HomeMy WebLinkAboutBid ResponseSTATEMENT OF NO RESPONSE
RFP #2013-32
FOR PROPOSERS SUBMITTING TO THIS OPPORTUNITY, YOU MAY
WRITE "N/A" ON THIS FORM.
If you are not proposing on this service/commodity, please complete and return this form to:
City of Doral — City Manager's Office 8401 NW 53rd Terrace, Doral, FL 33166. Failure to respond
may result in deletion of your firm's name from the qualified vendor list for the City of Doral.
COMPANY NAME:
ADDRESS:
TELEPHONE:
SIGNATURE:
DATE:
/P
We, the undersigned have declined to submit a Bid/Proposal on the above because of the
following reasons:
Specifications/Scope of Work too "tight", i.e., geared toward brand
or manufacturer only (explain below)
Insufficient time to respond
We do not offer this product, service or an equivalent
Our schedule would not permit us to perform
Unable to meet bond requirements
Specifications unclear (explain below)
Other (specify below)
REMARKS:
33
SECTION 4 - PROPOSAL SUBMITTAL FORM
RFP #2013-32
THIS PROPOSAL IS SUBMITTED TO:
City of Doral
8401 NW 53'd Terrace
Doral, Florida 33166
1. The undersigned Proposer proposes and agrees, if this RFP is accepted, to enter into an
agreement with The City of Doral to perform and furnish all goods and/or services as specified
or indicated in the Contract Documents for the Contract Price and within the Contract Time
indicated in this RFP and in accordance with the other terms and conditions of the Contract
Documents.
2. Proposer accepts all of the terms and conditions of the Advertisement or Request for Proposal
and Instructions to Proposers, including without limitation those dealing with the disposition of
RFP Security. This RFP will remain subject to acceptance for 90 days after the day of RFP
opening. Proposer agrees to sign and submit the Agreement with the Bends and other
documents required by the RFP Requirements within ten days after the date of City's Notice of
Award.
3. In submitting this Proposal, Proposer represents, as more fully set forth in the Agreement, that:
(a) Proposer has examined copies of all the RFP Documents and of the following Addenda
(receipt of all which is herebylacknowledged.)
Addendum No. �� / Dated:
Addendum No. Dated:
Addendum No. Dated:
Addendum No. Dated:
(b) Proposer has familiarized themselves with the nature and extent of the Contract
Documents, required goods and/or services, site, locality, and all local conditions and
Law and Regulations that in any manner may affect cost, progress, performance, or
furnishing of the Work.
(c) Proposer has studied carefully all reports and drawings of subsurface conditions and
drawings of physical conditions.
(d) Proposer has obtained and carefully studied (or assumes responsibility for obtaining and
carefully studying) all such examinations, investigations, explorations, tests and studies
28
(in addition to or to supplement those referred to in (c) above) which pertain to the
subsurface or physical conditions at the site or otherwise may affect the cost, progress,
performance, or furnishing of the Work at the Contract Price, within the Contract Time
and in accordance with the other terms and conditions of the Contract Documents, and
no additional examinations, investigations, explorations, tests, reports or similar
information or data are or will be required by Proposer for such purposes.
(e) Proposer has correlated the results of all such observations, examinations,
investigations, explorations, tests, reports, and studies with the terms and conditions of
the Contract Documents.
(f) Proposer has given the City written notice of all conflicts, errors, discrepancies that it has
discovered in the Contract Documents and the written resolution thereof by the City is
acceptable to Proposer.
(g) This Proposal is genuine and not made in the interest of or on behalf of any undisclosed
person, firm or corporation and is not submitted in conformity with any agreement or
rules of any group, association, organization, or corporation; Proposer has not directly
or indirectly induced or solicited any other Proposer to submit a false or sham Proposal;
Proposer has not solicited or induced any person, firm or corporation to refrain from
submitting a proposal. Proposer has not sought by collusion to obtain for itself any
advantage over any other Proposer or over the City.
4. Proposer understands that the quantities provided are only provided for bid evaluation only.
The actual quantities may be higher or lower than those in the bid form.
