Model # W220m2-130, Marine Forklift, (Repairs , r 'Start Target Quote! RankPrice Price; PricelUnit 1 70 Hour I Status Alert Previous Target Quote Minimum! Minimum Estimated Release! Release; LineActive Quantity! Amount Amount! Total Quotes 1 1 70.00 70.0012 Update http://imap 1.riverside. cmgov.net:8003/OA_HTML/OA.j sp?OAFunc—PONRESENQ_VIE... 7/26/2016 Quote: 2216352 (RFQ 616407,2) Page 4 of 12 Note to Buyer We are a Wiggins Authorized Dealer [Attachments liTitle Type Description 1Category Last Updated Usage UpdateDeiefl te INo results found. [3: Hide Notes 100.00 100.0012 Hourly Labor Rate Evenings (Monday -Friday, 7PM - 6AM), Weekends and Holidays for !Wiggins, Model 1# W220m2-130, Marine Forklift, [Repairs 2 Group 1: 1 100'Hourg 1, Note to Buyer We are a Wiggins Authorized Dealer [-Attachments !Type fiescription 1Categog Last Updated "Usage "„ Update Delete, Noresults found. Hide t3Group 1: Monthly Maintenance / Yearly Inspection for Wiggins Marine Forklift, per Specifications, iSection 3.0 Notes 600 !Each Note to Buyer We are a Wiggins Authorized Dealer Attachments 600.00 600.0012 [Type Description 'Category ILast Updated » lUsage I Update i Delete 11No results found. 1 1 http://imapl.riverside.cmgov.net:8003/0A_HTML/OA.jsp?0AFunc=PONRESENQ_VIE... 7/26/2016 Quote: 2216352 (RFQ 616407,2) Page 5 of 12 4Group 1: Percent Discount Off Parts Catalog fort Wiggins Equipment (percent discount expressed as ;decimal, i.e. 10%=.10) Notes Each Note to Buyer We are a Wiggins Authorized Dealer Attachments ;,Title frype ;Description !Category Last Updated No results found. 5 Group 2: Hourly Labor !Rate Weekdays (Monday -Friday, 17AM - 6PM) for IClark, Model # 'GCS15, Type G, Forklift and Clark, Model # C500-580, Type D, Forklift, Repairs Attachments Title _....... Type Description INC results found. 1 Hide 6 Group 2: Hourly Labor Rate Evenings (Monday -Friday, 17PM e. 6AM), Weekends and Holidays for Clark, Model # GCS15, Type G, Forklift and. Clark, Model # Houri [Category 1001Hour Last Updated sage, 0.10 1 0.10 2 Update I Delete II 70.00 70.00 2 Usage i Update Delete 100.00 100.002 http://imap 1.riverside.cmgov.net:8003/OA FITML/OA.j sp?OAFunc=PONRESENQ_VIE... 7/26/2016 Quote: 221.6352 (RFQ 616407,2) Page6of12 1C500-580,Type ID, Forklift, Repairs Attachments Title _Type b. iNo results found I Hide 17 Group 2: 'Monthly 'Maintenance / 'Yearly 'Inspection for 'Clark Forklifts, 'per 'Specifications,. 'Section 3.0 Attachments ¶Title 4No results found 1 Hide !Type 8 Group 2: .._M..... Percent Discount Off Parts Catalog for Clark Equipment (percent discount expressed as decimal, i.e. 10% = .10) Attachments 145Each 145.00l145.00l2 Description !Category [Last Updated Usage 1 Update ; Delete' I;Title .._ !Type .Description INo results found. Hide 9Group 3: Hourly Labor Rate Weekdays (Monday -Friday, 7AM - 6PM) for JLG, Model # 25EL (25AM), Vertical Lift and JLG, Model # 450A, Articulating 0.05Each 1! ! 0.05 0.05 2 Category__ Last Updated :Usage ; Update _Delete f 70iHour 70.00 70.00l2 http://imap 1.riverside.cmgov.net:8003/OA_HTML/OA.j sp?OAFunc=PONRESENQ_VIE... 7/26/2016 Quote: 2216352 (RFQ 616407,2) .„ • , Page 7 of 12 Boom Lift, Repairs Attachments Title Type Description Category Last Updated lUsage I Update]: Delete o results found. Hourly Labor 100.00 100.002 L3 Hide 10 Group 3: 100iHour, Rate Evenings (Monday -Friday, 7PM - 6AM), Weekends and Holidays for JLG, Model # 25EL (25AM) and JLG, Model # 450A, Articulating Boom Lift, Repairs IL Attachments HTitle Type iDescription ;Category ILast Updated 'Usage 1 oNo results found. e Hide I11Group 3: 1 'Monthly !Maintenance / 'Yearly Inspection for JLG Lifts, per Specifications, Updatei Delete 1451Each' 11 1 I 145.00 145.0012 , 1 . , , I Section 3.0 Attachments Title Type IDescription 1Category !Last Updated Usage Update Delete 11No results found. ,'d 13 e 112Group 3: !Percent 1 !Discount Off Parts Catalog for JLG Equipment (percent discount expressed as decimal, i.e. 2 0.051Eachl http ://imapl,riverside .cmgov.net:8003/0A_HTML/0Aj sp?0AFune=PONRESENQ VIE._ 7/26/2016 Quote: 2216352 (RFQ 616407,2) Page 8 of 12 10% = .10) Attachments '[Title No results found. Hide [Type !Description 13 Group 4: Hourly Labor Rate Weekdays (Monday -Friday, 17AM - 6PM) for 'Hoist, Model # M250 Neptune Lift Truck, Repairs Attachments Last Updated [Usage Update 1 Delete 1 ,Title Type 'Description Category [Last Updated =;No results found 1111 Hide 14 Group 4: 1 Hourly Labor Rate Evenings (Monday -Friday, 7PM - 6AM), Weekends and Holidays for Hoist, Model # M250 Neptune Lift Truck, ,Repairs Attachments 70.00 Usage Updal Delete 11 100'Hourl 'Title Type (Description 'Category Last Updated ]Usage 1 Update 1 Delete !No results found Hide 15'Group 4 Monthly Maintenance / Yearly Inspection for Hoist Lifts, per Specifications, Section 3.0 Attachments 600.001600 0 Type Description Category Last Updated ]Usage E Update Delete http://imap 1.riverside.cmgov.net:8003/OA HTIML/OA.j sp?OAFunc=PONRESENQ_VIE... 7/26/2016 Quote: 2216352 (RFQ 616407,2) Page 9 of 12 o results found. 16Group 4: Percent Discount Off Parts Catalog for ;Hoist Equipment (percent discount expressed as decimal, i.e. 10%=.10) Attachments Titie No results found. ml Hid l7Group 5 Hourly Labor Rate Weekdays (Monday -Friday, 7AM - 6PM) for Toyota, Model # 8FDU30, 7FDU35, 7FDAU50, 8FDU20, Forklifts, Repairs, Each; Type iDescription Category !Last Updated !Usage Update Attachments Title Type Description Category Last Updated (Usage ( Update ! Delete o results. found. le Hide 18 Group 5: Hourly Labor Rate Evenings (Monday -Friday, 7PM - 6AM), Weekends and Holidays for Toyota, Model # 8FDU30, 7FDU35, 7FDAU50, 8FDU20, Forklifts, Repairs Attachments 100.00 100.0012 http://imap 1.riverside.cmgov.net:8003/OA_HTML/OA.j sp?OAFunc=PONRESENQ_VIE... 7/26/2016 Quote: 2216352 (RFQ 616407,2) Page 10 of 12 (Type ,Description ;Title No results found. Type Description Category :.,,.. fE Hide 19Group 5: Monthly Maintenance / Yeary Inspection for Toyota Forklifts, per Specifications, Section 3.0 Attachments Title No results found. lJ Hide 120 Group 5: Percent Discount Off Parts Catalog for Toyota Equipment l(percent discount expressed as decimal, i.e. 10% = .10) Last Updated 145 Type description Category Last Updated Attachments Title o results found. Hide 21 Group 6: Hourly Labor Rate Weekdays (Monday -Friday, 7AM - 6PM) for ;Rotary, Model # 1SP015N310, SPOA1ON5GO, SPOA10N500, Automotive Lifts, Repairs Attachments Title (Type Description !Category iLast Updated Usage ' Update ; Delete No results found. 0.05;Each Usage J Update l Delete 145.00145 0012 Usage , Update 0 05 0 05i2 Category Last Updated 'Usage Update 701Houri 1 70.00 Delete http://imapl,riverside.cmgov.net:8003/OA HTML/OA.jsp?OAFunc=PONRESENQ_VIE... 7/26/2016 Quote: 2216352 (RFQ 616407,2) Page 11 of 12 f=i Hide ;22 Group 6. Hourly Labor Rate Evenings (Monday -Friday, I 7PM - 6AM), Weekends and Holidays for Rotary, Model # SP015N310, SPOA1ON5GO, SPOA10N500 Automotive Lifts Repairs Attachments 100°Hour€ ;Title Type 'Description Category 'Last Updated No results found ft Hide 23 Group 6: Monthly Maintenance / Yearly 'Inspection for ;Rotary Automotive Lifts, per Specifications, Section 3.0 Attachments 145Each 100.00 100.0012 Usage Update) Delete 145.00 145.00 2 Title Type Description iCategory jLast Updated Usage Update Delete No results found 1 Hide 24Group 6: Percent Discount Off Parts Catalog for Rotary Equipment (percent discount ,expressed as !decimal, i.e. 10%0 = .10) Attachments !Title `.Noresults found. Type Description TCategory ;Last Updated Usage .. Update Delete http ://imap 1.riverside.cmgov.net:8003/OA_HTML/OA.j sp?OAFunc=PONRESENQ_VIE... 7/26/2016 Quote: 2216352 (RFQ 616407,2) Page 12 of 12 ,e Hide I25Group 7: 701HoUri 1Hourly Labor IRate Weekdays (Monday -Friday, 7AM - 6PM) for Mohawk, Model # System-1A- 110, Automotive 'Lift, Repairs Attachments 1 1 70.00 70.002 Title Type Description 'Category ILast Updated iUsage , Update i Deletel No results found. I I 1 Return to Award by Quote (RFQ 6164072) (S1) Previous 1-25 Next 25 (..1) Actions Online Discussions Go. Requisitions Negotiations Intelligence Home Logout Preferences Help Privacy Statement Copyright (c) 2006, Oracle. All rights reserved. http://imapl.riverside.cmgov.net:8003/0A_HTML/OAjsp?0AFune—PONRESENQ_VIE... 7/26/2016 CITY OF MIAMI LOCAL OFFICE CERTIFICATION (City Code, Chapter 18, Article 111, Section 18-73) Solicitation Type and Number: RFQ. 616407,2 IFQ/IFB/REP/RFQ/RFLI. No. 123456) Sudden Service Inc. Solicitation Title: (Bidder/Proposer) hereby certifies compliance with the Local Office requirements stated under Chapter 18/Article III, Section 18-73, of the Code of the City of Miami, Florida, as amended. Local- office Means a business within the city which meets all of the following criteria: (1) Has had a staffed and fixed office or distribution point, operating within a permanent structure with a verifiable street address that is located within the corporate limits of the city, for a minimum of twelve (12) months immediately preceding the date bids or proposals were received for the purchase or contract at issue; for purposes of this section., "staffed" shall mean verifiable, full.titne, on -site employment at the local office for a minimum of forty (40) hours per calendar week, whether as a duly authorized employee, officer, principal or owner of the local business; a post office box shall not be suffieient to constitute a local office within the city; (2) If the business is located in the permanent structure pursuant to a lease, such lease must be in -writing, for a term of no less that twelve (12) months, been in effect for no less than the twelve (12) months immediately preceding the date bids or proposals were received, and be available for review and approval by the chief procurement officer or its designee; for recently -executed leases that have been in effect for any period less than the twelve (12) months immediately preceding the date bids or proposals were received, a prior fully -executed lease within the corporate limits of the city that docuiments, in writing, continuous business residence within the corporate limits of the city for a term of no less than the twelve (12) months immediately preceding the date bids or proposals were received shall be acceptable to satisfy the requirements of this section, and shall be available for review and approval by the chief procurement officer or its designee; further requiring that historical, cleared rent checks or other rent payment documentation in writing that documents local office tenancy shall be available for review and approval by the chief procurement officer or its designee; (3) Has had, for a minimum of twelve (12) months immediately preceding the date bids or proposals were received for the purchase or contract at issue, a current business tax receipt issued by both the city and Miami - Dade County, if applicable; and (4) Has had, for a minirraun of twelve (12) months immediately preceding the date bids or proposals were received for the purchase or contract at issue, any license or certificate of competency and certificate of use required by either the city or Miami -Dade County that authorizes the performance of said business operations; and (5) Has certified in writing its compliance with the foregoing at the time of submitting its bid or proposal to be eligible for consideration under this section; provided, however, that the burden of proof to provide all supporting documentation in support of this local office certification is borne by the business applicant submitting a bid or proposal, 1, FORM -City of Miami Local Office Certification 7/22/201 PLEASE PROVIDE THE FOLLOWING INFomAnoNI 8351 NW 64th St. Miami, FL 3 166 Bidder/Proposer Local Office Address: Does Bidder/Proposer conduct vetifiable, full- time, on -site employment at the local office for a minimum of forty (40) hours per calendar week? YES NO If Bidder/Proposer's Local Office tenancy is pursuant to a lease, has Bidder/Proposer YES NO N/A IZ enclosed a copy of die lease? Has Bidder/Proposer enclosed a copy of the Business Tax Receipt (BTR) issued by the City of Miami and Miami -Dade County? City of Ivliatni: Cite Exemption: El YES located 0 NO Exempt Office not in the City of Miami Miami -Dade County: Cite Exemption: YES NO _EL 1 Exempt Has I3idder/Proposer enclosed a copy of the license, certificate of competency and certificate of use that authorizes the performance of Bidder/Proposer' s business o • orations? YES NO Bidder/Proposer's signature below certifies compliance with the Local Office requirements stated under Chapter 1/3/Article III, Section 18-73, of the Code of the City of Miami, Florida, as amended. Alberto Perez Print Name (Bidder/Proposer Authorized Representative) Signature 2 FORM -City of Miami Local Office Certification 7/22/2Q13 Date STATE OF FLOR1T A: COUNTY OF Certified to and subscribed before me this lettaal Eta l landdr ninto ff94,0895 Deco ber 3, 2019 Bonded thri Aarhn Notary (NOTARY SEAL) Personally \li OR Produced ldentifieation Type roduced FORiv-cloy of Miami Local offiee Corti 7/22/2013 MA ,m«<<<y d � 7 E < A Form W'9 (Rev. December2014) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification Give Form to the requester. Do not send to the IRS. Print or type See Specific Instructions on page 2. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Sudden Service, Inc. 2 Business name/disregarded entity name, if different from above 3 Check appropriate box for federal tax classification; check only ii Individual/sole proprietor or 0 C Corporation P p p single -member LLC ill Limited liability Enter the tax one of the following seven boxes: S Corporation PartnershipTrust/estate p S=S P=partnership) I. 4 Exemptions (codes apply only to certain ioennsion, not individuals; see instructions on page 3): Exempt payee code (If any) oompany. classification (C=C corporation, corporation, Note. For a single -member LLC that is disregarded, do not check LLC; check the appropriate box in the line above for the tax classification of the single -member owner. Exemption from FATCA reporting code (if any) ig Other (see instructions) ► (Applies to accounts maintained outside the U.S.) 5 Address (number, street, and apt. or suite no.) 650 North Church Ave. Remit to Address: PO Box 903 Requester's name and address (optional) 6 City, state, and ZIP code Louisville, MS 39339 7 List account number(s) here (optional) Part I Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN). However, for resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to aet a Social secu ity number - - TIN on page 3. Note. If the account Is in more than one name, see the instructions for line 1 and the chart on page 4 for guidelines on whose number to enter. or Employer identification number 6 4 0 8 0 8 2 8 2 Part II Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and 2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. I am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions on page 3. Sign Here Digitally signed by e(tlney Luke Signature of Blttley Luke DN cn B aoLuke, o=TTaylor SGroo ,Inc., cu, U.S. person► iblokela2o o,; 9e3,o, Date ► General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments, Information about developments affecting Form W-9 (such as legislation enacted after we release it) is at www.irs.gov/fw9. Purpose of Form An individual or entity (Form W-9 requester) who is required to file an Information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), Individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following: • Form 1099-INT (interest earned or paid) • Form 1099-DIV (dividends, Including those from stooks or mutual funds) • Form 