5. Proposer understands and agrees that the Contract Price is a Unit Price Contract to furnish and
deliver all of the Work complete in place. As such the Contractor shall furnish all labor,
materials, equipment, tools superintendence, and services necessary to provide a complete
Service for the proposal price of:
29
Item
1
Description
Cleaning of Catch Basin
Quantity
2,060
Unit
EA
Unit Price
/ ( S cf2-
Amount
%G,i 700--
2
Cleaning of Manhole
525
EA
/ q S
/0 2 3.7_
3
Cleaning of Slab -Covered -Trench Box
71
EA
/ G:/ S' c`
/ ? p• y�
JiO
4
Cleaning of Outfall Structure
84
EA
/ ! cL
/‘ 3go
5
Cleaning of Pipe
274,000
LF
r S O
/ 6ov-
7
/
6
Emergency Vac -Truck (includes operator)
160
HR
/ Cr, Uu-
Z LJ fee) —
PROPOSAL TOTAL �/UQ--
l
6. Proposer agrees that the work will be completed as scheduled from the date stipulated in the
Notice to Proceed.
7. Communications concerning this Proposal shall be addressed to:
Proposer: EnviroWaste Services Group, Inc.
Address:
Telephone
Facsimile Number
Attention:
4 SE 1st Street, Second Floor
Miami, FL 33131
(305) 637-9665
(305) 637-9659
Eduardo Barba, President
30
8. The terms used in this RFP which are defined in the General Conditions of the Contract included
as part of the Contract documents have the meanings assigned to them in the General
Conditions
STATEMENT
I understand that a "person" as defined in Para. 287.133(1)(e), Florida Statutes, means any natural
person or entity organized under the laws of any state or of the United States with the legal power to
enter into a binding Contract and which Proposals or applies to Propose on Contracts for the provision
of goods or services let by a public entity, or which otherwise transacts or applies to transact business
with a public entity. The term "persons" includes those officers, directors, executives, partners,
shareholders, employees, members, and agents who are active in management of any entity.
SUBMITTED THIS
3 DAY A.juA•
Person Authorized to sign Bid/RFP:
Signature:
Print Name: Eduardo Barba
Title:
Company Name:
Company Address:
,201`I.
President
EnviroWaste Services Group, Inc.
4 SE 1st Street, Second Floor
Miami, FL 33131
Phone: (305) 637-9665 Fax: (305) 637-9659 Email: eddy.barba@envirowastesg.com
31
PROPOSER INFORMATION WORKSHEET
RFP #2013-32
COMPANY/AGENCY/FIRM NAME: EnviroWaste Services Group, Inc.
ADDRESS: 4 SE 1st Street, Second Floor, Miami, FL 33131
BUSINESS EMAIL ADDRESS: info@envirowastesg.com PHONE No.: (305) 637-9665
CONTACT PERSON & TITLE: Eduardo Barba, President
CONTACT EMAIL ADDRESS: eddy.barba@envirowastesg.com PHONE No.: (305) 637-9665
BUSINESS HOURS: Monday - Friday 8:30 AM - 5:30 PM (Corporate Office Hours)
BUSINESS LEGAL STATUS: (circle one)
CORPORATION
/ PARTNERSHIP / JOINT VENTURE / LLC
BUSINESS IS A: (circle one) PARENT / SUBSIDIARY / OTHER
DATE BUSINESS WAS ORGANIZED/INCORPORATED: February 1998 2-//3//14 Q' ,►ioe
r Sy.,.
ADDRESS OF OFFICE WHERE WORK IS TO BE DONE FOR THIS PROJECT
(If different from address provided above):
INDIVIDUALS(S) AUTHORIZED TO MAKE REPRESENTATIONS
Miguel Garcia
(First, Last Name)
Jose Polanco
(First, Last Name)
Operations Manager
(Title)
Project Manager
(Title)
(First, Last Name) (Title)
CONTACT'S SIGNATURE:
35
FOR THE BIDDER:
(305) 796-9357
(Contact Phone Number)
(786) 546-7722
(Contact Phone Number)
(Contact Phone Number)
DATE: //V/V
PROPOSER QUALIFICATION STATEMENT
RFP #2013-32
The Bidder's/Proposer's response to this questionnaire will be utilized as part of the City's
overall Bid/Proposal Evaluation to ensure that the Bidder/Proposer meets, to the satisfaction of
the City of Doral, the minimum requirements for participating in this solicitation.