1099-MISC (various types of income, prizes, awards, or gross proceeds) • Form 1099-B (stock or mutual fund sales and certain other transactions by brokers) Form 1099-S (proceeds from real estate transactions) • Form 1099-K (merchant card and third party network transactions) • Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition) • Form 1099-C (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN. If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding, See What is backup withholding? on page 2. By signing the filled -out form, you: 1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued), 2. Certify that you are not subject to backup withholding, or 3. Claim exemption from backup withholding if you are a U.S. exempt payee. If applicable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business Is not subject to the withholding tax on foreign partners' share of effectively connected income, and 4. Certify that FATCA code(s) entered on this form (If any) indicating that you are exempt from the FATCA reporting, Is correct. See What is FATCA reporting? on page 2 for further information. Cat. No. 10231X Form W-9 (Rev. 12-2014) Form W-9 (Rev. 12-2014) Page 2 Note. If you are a U.S, person and a requester gives you a form other than Form W-9 to request your TIN, you must use the requester's form if it is substantially similar to this Form W-9. Definition of a U.S. person. For federal tax purposes, you are considered a U.S. person If you are: • An individual who is a U.S. citizen or U.S. resident alien; • A partnership, corporation, company, or association created or organized in the United States or under the laws of the United States; • An estate (other than a foreign estate); or • A domestic trust (as defined in Regulations section 301.7701-7). Special rules for partnerships. Partnerships that conduct a trade or business in the United States are generally required to pay a withholding tax under section 1446 on any foreign partners' share of effectively connected taxable income from such business. Further, in certain cases where a Form W-9 has not been received, the rules under section 1446 require a partnership to presume that a partner is a foreign person, and pay the section 1446 withholding tax. Therefore, if you are a U.S. person that is a partner in a partnership conducting a trade or business in the United States, provide Form W-9 to the partnership to establish your U.S. status and avoid section 1446 withholding on your share of partnership income. In the cases below, the following person must give Form W-9 to the partnership for purposes of establishing its U.S. status and avoiding withholding on its allocable share of net income from the partnership conducting a trade or business in the United States: • In the case of a disregarded entity with a U.S. owner, the U.S. owner of the disregarded entity and not the entity; • In the case of a grantor trust with a U.S. grantor or other U.S. owner, generally, the U.S. grantor or other U.S. owner of the grantor trust and not the trust; and • In the case of a U.S. trust (other than a grantor trust), the U.S. trust (other than a grantor trust) and not the beneficiaries of the trust. Foreign person. If you are a foreign person or the U.S. branch of a foreign bank that has elected to be treated as a U.S. person, do not use Form W-9. Instead, use the appropriate Form W-8 or Form 8233 (see Publication 515, Withholding of Tax on Nonresident Aliens and Foreign Entitles). Nonresident alien who becomes a resident alien. Generally, only a nonresident alien individual may use the terms of a tax treaty to reduce or eliminate U.S. tax on certain types of income. However, most tax treaties contain a provision known as a "saving clause." Exceptions specified in the saving clause may permit an exemption from tax to continue for certain types of income even after the payee has otherwise become a U.S. resident alien for tax purposes. If you area U.S. resident alien who is relying on an exception contained in the saving clause of a tax treaty to claim an exemption from U.S. tax on certain types of income, you must attach a statement to Form W-9 that specifies the following five items: 1. The treaty country. Generally, this must be the same treaty under which you claimed exemption from tax as a nonresident alien. 2. The treaty article addressing the income. 3. The article number (or location) in the tax treaty that contains the saving clause and its exceptions. 4. The type and amount of income that qualifies for the exemption from tax. 5. Sufficient facts to justify the exemption from tax under the terms of the treaty article. Example. Article 20 of the U.S.-China income tax treaty allows an exemption from tax for scholarship income received by a Chinese student temporarily present in the United States. Under U.S. law, this student will become a resident alien for tax purposes if his or her stay in the United States exceeds 5 calendar years. However, paragraph 2 of the first Protocol to the U.S.-China treaty (dated April 30, 1984) allows the provisions of Article 20 to continue to apply even after the Chinese student becomes a resident alien of the United States. A Chinese student who qualifies for this exception (under paragraph 2 of the first protocol) and is relying on this exception to claim an exemption from tax on his or her scholarship or fellowship income would attach to Form W-9 a statement that includes the information described above to support that exemption. If you are a nonresident alien or a foreign entity, give the requester the appropriate completed Form W-8 or Form 8233. Backup Withholding What is backup withholding? Persons making certain payments to you must under certain conditions withhold and pay to the IRS 28% of such payments. This is called "backup withholding." Payments that may be subject to backup withholding include interest, tax-exempt interest, dividends, broker and barter exchange transactions, rents, royalties, nonemployee pay, payments made in settlement of payment card and third party network transactions, and certain payments from fishing boat operators. Real estate transactions are not subject to backup withholding. You will not be subject to backup withholding on payments you receive if you give the requester your correct TIN, make the proper certifications, and report all your taxable interest and dividends on your tax return. Payments you receive will be subject to backup withholding if: 1. You do not furnish your TIN to the requester, 2. You do not certify your TIN when required (see the Part II instructions on page 3 for details), 3. The IRS tells the requester that you furnished an incorrect TIN, 4. The IRS tells you that you are subject to backup withholding because you did not report all your interest and dividends on your tax return (for reportable interest and dividends only), or 5. You do not certify to the requester that you are not subject to backup withholding under 4 above (for reportable interest and dividend accounts opened after 1983 only). Certain payees and payments are exempt from backup withholding. See Exempt payee code on page 3 and the separate Instructions for the Requester of Form W-9 for more information. Also see Special rules for partnerships above. What is FATCA reporting? The Foreign Account Tax Compliance Act (FATCA) requires a participating foreign financial Institution to report all United States accountholders that are specified United States persons. Certain payees are exempt from FATCA reporting. See Exemption from FATCA reporting code on page 3 and the Instructions for the Requester of Form W-9 for more Information. Updating Your Information You must provide updated information to any person to whom you claimed to be an exempt payee if you are no longer an exempt payee and anticipate receiving reportable payments In the