The following minimum experience is required for this project: refer to applicable sections 2.2,
4 and 5 of this RFP.
ON THE FORM BELOW, BIDDER/PROPOSER MUST PROVIDE DETAILS
FULFILLING ABOVE MINIMUM EXPERIENCE REQUIREMENTS. IT IS
MANDATORY THAT BIDDERS USE THIS FORM IN ORDER TO INDICATE THAT
THE MINIMUM EXPERIENCE REQUIREMENT IS MET. NO EXCEPTIONS WILL BE
MADE.
1. Project Name/Location
Owner Name
Contact Person
Contact Telephone No.
Email Address:
Yearly Budget/Cost
Dates of Contract
Cv 6)
�:royo
3 os-5673-672s
Gfir!uS. L�'�yo e
CITDC ciGrAI,Cdh
From:/ /A j/ 7,607 To: Cc.����
(Continues below)
36
2. Project Name/Location
Owner Name
Contact Person
Contact Telephone No.
Email Address:
Yearly Budget/Cost
Dates of Contract
3. Project Name/Location
Owner Name
Contact Person
Contact Telephone No.
Email Address:
Yearly Budget/Cost
Dates of Contract
(l,a-W 13&,,-, 14A tlenAwce
-7 4dA)o C_I /t,- 14,4,7
303—- 2. 5f-'VZ C Z
fGa-+Ue�L. I� e 7
l
Ae6ui�h'ce cti/(may- 'l y6L1
2-7SCx)o
From: l 0 /Og-
To: Cc, rrs„ >L
S1�U.44 arA L..fe,„,
17/ c , ;AHI
Ei/ rshve z
3c.sq/r;/Z/7
eesfCvez .urAAA! ov. Co/'l
7e 60d 000 Or -440r4-
From: ZOO 3 To: Curie-, 'L
37
f0.
4. Project Name/Location Stormwater System Inspection, Cleaning, Sealing
Owner Name
Contact Person
Contact Telephone No.
Email Address:
Yearly Budget/Cost
Dates of Contract
S. Project Name/Location
Owner Name
Contact Person
Contact Telephone No.
Email Address:
Yearly Budget/Cost
Dates of Contract
Orange County Florida
Charles West
407-836-7876
charles.west2@ocfl.net
$1, 700, 000
From: May 2007 To: Current
Horizontal Job Order Contract, Stormwater Cleaning
City of Miami Beach
Mike Alvarez
786-367-6109
mikealvarezPmiamibeachfl.gov
$500,000(just in Stormwater) >S2M overall
From: April 2008 To: current
37
6. Project Name/Location Catch Basin Maintenance
Owner Name Village of Pinecrest
Contact Person Dan Moretti
Contact Telephone No. 305-669-6916
Email Address: dmoretti@pinecrest-fl.gov
Yearly Budget/Cost $75,000
Dates of Contract From: 1998 To: Current
7. Project Name/Location S-847 Lining by the Sectional Method
Owner Name Miami Dade County
Contact Person Miguel Pichardo
Contact Telephone No. 786-258-2573
Email Address: mpich@miamidade.gov
Yearly Budget/Cost $750,000
Dates of Contract From: 2006 To: current
37
BUSINESS ENTITY AFFIDAVIT
VENDOR / BIDDER/PROPOSER DISCLOSURE
RFP #2013-32
1, Eduardo Barba , being first duly sworn state:
The full legal name and business address of the person(s) or entity contracting or transacting
business with the City of Doral ("City") are (Post Office addresses are not acceptable), as
follows:
65-0829090
Federal Employer Identification Number (If None, Social Security Number)
EnviroWaste Services Group, Inc.
Name of Entity, Individual, Partners, or Corporation
Doing business as (if some as above, leave blank)
4 SE 1st Street Second Floor Miami FL 33131
Street Address Suite City State Zip Code
OWNERSHIP DISCLOSURE AFFIDAVIT
1. If the contact or business transaction is with a corporation, the full legal name and
business address shall be provided for each officer and director and each stockholder
who holds directly or indirectly five percent (5%) or more of the corporation's stock. If
the contract or business transaction is with a trust, the full legal name and address shall
be provided for each trustee and each beneficiary. All such names and addresses are
(Post Office addresses are not acceptable), as follows:
Full Legal Name Address Ownership
Eduardo Barba - 4 SE 1st Street, Second Floor, Miami, FL 33131 44.5% aia
Ralph Barba - 4 SE 1st Street, Second Floor, Miami, FL 33131 44.5% a�
Julio Fojon - 4 SE 1st Street, Second Floor, Miami, FL 33131 11.0% %
38
2. The full legal names and business address of any other individual (other than
subcontractors, material men, suppliers, laborers, or lenders) who have, or will have,
any interest (legal, equitable, beneficial or otherwise) in the contract or business
transaction with the City are as follows (Post Office addresses are not acceptable):
// / 3,/i y
Signature of Affiant Date
Eduardo BArba
Printed Name of Affant
Sworn to and subscribed before me this / 3 day of T .,t-7 , 20 / v
® Personally known, or
0 Produced identification
Type of Identification
Notary Public - State of Florida
My c%•���, fission expires: 11/15/2014
Ogo
Notary _ re
(Printed, typed, or stamped commissioned name of Notary Public)
39
JELEANY MESA
r MY COMMISSION # EE862392
EXPIRES November 15, 2014
(4O7iiai-0+53 Nosryotrm.le..00m
AMERICANS WITH DISABILITIES ACT (ADA)
DISABILITY NONDISCRIMINATION STATEMENT
RFP #2013-32
THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR
OTHER OFFICIAL AUTHORIZED TO ADMINISTER OATHS.
This sworn statement is submitted to the City Of Doral, Florida
by: Eduardo Barba, President
(Print individual's name and title)
for: EnviroWaste Services Group, Inc.
(Print name of entity submitting sworn statement)
whose business address is: 4 SE 1st Street, Second Floor, Miami, FL 33131
and (if applicable) its Federal Employer Number (FEIN) is: 63-0829090
Of the entity has no FEIN, include the Social Security Number of the individual signing this sworn
statement:
I, being duly first sworn state:
That the above named firm, corporation or organization is in compliance with and agreed to
continue to comply with, and assure that any subcontractor, or third party contractor under
this project complies with all applicable requirements of the laws listed below including, but not
limited to, those provisions pertaining to employment, provision of programs and services,
transportation, communications, access to facilities, renovations, and new construction.
The American with Disabilities Act of 1990 (ADA), Pub. L. 101-336, 104 Stat 327, 42 USC
1210112213 and 47 USC Sections 225 and 661 including Title I, Employment; Title II, Public
Services; Title III, Public Accommodations and Services Operated by Private entities; Title IV,
Telecommunications; and Title V, Miscellaneous Provisions.
The Florida Americans with Disabilities Accessibility Implementation Act of 1993, Section
553.501 553.513, Florida Statutes:
The Rehabilitation Act of 1973, 229 USC Section 794;
The Federal Transit Act, as amended 49 USC Section 1612;
The Fair Housing Act as amended 42 USC Section 3601-3631.
40
SIGNATURE
Sworn to and subscribed before me this / 3 day of a �N� r , 20/ `/ .