future from this person. For example, you may need to provide updated information if you are a C corporation that elects to be an S corporation, or if you no longer are tax exempt. In addition, you must furnish a new Form W-9 if the name or TIN changes for the account; for example, if the grantor of a grantor trust dies. Penalties Failure to furnish TIN. If you fail to furnish your correct TIN to a requester, you are subject to a penalty of $50 for each such failure unless your failure is due to reasonable cause and not to willful neglect. Civil penalty for false information with respect to withholding. If you make a false statement with no reasonable basis that results In no backup withholding, you are subject to a $500 penalty. Criminal penalty for falsifying information. Willfully falsifying certifications or affirmations may subject you to criminal penalties including fines and/or imprisonment. Misuse of TINs. If the requester discloses or uses TINs in violation of federal law, the requester may be subject to civil and criminal penalties. Specific Instructions Line 1 You must enter one of the following on this line; do not leave this line blank. The name should match the name on your tax return. If this Form W-9 is for a joint account, Ilst first, and then circle, the name of the person or entity whose number you entered In Part I of Form W-9. a. Individual. Generally, enter the name shown on your tax return. If you have changed your last name without informing the Social Security Administration (SSA) of the name change, enter your first name, the last name as shown on your social security card, and your new last name. Note. ITIN applicant: Enter your individual name as it was entered on your Form W-7 application, line 1 a. This should also be the same as the name you entered on the Form 1040/1040A/1040EZ you filed with your application. b. Sole proprietor or single -member LLC. Enter your individual name as shown on your 1040/1040A/1040EZ on line 1. You may enter your business, trade, or "doing business as" (DBA) name on line 2. c. Partnership, LLC that is not a single -member LLC, C Corporation, or S Corporation. Enter the entity's name as shown on the entity's tax return on line 1 and any business, trade, or DBA name on line 2. d. Other entities. Enter your name as shown on required U.S. federal tax documents on line 1. This name should match the name shown on the charter or other legal document creating the entity. You may enter any business, trade, or DBA name on line 2. e. Disregarded entity. For U.S. federal tax purposes, an entity that is disregarded as an entity separate from its owner is treated as a "disregarded entity." See Regulations section 301.7701-2(c)(2)(iii). Enter the owner's name on line 1. The name of the entity entered on line 1 should never be a disregarded entity. The name on line 1 should be the name shown on the income tax return on which the income should be reported. For example, If a foreign LLC that is treated as a disregarded entity for U.S. federal tax purposes has a single owner that is a U.S. person, the U.S. owner's name is required to be provided on line 1. If the direct owner of the entity is also a disregarded entity, enter the first owner that is not disregarded for federal tax purposes. Enter the disregarded entity's name on line 2, "Business name/disregarded entity name." If the owner of the disregarded entity is a foreign person, the owner must complete an appropriate Form W-8 instead of a Form W-9. This is the case even if the foreign person has a U.S. TIN. Form W-9 (Rev. 12-2014) Page 3 Line 2 If you have a business name, trade name, DBA name, or disregarded entity name, you may enter it on line 2. Line 3 Check the appropriate box in line 3 for the U.S. federal tax classification of the person whose name is entered on line 1. Check only one box in line 3. Limited Liability Company (LLC). If the name on line 1 is an LLC treated as a partnership for U.S. federal tax purposes, check the "Limited Liability Company" box and enter "P" in the space provided. If the LLC has filed Form 8832 or 2553 to be taxed as a corporation, check the "Limited Liability Company" box and in the space provided enter "C" for C corporation or "S" for S corporation. If it is a single -member LLC that is a disregarded entity, do not check the "Limited Liability Company" box; instead check the first box In line 3 "Individual/sole proprietor or single -member LLC." Line 4, Exemptions If you are exempt from backup withholding and/or FATCA reporting, enter in the appropriate space in line 4 any code(s) that may apply to you. Exempt payee code. • Generally, individuals (including sole proprietors) are not exempt from backup withholding. • Except as provided below, corporations are exempt from backup withholding for certain payments, including interest and dividends. • Corporations are not exempt from backup withholding for payments made in settlement of payment card or third party network transactions. • Corporations are not exempt from backup withholding with respect to attorneys' fees or gross proceeds paid to attorneys, and corporations that provide medical or health care services are not exempt with respect to payments reportable on Form 1099-MISC. The following codes identify payees that are exempt from backup withholding. Enter the appropriate code in the space in line 4. 1—An organization exempt from tax under section 501(a), any IRA, or a custodial account under section 403(b)(7) if the account satisfies the requirements of section 401(f)(2) 2—The United States or any of its agencies or instrumentalities 3—A state, the District of Columbia, a U.S. commonwealth or possession, or any of their political subdivisions or instrumentalities 4—A foreign government or any of its political subdivisions, agencies, or instrumentalities 5—A corporation 6—A dealer in securities or commodities required to register in the United States, the District of Columbia, or a U.S. commonwealth or possession 7—A futures commission merchant registered with the Commodity Futures Trading Commission 8—A real estate investment trust 9—An entity registered at all times during the tax year under the Investment Company Act of 1940 10—A common trust fund operated by a bank under section 584(a) 11—A financial institution 12—A middleman known in the investment community as a nominee or custodian 13—A trust exempt from tax under section 664 or described in section 4947 The following chart shows types of payments that may be exempt from backup withholding. The chart applies to the exempt payees listed above, 1 through 13. IF the payment is for ... THEN the payment is exempt for, , . Interest and dividend payments All exempt payees except for 7 Broker transactions Exempt payees 1 through 4 and 6 through 11 and all C corporations. S corporations must not enter an exempt payee code because they are exempt only for sales of noncovered securities acquired prior to 2012. Barter exchange transactions and patronage dividends Exempt payees 1 through 4 Payments over $600 required to be reported and direct sales over $5,0001 Generally, exempt payees 1 through 52 Payments made in settlement of payment card or third party network transactions Exempt payees 1 through 4 1 See Form 1099-MISC, Miscellaneous Income, and its Instructions. 