O Personally known, or
❑ Produced identification
Type of Identification
Notary Public - State of Florida
My commysion expires: 11/15/2014
Notary Srgnaa ure
(Printed, typed, or stamped commissioned name of Notary Public)
41
JELEANy MESA
•r MY COMMISSION # EE862392
• oi• EXPIRES November 15. 2014
I4oly3•ot53 ►+oervor^ oom
NON -COLLUSION AFFIDAVIT
RFP #2013-32
State of Florida )
) SS:
County of Miami -Dade )
Eduardo Barba being first duly sworn, deposes and says that:
(1) He/She/They is/are the President
(Owner, Partner, Officer, Representative or Agent) of EnviroWaste Services Group, Inc. the
BIDDER that has submitted the attached Bid;
(2) He/She/They is/are fully informed respecting the preparation and contents of the attached Bid
and of all pertinent circumstances respecting such Bid;
(3) Such Bid is genuine and is not a collusive or sham Bid;
(4) Neither the said BIDDER nor any of its officers, partners, owners, agents, representatives,
employees or parties in interest, including this affiant, have in any way colluded, conspired, connived or
agreed, directly or indirectly, with any other BIDDER, firm, or person to submit a collusive or sham Bid in
connection with the Work for which the attached Bid has been submitted; or to refrain from bidding in
connection with such Work; or have in any manner, directly or indirectly, sought by agreement or
collusion, or communication, or conference with any BIDDER, firm, or person to fix any overhead, profit,
or cost elements of the Bid or of any other BIDDER, or to fix any overhead, profit, or cost elements of
the Bid Price or the Bid Price of any other BIDDER, or to secure through any collusion, conspiracy,
connivance, or unlawful agreement any advantage against (Recipient), or any person interested in the
proposed Work;
(5) The price or prices quoted in the attached Bid are fair and proper and are not tainted by any
collusion, conspiracy, connivance, or unlawful agreement on the part of the BIDDER or any other of its
agents, representatives, owners, employees or parties in interest, including this affiant.
Signed, sealed and delivered in the presence of;
Eduardo Barba
(Printed Name)
42
By:
President
(Title)
ACKNOWLEDGMENT
State of Florida
County of Miami -Dade
On this the / 3 day of .),A.-ir°,,y , 20 / i , before me, the undersigned Notary Public of The
State of Florida, personally appeared
Eduardo Barba and
(Name(s) of individual(s) who appeared before notary)
Whose name(s) is/are Subscribed to the within instrument, and he/she/they acknowledge that he/she/they
executed it.
WITNESS my hand and official seal.
NOTAR' ' UBLIC, STATE OF FLORIDA
NOTARY PUBLIC:
SEAL OF OFFICE:
Jeleany Mesa
JELEANY MESA
MY COMMISSION • EE662362
EXPIRES Wangler 16, 2014
tutriNitoss
(Name of Notary Public: Print, Stamp, or Type as Commissioned.)
0 Personally known to me, or
0 Personally identification:
(Type of Identification Produced)
®DID take an oath, or
❑ DID NOT take an oath.
OPTIONAL INFORMATION:
Type of Document: Number of Pages:
Number of Signatures Notarized:
43
SWORN STATEMENT PURSUANT TO SECTION 287.133(3)(a)
FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES
RFP #2014-32
THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER
OFFICIAL AUTHORIZED TO ADMINISTER OATHS. 1. This sworn statement is submitted to r t/do Do, -,A /
by Eduardo Barba for EnviroWaste Services Group, Inc. whose
business address is 4 SF 1st Street Secnnri F(nnr, MiemL Fi 33131 and (if applicable) its
Federal Employer Identification number (FEIN) is 65-0829090 . If the entity has no
FEIN, include the Social Security Number of the individual signing this sworn statement:
2. I understand that a "public entity crime" as defined in Paragraph 287.133(1)(g), Florida Statutes,
means a violation of any state or federal law by a person with respect to and directly related to the
transaction of business with any public entity or with an agency or political subdivision of any other
state or with the United States, including, but not limited to, any Bid or Contract for goods or services to
be provided to any public entity or an agency or political subdivision of any other state of the United
States and involving antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material
misrepresentation.
3. I understand that "convicted" or "conviction" as defined in Para. 287.133(1)(b), Florida .Statutes,
means a finding of guilt or a conviction of a public entity crime, with or without an adjudication of guilt,
in any federal or state trail court of record relating to charges brought by indictment or information
after July 1, 1989, as a result of a jury verdict, non -jury trial, or entry of a plea of guilty or nolo
contendere.
4. I understand that an "affiliate" as defined in Para. 287.133(1)(a), Florida Statutes, means:
1. A predecessor or successor of a person convicted of a public entity crime; or
2. Any entity under the control of any natural person who is active in the management of
the entity and who has been convicted of a public entity crime. The term "affiliate"
includes those officers, directors, executors, partners, shareholders, employees,
members, and agents who are active in the management of an affiliate. The ownership
by one person of shares constituting a controlling interest in another person, or a
pooling of equipment or income among persons when not for fair market value under
an arm's length agreement, shall be a prime facie case that one person controls another
person. A person who knowingly enters into a joint venture with a person who has
been convicted of a public entity crime in Florida during the preceding 36 months shall
be considered an affiliate.