'However, the following payments made to a corporation and reportable on Form 1099-MISC are not exempt from backup withholding: medical and health care payments, attorneys' fees, gross proceeds paid to an attorney reportable under section 6045(f), and payments for services paid by a federal executive agency. Exemption from FATCA reporting code. The following codes identify payees that are exempt from reporting under FATCA. These codes apply to persons submitting this form for accounts maintained outside of the United States by certain foreign financial institutions. Therefore, if you are only submitting this form for an account you hold in the United States, you may leave this field blank. Consult with the person requesting this form if you are uncertain if the financial Institution Is subject to these requirements. A requester may Indicate that a code is not required by providing you with a Form W-9 with "Not Applicable" (or any similar indication) written or printed on the line for a FATCA exemption code. A —An organization exempt from tax under section 501(a) or any individual retirement plan as defined in section 7701(a)(37) B—The United States or any of Its agencies or instrumentalities C—A state, the District of Columbia, a U.S. commonwealth or possession, or any of their political subdivisions or instrumentalities D—A corporation the stock of which Is regularly traded on one or more established securities markets, as described in Regulations section 1.1472-1(c)(1)(i) E—A corporation that is a member of the same expanded affiliated group as a corporation described in Regulations section 1.1472-1(c)(1)(I) F—A dealer in securities, commodities, or derivative financial Instruments (including notional principal contracts, futures, forwards, and options) that is registered as such under the laws of the United States or any state G—A real estate investment trust H—A regulated investment company as defined in section 851 or an entity registered at all times during the tax year under the Investment Company Act of 1940 I —A common trust fund as defined in section 584(a) J—A bank as defined in section 581 K—A broker L—A trust exempt from tax under section 664 or described in section 4947(a)(1) M—A tax exempt trust under a section 403(b) plan or section 457(g) plan Note. You may wish to consult with the financial Institution requesting this form to determine whether the FATCA code and/or exempt payee code should be completed. Line 5 Enter your address (number, street, and apartment or suite number). This is where the requester of this Form W-9 will mall your Information returns. Line 6 Enter your city, state, and ZIP code. Part I. Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. If you are a resident alien and you do not have and are not eligible to get an SSN, your TIN is your IRS individual taxpayer identification number (ITIN), Enter it in the social security number box. If you do not have an ITIN, see How to get a TIN below. If you are a sole proprietor and you have an EIN, you may enter either your SSN or EIN. However, the IRS prefers that you use your SSN. If you are a single -member LLC that is disregarded as an entity separate from its owner (see Limited Liability Company (LLC) on this page), enter the owner's SSN (or EIN, if the owner has one). Do not enter the disregarded entity's EIN. If the LLC is classified as a corporation or partnership, enter the entity's EIN. Note. See the chart on page 4 for further clarification of name and TIN combinations. How to get a TIN. If you do not have a TIN, apply for one immediately. To apply for an SSN, get Form SS-5, Application for a Social Security Card, from your local SSA office or get this form online at www.ssa.gov. You may also get this form by calling 1-800-772-1213. Use Form W-7, Application for IRS Individual Taxpayer Identification Number, to apply for an ITIN, or Form SS-4, Application for Employer Identification Number, to apply for an EIN. You can apply for an EIN online by accessing the IRS website at www.irs.gov/businesses and clicking on Employer Identification Number (EIN) under Starting a Business. You can get Forms W-7 and SS-4 from the IRS by visiting IRS.gov or by calling 1-800-TAX-FORM (1-800-829-3676). If you are asked to complete Form W-9 but do not have a TIN, apply for a TIN and write "Applied For" in the space for the TIN, sign and date the form, and give it to the requester. For interest and dividend payments, and certain payments made with respect to readily tradable instruments, generally you will have 60 days to get a TIN and give it to the requester before you are subject to backup withholding on payments. The 60-day rule does not apply to other types of payments. You will be subject to backup withholding on all such payments until you provide your TIN to the requester. Note. Entering "Applied For" means that you have already applied for a TIN or that you intend to apply for one soon. Caution: A disregarded U.S. entity that has a foreign owner must use the appropriate Form W-8. Form W-9 (Rev. 12-2014) Page 4 Part II. Certification To establish to the withholding agent that you are a U.S. person, or resident alien, sign Form W-9. You may be requested to sign by the withholding agent even if items 1, 4, orb below indicate otherwise. For a joint account, only the person whose TIN is shown in Part I should sign (when required). In the case of a disregarded entity, the person identified on line 1 must sign. Exempt payees, see Exempt payee code earlier. Signature requirements. Complete the certification as indicated in items 1 through 5 below. 1. Interest, dividend, and barter exchange accounts opened before 1984 and broker accounts considered active during 1983. You must give your correct TIN, but you do not have to sign the certification. 2. Interest, dividend, broker, and barter exchange accounts opened after 1983 and broker accounts considered inactive during 1983. You must sign the certification or backup withholding will apply. If you are subject to backup withholding and you are merely providing your correct TIN to the requester, you must cross out item 2 In the certification before signing the form. 3. Real estate transactions. You must sign the certification. You may cross out item 2 of the certification. 4. Other payments. You must give your correct TIN, but you do not have to sign the certification unless you have been notified that you have previously given an incorrect TIN. "Other payments" Include payments made in the course of the requester's trade or business for rents, royalties, goods (other than bills for merchandise), medical and health care services (Including payments to corporations), payments to a nonemployee for services, payments made in settlement of payment card and third party network transactions, payments to certain fishing boat crew members and fishermen, and gross proceeds paid to attorneys (including payments to corporations). 5. Mortgage interest paid by you, acquisition or abandonment of secured property, cancellation of debt, qualified tuition program payments (under section 529), IRA, Coverdell ESA, Archer MSA or HSA contributions or distributions, and pension distributions. You must give your correct TIN, but you do not have to sign the certification. What Name and Number To Give the Requester For this type of account: Give name and SSN of: 1. Individual 2. Two or more individuals (joint account) 3. Custodian account of a minor (Uniform Gift to Minors Act) 4. a. The usual revocable savings trust (grantor is also trustee) b. So-called trust account that Is not a legal or valid trust under state law 5. Sole proprietorship or disregarded entity owned by an individual 6. Grantor trust filing under Optional Form 1099 Filing Method 1 (see Regulations section 1.671-4(b)(2)(1) (A)) The Individual The actual owner of the account or, if combined funds, the first individual on the account' The minor' The grantor -trustee' The actual owner' The owner' The grantor* For this type of account: Give name and EIN of: 7. Disregarded entity not owned by an individual 8, A valid trust, estate, or pension trust 9. Corporation or LLC electing corporate status on Form 8832 or Form 2553 10. Association, club, religious, charitable, educational, or other tax- exempt organization '11. Partnership or multi -member LLC 12. A broker or registered nominee 13. Account with the Department of Agriculture in the name of a public entity (such as a state or local government, school district, or prison) that receives agricultural program payments 14. Grantor trust filing under the Form 1041 Filing Method or the Optional Form 1099 Filing Method 2 (see Regulations section 1.671-4(b)(2)(i) (B)) The owner Legal entity' The corporation The organization The partnership The broker or nominee The public entity The trust 'List first and circle the name of the person whose number you furnish. If only one person on a joint account has an SSN, that person's number must be furnished. 