5. I understand that a "person" as defined in Para. 287.133(1)(e), Florida Statutes, means any
natural person or entity organized under the laws of any state or of the United States with the legal
power to enter into a binding Contract and which Bids or applies to Bid on Contracts for the provision of
goods or services let by a public entity, or which otherwise transacts or applies to transact business with
44
a public entity. The term "persons" includes those officers, directors, executives, partners, shareholders,
employees, members, and agents who are active in management of any entity.
6. Based on information and belief, the statement which I have marked below is true in relation to
the entity submitting this sworn statement. (Indicate which statement applies.)
Neither the entity submitting this sworn statement, nor any of it's officers, directors,
executives, partners, shareholders, employees, members, or agents who are active in the management
of the entity, nor any affiliate of the entity has been charged with and convicted of a public entity crime
subsequent to July 1, 1989.
The entity submitting this sworn statement, or one or more of its officers, directors,
executives, partners, shareholders, employees, members, or agents who are active in the management
of the entity, or an affiliate of the entity has been charged with and convicted of a public entity crime
subsequent to July 1, 1989.
The entity submitting this sworn statement, or one or more of its officers, directors,
executives, partners, shareholders, employees, members, or agents who are active in the management
of the entity, or an affiliate of the entity has been charged with and convicted of a public entity crime
subsequent to July 1, 1989. However, there has been a subsequent proceeding before a Hearing Officer
of the State of Florida, Division of Administrative Hearings and the Final Order entered by the Hearing
Officer of the State cf Florida, Division of Administrative Hearings and the Final Order entered by the
Hearing Officer determined that it was not in the public interest to place the entity submitting this
sworn statement on the convicted vendor list. (Attach a copy of the final order)
I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR THE PUBLIC
ENTITY IDENTIFIED IN PARAGRAPH 1 (ONE) ABOVE IS FOR THAT PUBLIC ENTITY ONLY AND, THAT THIS
FORM IS VALID THROUGH DECEMBER 31 OF THE CALENDAR YEAR IN WHICH IT IS FILED. I ALSO
UNDERSTAND THAT I AM REQUIRED TO INFORM THE PUBLIC ENTITY PRIOR TO ENTERING INTO A
CONTRACT IN EXCESS OF THE THRESHOLD AMOUNT PROVIDED IN SECTION 287.017, FLORIDA
STATUTES, FOR CATEGORY TWO OF ANY, CHANGE IN THE INFORMATION CONTAINED IN THIS FORM.
By:
Eduardo Barba
(Printed Name)
President
(Title)
45
Sworn to and subscribed before me this day of , 20 /V .
® Personally known, or
0 Produced Identification
(Type of Identification)
Notary Public — State of Florida
My Comm, n Expires 11/15/2014
JELEANY MESA
: .r. MY COMMISSION # EE862392
EXPIRES November 15, 2014
(407)3ee.ol53 ►+otrvot 'erlos en
(Notary Sirra't`ure)
(Printed, typed, or stamped commission name of notary public)
46
DRUG -FREE WORKPLACE PROGRAM
RFP #2013-32
IDENTICAL TIE PROPOSALS — Preference shall be given to businesses with drug -free workplace programs.
Whenever two or more proposals which are equal with respect to price, quality, and service are
received by the State or by any political subdivision for the procurement of commodities or contractual
services, a proposal received from a business that certifies that it has implemented a drug -free
workplace program shall be given preference in the award process. Established procedures for
processing tie proposals will be followed if none of the tied vendors have a drug -free workplace
program. In order to a have a drug -free workplace program, a business shall:
1. Publish a statement notifying employees that the unlawful manufacture, distribution,
dispensing, possession, or use of a controlled substance is prohibited in the workplace and specifying
the actions that will be taken against employees for violations of such prohibition.
2. Inform Employees about the dangers of drug abuse in the workplace, the business'
policy of maintaining drug -free workplace, any available drug counseling, rehabilitation, and
employee assistance programs, and the penalties that may be imposed upon employees for drug
abuse violations.