2 Circle the minor's name and furnish the minor's SSN. 'You must show your individual name and you may also enter your business or DBA name on the "Business name/disregarded entity" name line. You may use either your SSN or EIN (if you have one), but the IRS encourages you to use your SSN. 'List first and circle the name of the trust, estate, or pension trust. (Do not furnish the TIN of the personal representative or trustee unless the legal entity itself Is not designated In the account title.) Also see Special rules for partnerships on page 2. *Note. Grantor also must provide a Form W-9 to trustee of trust. Note. If no name is circled when more than one name is listed, the number will be considered to be that of the first name listed. Secure Your Tax Records from Identity Theft Identity theft occurs when someone uses your personal information such as your name, SSN, or other identifying Information, without your permission, to commit fraud or other crimes. An identity thief may use your SSN to get a job or may file a tax return using your SSN to receive a refund. To reduce your risk: • Protect your SSN, • Ensure your employer is protecting your SSN, and • Be careful when choosing a tax preparer. If your tax records are affected by identity theft and you receive a notice from the IRS, respond right away to the name and phone number printed on the IRS notice or letter. If your tax records are not currently affected by identity theft but you think you are at risk due to a lost or stolen purse or wallet, questionable credit card activity or credit report, contact the IRS Identity Theft Hotline at 1-800-908-4490 or submit Form 14039. For more information, see Publication 4535, Identity Theft Prevention and Victim Assistance. Victims of identity theft who are experiencing economic harm or a system problem, or are seeking help in resolving tax problems that have not been resolved through normal channels, may be eligible for Taxpayer Advocate Service (TAS) assistance. You can reach TAS by calling the TAS toll -free case intake line at 1-877-777-4778 or TTY/TDD 1-800-829-4059. Protect yourself from suspicious emails or phishing schemes. Phishing Is the creation and use of email and websites designed to mimic legitimate business emails and websites. The most common act is sending an email to a user falsely claiming to be an established legitimate enterprise In an attempt to scam the user into surrendering private information that will be used for identity theft. The IRS does not initiate contacts with taxpayers via emails. Also, the IRS does not request personal detailed information through email or ask taxpayers for the PIN numbers, passwords, or similar secret access information for their credit card, bank, or other financial accounts. If you receive an unsolicited email claiming to be from the IRS, forward this message to phishing@irs.gov. You may also report misuse of the IRS name, logo, or other IRS property to the Treasury Inspector General for Tax Administration (TIGTA) at 1-800-366-4484. You can forward suspicious emails to the Federal Trade Commission at: spam@uce.gov or contact them at www.ftc.govlldtheft or 1-877-I DTH EFT (1-877-438-4338). Visit IRS.gov to learn more about identity theft and how to reduce your risk. Privacy Act Notice - Section 6109 of the Internal Revenue Code requires you to provide your correct TIN to persons (Including federal agencies) who are required to file information returns with the IRS to report interest, dividends, or certain other income paid to you; mortgage interest you paid; the acquisition or abandonment of secured property; the cancellation of debt; or contributions you made to an IRA, Archer MSA, or HSA. The person collecting this form uses the information on the form to file information returns with the IRS, reporting the above information. Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and to cities, states, the District of Columbia, and U.S. commonwealths and possessions for use in administering their laws. The information also may be disclosed to other countries under a treaty, to federal and state agencies to enforce civil and criminal laws, or to federal law enforcement and Intelligence agencies to combat terrorism. You must provide your TIN whether or not you are required to file a tax return, Under section 3406, payers must generally withhold a percentage of taxable interest, dividend, and certain other payments to a payee who does not give a TIN to the payer. Certain penalties may also apply for providing false or fraudulent information. -''f^= 0: p� �+ y^�t p �y pg �1 p{ /^a i RE CERTIFICATE Ira l dF Ci^1 OF L I3�L(� I N URANC DATE (MM/D fYY' Y}. 06/22/20''16 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR. PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(tes) must be endorsed, If SUBROGATION :IS WAIVED, subject to 1 the terms and conditions of the policy, certain polictes may require an endorsement; A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s), RROgic.s Lit #0B29370 1-2.05-581-3330 Edgewood Partners Insurance Center (EPIC) (Alabaa Branch - Branch ID 15491] m 2901 2nd Avenue South,. Suite 200 Birmingham, AL 35233 CONT CT Erika >reNeman_ PHONE FAX A/C,No (t: (205) 581-3336 (AtC,No}c E-MAIL ADDRESS: erika.£roeman@epicbro)tersaom INSURER(S) AFFORDING COVERAGE NAIL INSURER A ; Il TIO2 AL FIRD INS CO OE HIARTFORD' 20478 INSURED Sudden Service, 2aD., The Taylor Group, Inn -•, Taylor Power Systems, Inc„ Taylor Machine Works, inc. , Taylor Leasing Corporation 350 Norbh Church Avenue Louisville, MS 39339 INSURERe: CONTINENTAL INS CO 35289 1NSURERC; VALLEY FORGE INS CO 20508 INSURERO: ,. 1NSUt;eR E: ... COVERAGES CERTIFICATE NUMBER: 47173.082 REVISION NUMBER: THIS 1S TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIDNS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED By PAID CLAIMS, IRSR LTR TYPE-OFINSURANCE A004'SUBR POLICY NUMBER •. POLICY :E F MMIDOL* PO(.1CYEXP. MMIDO/Y Y LIMITS. _.., A GENERALLIABILCTY X 1- COMMERCIAL GENE CLAIMS -MADE AL X OCCUR X X 6042b•31815 07/01/10 07/01/11 EACHOCCURRENOE $ 1,000,000 NTSD •A MIAE STI5a xurr PAEAGES(Eacxurre e S 1r 000, OOA MED SXP (Arty ono psrson) S 15, 000 X $25,GOO Ded PERSONAL &AOViNJURY •$1,000,000 GENERAL AGGREGATE $2,000,000 GEN`LAGGREGATE LIMIT APPLIES PER: POLICY X PRO- LOC PRODUCTS-COMP/OP AGO $2,000,000 8 AUTOMOBILELIAEILITY X - ANY AUTO, ALL OWNED AUTOS HIRED AUTOS 1f SCHEDULED AUTOS MON-OWNED AUTOS X X 6024050419 07/01/15 : 07/01/ 7 COMBINED SINGLE LIMIT Ea accident 52,000,000 BODILY INJURY (Per person)' -$ BODILY INJURY (Perecotdenl) $ X PROPERTY DAMAGE Per acedent $ _.. .. S 8 •X UMBRELLALIAB EXCESS LIAR: _X_ OCCUR CLAS,IS-ti1ADE 6042915462 07/01/1: tl7/01/17 EACH000URRENCF_ $ 10,000,000 AGGREGATE $ 10, 000, 000 DED RETENTIONS S WORKERS COMPENSATION ' AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE OFFMCER/MEMBER EXCLUDED? ( rY In ) if yyes, descrlha Under DESCI$IPTIONCF:OPERATIONS Y / N / A X 6024059453 07./01/1: 07/01/17 X T.CSTAII7 Oft ff E.L. EACH ACCIDENT $ 1:.000,000 _ - X 94 9 - .1_,DISEASE. EA PLOYSS 1000, 000 EL. DISEASE-POUCYLIMIT 1 $ .000, 000- pESCRIPTION OF OPERATIONS:! LOCATIONS 1. VEHICLES (Attach AGORD 101, Additional Remarks SchedUle,.0 more apace Ia required)- 2226 Academy Business Park and Colliers International and Southpace Management, Inc. shall be named additional insured as respects general liability Coverage where ragiaired by written contract ATIMA es landlord of preen aes leased from them by the named insured, CERTIFICATE HOLDER ACORD 25 (2010/05) EFreeman 41173082 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL SE DELIVERED IN ACCORDANCE WITH 'THE POLICY PROVISIONS. MimoRILEO REPRESERTATtVE © 1988.2010 ACORD CORPORATION, AN rights reserved. The ACORD name and logo are registered marks of ACORD City of Miami Invitation for Bid (IFB) Purchasing Department Miami Riverside Center 444 SW 2nd Avenue, 6ih Floor Miami, Florida 33130 Web Site Address: http://ci.miami.fl.us/procurement IFB Number: Title: Issue Date/Time: IFB Closing Date/Time: Pre -Bid Conference: Pre -Bid Date/Time: Pre -Bid Location: Deadline for Request for Clarification: Buyer: Hard Copy Submittal Location: Buyer E-Mail Address: Buyer Facsimile: 616407,1 Invitation For Bid for Forklift & Other Hydraulic Lifts Maintenance & Repairs 08-JUL-2016 19-JUL-2016 @ 14:00:00 None Wednesday, July 6, 2016 at 3:00 PM Hansen, Anthony City of Miami - City Clerk 3500 Pan American Drive Miami FL 33133 US amhansen@miamigov.com (305)400-5237 Page 1 of 45 Certification Statement Please quote on this form, if applicable, n retain a copy for your files. Prices should in City reserves the right to accept or reject all minimum of 180 days following the time prices for the item(s) listed. Return signed original: and lude all costs, including transportation to destination. The, any part of this submission. Prices should be firm for a or 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, furnish and deliver, F.O.I. DESTINATION, the items or services specified herein. The undersigned hereby certifies that neither the contractual party nor any of its prin personnel have been convicted of any of the violations,' or debarred or suspended as 18-107 or Ordinance No. 12271. All exceptions to this submission have beer. documented in the section below (refer to paragraph and section). EXCEPTIONS: and propose to pal owners or set in section ify that any and all information contained in this submission is true; and we (I) further certify submission is made without prior understanding, agrecm:ent, or connection with any corporation, firm., 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 editions of this solicitation and certify that I am authorized to sign this submission for the subi Please print the following and sign your name'. SUPPLIER NA E. Sudden Service Inc ADDRESS: PHONE: 511 NW 64th St. Miami, FL 38166 05) 599-2070 FAX: EMAIL; apere(itayiorbi redcorri IGNED By, Alberto Perez LE: Service Man or i99-261 1 BEEP: DATE• 7/2 THIS I ftlRivT 81I 6 THIS. Page 2 of 4 Certifications Legal Name of Firm: Sudden Service Inc. Entity Type: Partnership, Sole Proprietorship, Corporation, etc. Corporation Year Established: 1927 Office Location: City of Miami, Miami -Dade County, or Other Miami -Dade County Business Tax Receipt / Occupational License Number: 2014010054 Business Tax Receipt / Occupational License Issuing Agency: Miami -Dade County Business Tax Receipt / Occupational License Expiration Date: Unlimited Will Subcontractor(s) be used? (Yes or No) No If subcontractor(s) will be utilized, provide their name, address and the the portion of the work they will be responsible for under this contract (a copy of their license(s) must be submitted with your bid response): N/A Please list and acknowledge all addendum/addenda received. List the addendum/addenda number and date of receipt (i.e. Addendum No. 1, 7/1/07), If no addendum/addenda was/were issued, please insert N/A. Addendum No.1, 7/8/16; Addendum No. 2, 7/19/16 If Bidder has a Local Office, as defined under Chapter 18/Articlle III, Section 18-73 of the City Code, has Bidder filled out, notarized, and included with its bid response the "City of Miami Local Office Certification" form? YES OR NO? (The City of Miami Local Office Certification form is located in the Oracle Sourcing system ("iSupplier"), under the Header/Notes and Attachments Section of this solicitation) Yes Reference No. 1: Name of Company/Agency for which bidder is currently providing the services/goods Page 3 of 45 as described in this solicitation, or has provided such services/goods in the past: TNT Marine Center Reference No. 1: Address, City, State, and Zip for above reference company/agency listed: 1940 NW 135 St. North Miami, FL 33181 Reference No. 1: Name of Contact Person and Telephone Number for above reference no, 1 Ron Goldberg, John Carrington (305) 944-2118 Reference No. 1: Date of Contract or Sale for above reference no. 1 2010 Reference No. 2: Name of Company/Agency for which bidder is currently providing the services/goods as described in this solicitation, or has provided such services/goods in the past: Eller I.T.O. Stevedoring Co. Reference No. 2: Address, City, State, and Zip for above reference company/agency listed: 1007 North American Way Miami, FL 33132 Reference No. 2: Name of Contact Person and Telephone Number for above reference no. 2 Domingo Diaz (305) 910-7842 Reference No. 2: Date of Contract or Sale for above reference no. 2 2010 Reference No. 3: Name of Company/Agency for which bidder is currently providing the services/goods as described in this solicitation, or has provided such services/goods in the past: South Florida Container Terminals Reference No. 3: Address, City, State, and Zip for above reference company/agency listed: 2299 Port Blvd. Miami, FL 33132 Reference No. 3: Name of Contact Person and Telephone Number for above reference no. 3 Frank Fernandez (305) 347-3816 Reference No. 3: Date of Contract or Sale for above reference no. 3 2010 Page 4of45 Line: 1 Description: Group 1: Hourly Labor Rate Weekdays (Monday -Friday, 7AM - 6PM) for Wiggins, Model # W220m2-130, Marine Forklift, Repairs Category: 56075-00 Unit of Measure: Hour Unit Price: $ 70.00 Line: 2 Number of Units: 1 Total: $ 70.00 Description: Group 1: Hourly Labor Rate Evenings (Monday -Friday, 7PM - 6AM), Weekends and Holidays for Wiggins, Model # W220m2-130, Marine Forklift, Repairs Category: 56075-00 Unit of Measure: Hour Unit Price: $ 100.00 Number of Units: 1 Total: $ 100.00 Line: 3 Description: Group 1: Monthly Maintenance / Yearly Inspection for Wiggins Marine Forklift, per Specifications, Section 3.0 Category: 56075-00 Unit of Measure: Each Unit Price: $ 600.00 Line: 4 Number of Units: 1 Total: $ 600.00 Description: Group 1: Percent Discount Off Parts Catalog for Wiggins Equipment (percent discount expressed as decimal, i.e. 10% = .10) Category: 56075-00 Unit of Measure: Each Unit Price: $ • 10 Number of Units: 1 Total: $ • 10 Page 5 of 45 Line: 5 Description: Group 2: Hourly Labor Rate Weekdays (Monday -Friday, 7AM - 6PM) for Clark, Model # GCS15, Type G, Forklift and Clark, Model # C500-580, Type D, Forklift, Repairs Category: 56075-00 Unit of Measure: Hour Unit Price: $ 70.00 Line: 6 Number of Units: 1 Total: $ 70.00 Description: Group 2: Hourly Labor Rate Evenings (Monday -Friday, 7PM - 6AM), Weekends and Holidays for Clark, Model # GCS15, Type G, Forklift and Clark, Model # C500-580, Type D, Forklift, Repairs Category: 56075-00 Unit of Measure: Hour Unit Price: $ 100.00 Line: 7 Number of Units: 1 Total: $ 100.00 Description: Group 2: Monthly Maintenance / Yearly Inspection for Clark Forklifts, per Specifications, Section 3.0 Category: 56075-00 Unit of Measure: Each Unit Price: $ 145.00 Number of Units: 1 Total: $ 145.00 Line: 8 Description: Group 2: Percent Discount Off Parts Catalog for Clark Equipment (percent discount expressed as decimal, i.e. 10% = .10) Category: 56075-00 Unit of Measure: Each Unit Price: $ .05 Number of Units: 1 Total: $ .05 Page 6 of 45 Line: 9 Description: Group 3: Hourly Labor Rate Weekdays (Monday -Friday, 7AM - 6PM) for JLG, Model # 25EL (25AM), Vertical Lift and JLG, Model # 450A, Articulating Boom Lift, Repairs Category: 56075-00 Unit of Measure: Hour Unit Price: $ 70.00 Line: 10 Number of Units: 1 Total: $ 70.00 Description: Group 3: Hourly Labor Rate Evenings (Monday -Friday, 7PM - 6AM), Weekends and Holidays for JLG, Model # 25EL (25AM) and JLG, Model # 450A, Articulating Boom Lift, Repairs Category: 56075-00 Unit of Measure: Hour Unit Price: $ 100.00 Number of Units: 1 Total: $ 100.00 Line: 11 Description: Group 3: Monthly Maintenance / Yearly Inspection for JLG Lifts, per Specifications, Section 3.0 Category: 56075-00 Unit of Measure: Each Unit Price: $ 145.00 Line: 12 Number of Units: 1 Total: $ 145.00 Description: Group 3: Percent Discount Off Parts Catalog for JLG Equipment (percent discount expressed as decimal, i.e. 10% = .10) Category: 56075-00 Unit of Measure: Each Page 7 of 45 Unit Price: $ .05 Line: 13 Number of Units: 1 Total: $ .05 Description: Group 4: Hourly Labor Rate Weekdays (Monday -Friday, 7AM - 6PM) for Hoist, Model # M250 Neptune Lift Truck, Repairs Category: 56075-00 Unit of Measure: Hour Unit Price: $ 70.00 Line: 14 Number of Units: 1 Total: $ 70.00 Description: Group 4: Hourly Labor Rate Evenings (Monday -Friday, 7PM - 6AM), Weekends and Holidays for Hoist, Model # M250 Neptune Lift Truck, Repairs Category: 56075-00 Unit of Measure: Hour Unit Price: $ 100.00 Line: 15 Number of Units: 1 Total: $ 100.00 Description: Group 4: Monthly Maintenance / Yearly Inspection for Hoist Lifts, per Specifications, Section 3.0 Category: 56075-00 Unit of Measure: Each Unit Price: $ 600.00 Line: 16 Number of Units: 1 Total: $ 600.00 Description: Group 4: Percent Discount Off Parts Catalog for Hoist Equipment (percent discount expressed as decimal, i.e. 10% = .10) Category: 56075-00 Unit of Measure: Each Page 8 of 45 Unit Price: $ .05 Line: 17 Number of Units: 1 Total: $ .05 Description: Group 5: Hourly Labor Rate Weekdays (Monday -Friday, 7AM - 6PM) for Toyota, Model # 8FDU30, 7FDU35, 7FDAU50, 8FDU20, Forklifts, Repairs Category: 07544-00 Unit of Measure: Hour Unit Price: $ 70.00 Line: 18 Number of Units: 1 Total: $ 70.00 Description: Group 5: Hourly Labor Rate Evenings (Monday -Friday, 7PM 6AM), Weekends and Holidays for Toyota, Model # 8FDU30, 7FDU35, 7FDAU50, 8FDU20, Forklifts, Repairs Category: 07544-00 Unit of Measure: Hour Unit Price: $ 100.00 Line: 19 Number of Units: 1 Total: $ 100.00 Description: Group 5: Monthly Maintenance / Yeary Inspection for Toyota Forklifts, per Specifications, Section 3.0 Category: 07544-00 Unit of Measure: Each Unit Price: $ 145.00 Line: 20 Number of Units: 1 Total: $ 145,00 Description: Group 5: Percent Discount Off Parts Catalog for Toyota Equipment (percent discount expressed as decimal, i.e. 10% = .10) Category: 07544-00 Page 9 of 45 Unit of Measure: Each Unit Price: $ .05 Line: 21 Number of Units: 1 Total: $ .05 Description: Group 6: Hourly Labor Rate Weekdays (Monday -Friday, 7AM - 6PM) for Rotary, Model # SP015N310, SPOA1ON5GO, SPOA1ON500, Automotive Lifts, Repairs Category: 07544-00 Unit of Measure: Hour Unit Price: $ 70.00 Line: 22 Number of Units: 1 Total: $ 70.00 Description: Group 6: Hourly Labor Rate Evenings (Monday -Friday, 7PM - 6AM), Weekends and Holidays for Rotary, Model # SP015N310, SPOA1ON5GO, SPOA1ON500 Automotive Lifts, Repairs Category: 07544-00 Unit of Measure: Hour Unit Price: $ 100.00 Line: 23 Number of Units: 1 Total: $ 100.00 Description: Group 6: Monthly Maintenance / Yearly Inspection for Rotary Automotive Lifts, per Specifications, Section 3.0 Category: 07544-00 Unit of Measure: Each Unit Price: $ 145.00 Line: 24 Number of Units: 1 Total: $ 145.00 Description: Group 6: Percent Discount Off Parts Catalog for Rotary Equipment (percent discount expressed as decimal, i.e. 10% = .10) Page 10 of 45 Category: 07544-00 Unit of Measure: Each Unit Price: $ .05 Line: 25 Number of Units: 1 Total: $ .05 Description: Group 7: Hourly Labor Rate Weekdays (Monday -Friday, 7AM 6PM) for Mohawk, Model # System-1A-10, Automotive Lift, Repairs Category: 56075-00 Unit of Measure: Hour Unit Price: $ 70.00 Line: 26 Number of Units: 1 Total: $ 70.00 Description: Group 7: Hourly Labor Rate Evenings (Monday -Friday, 7PM - 6AM), Weekends and Holidays for Mohawk, Model # System-1A-10, Automotive Lift, Repairs Category: 56075-00 Unit of Measure: Hour Unit Price: $ 100.00 Line: 27 Number of Units: 1 Total: $ 100.00 Description: Group 7: Monthly Maintenance / Yearly Inspection for Mohawk Automotive Lifts, per Specifications, Section 3.0 Category: 56075-00 Unit of Measure: Each Unit Price: $ 145.00 Line: 28 Number of Units: 1 Total: $ 145.00 Description: Group 7: Percent Discount Off Parts Catalog for Mohawk Equipment (percent discount expressed as decimal, i.e. 10% = .10) Page 11 of 45 Category: 56075-00 Unit of Measure: Each Unit Price: $ .05 Line: 29 Number of Units: 1 Total: $ .05 Description: Group 8: Hourly Labor Rate Weekdays (Monday -Friday, 7AM - 6PM) for Omer/Stertil-Koni, Model # VEGA 240/50 OF-26-FM, Automotive Lift, Repairs Category: 56075-00 Unit of Measure: Hour Unit Price: $ 70.00 Line: 30 Number of Units: 1 Total: $ 70.00 Description: Group 8: Hourly Labor Rate Evenings (Monday -Friday, 7PM - 6AM), Weekends and Holidays for Omer/Stertil-Koni, Model # VEGA 240/50 OF-26-FM, Automotive Lift, Repairs Category: 56075-00 Unit of Measure: Hour Unit Price: $ 100.00 Line: 31 Number of Units: 1 Total: $ 100.00 Description: Group 8: Monthly Maintenance / Yearly Inspection for Omer/Stertil-Koni Automotive. Lifts, per Specifications, Section 3.0 Category: 07544-00 Unit of Measure: Each Unit Price: $ 145.00 Line: 32 Number of Units: 1 Total: $ 145.00 Description: Group 8: Percent Discount Off Parts Catalog for Omer-Stertil-Koni Equipment Page 12 of 45 (percent discount expressed as decimal, i.e. 10% _ .10) Category: 07544-00 Unit of Measure: Each Unit Price: $ .05 Line: 33 Number of Units: 1 Total: $ .05 Description: Group 9: Hourly Labor Rate Weekdays (Monday -Friday, 7AM - 6PM) for Heftee, Model # D201T4854-20-25, Automotive Lift, Repairs Category: 07544-00 Unit of Measure: Hour Unit Price: $ 70.00 Line: 34 Number of Units: 1 Total: $ 70.00 Description: Group 9: Hourly Labor Rate Evenings (Monday -Friday, 7PM - 6AM), Weekends and Holidays for Heftee, Model # D201T4854-20-25, Automotive Lift, Repairs Category: 07544-00 Unit of Measure: Hour Unit Price: $_100.00 Line: 35 Number of Units: 1 Total: $ 100.00 Description: Group 9: Monthly Maintenance / Yearly Inspection for Heftee Automotive Lifts, per Specifications, Section 3.0 Category: 56075-00 Unit of Measure: Each Unit Price: $ 145.00 Line: 36 Number of Units: 1 Total: $ 145.00 Page 13 of 45 Description: Group 9: Percent Discount Off Parts Catalog for Heftee Equipment (percent discount expressed as decimal, i.e. 10% _ .10) Category: 56075-00 Unit of Measure: Each Unit Price: $ .05 Line: 37 Number of Units: 1 Total: $ .05 Description: Group 10: Hourly Labor Rate Weekdays (Monday -Friday, 7AM - 6PM) for Daewoo, Model # GC255-3, Forklift, Repairs Category: 56075-00 Unit of Measure: Hour Unit Price: $ 70.00 Line: 38 Number of Units: 1 Total: $ 70.00 Description: Group 10: Hourly Labor Rate Evenings (Monday -Friday, 7PM - 6AM), Weekends and Holidays for Daewoo, Model # GC255-3, Forklift, Repairs Category: 56075-00 Unit of Measure: Hour Unit Price: $ 100.00 Line: 39 Number of Units: 1 Total: $ 100.00 Description: Group 10: Monthly Maintenance / Yearly Inspection for Daewoo Forklifts, per Specifications, Section, 3.0 Category: 56075-00 Unit of Measure: Each Unit Price: $ 145.00 Line: 40 Number of Units: 1 Total: $ 145.00 Page 14 of 45 Description: Group 10: Percent Discount Off Parts Catalog for Daewoo Equipment (percent discount expressed as decimal, i.e. 10% = .10) Category: 56075-00 Unit of Measure: Each Unit Price: $ .05 Number of Units: 1 Total: $ .05 Page 15 of 45