3. Give each employee engaged in providing the commodities or contractual services that
are under bid a copy of the statement specified in subsection (1).
4. In the statement specified in subsection (1), notify the employees that, as a conditions
of working on the commodities or contractual services that are under bid, the employee will abide by
the terms of the statement and will notify the employer of any conviction of, or plea of guilty or nolo
contendere to, any violation of chapter 893 or of any controlled substance law of the United States or
any state, for a violation occurring in the workplace no later than five (5) days after such conviction.
5. Impose a sanction on, or require the satisfactory participation in a drug abuse assistance
or rehabilitation program if such is available in the employee's community, by any employee who is so
convicted.
5. Make good faith effort to continue to maintain a drug -free workplace through
implementation of this section.
As the person authorized to sign the statement, I certify that this firm complies fully with the above
requirements.
EnviroWaste Services Group, Inc.
VENDOR'S SIGNATURE NAME OF COMPANY
Eduardo Barba
VENDOR PRINT NAME
47
COPELAND ACT ANTI -KICKBACK AFFIDAVIT
RFP #2013-32
STATE OF Florida }
} SS:
COUNTY OF Miami -Dade 1
I, the undersigned, hereby duly sworn, depose and say that no portion of the sum herein bid will be paid
to any employees of the City of Doral, its elected officials, and or
its design consultants, as a commission, kickback, reward or gift, directly or indirectly by me or any
member of my firm or by an officer of the corporation.
Sworn and subscribed before this
/3 day of
Jeleany Mesa
,20 /V
(Printed Name)
My commission expires: 11/15/2014
48
By:
Title: P
sident
JELEANY MESA
•`: MY COMMISSION* EE862392
EXPIRES November 15, 2014
(401 -0153 Notry0t meAoa.oem
of
EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION
RFP #2013-32
Eduardo Barba President
(Individual's Name) (Title)
EnviroWaste Services Group, inc. do hereby certify that
(Name of Company)
I have read and understand the Compliance with Equal Employment Opportunity requirements
set forth under sub -section 2.14.3 of this document.
Attachment of this executed form, as such, is required to complete a valid bid proposal.
Individual's Signature
Date
49
CONE OF SILENCE CERTIFICATION
RFP #2013-32
Eduardo Barba President
of
(Individual's Name) (Title)
EnviroWaste Services Group, Inc. do hereby certify that
(Name of Company)
I have read and understand the terms set forth under Section 1.11 of this document titled
"Cone of Silence".
Attachment of this executed form, as such, is required to complete a valid bid proposal.
Individual's Signature
//0/
Date
50
TIE PROPOSAL CERTIFICATION
RFP #2013-32
Eduardo Barba President
(Individual's Name) (Title)
of EnviroWaste Services Group, Inc. do hereby certify that
(Name of Company)
I have read and understand the requirements/procedures for Tie Bids set forth under sub-
section 2.14.5 of this document.
Attachment of this executed form, as such, is required to complete a valid bid proposal.
Individual's Signature
441//v
Date
51
PROPOSER'S CERTIFICATION
RFP #2013-32
I have carefully examined the Request for Proposal, Instructions to Bidders, General and/or Special Conditions,
Vendor's Notes, Specifications, proposed agreement and any other documents accompanying or made a part of
this Request for Proposal.
I hereby propose to furnish the goods or services specified in the Request for Proposal. I agree that my proposal
will remain firm for a period of 365 days in order to allow the City adequate time to evaluate the proposals.
I certify that all information contained in this proposal is truthful to the best of my knowledge and belief. I further
certify that I am duly authorized to submit this proposal on behalf of the firm as its act and deed and that the firm
is ready, willing and able to perform if awarded the contract.
I further certify, under oath, that this proposal is made without prior understanding, agreement, connection,
discussion, or collusion with any other person, firm or corporation submitting a proposal for the same product or
service; no officer, employee or agent of the City of Doral or any other proposer is interested in said proposal; and
that the undersigned executed this Proposer's Certification with full knowledge and understanding of the matters
therein contained and was duly authorized to do so.
A person or affiliate who has been placed on the convicted vendor list following a conviction for public entity
crimes may not submit a bid on a contract to provide any goods or services to a public entity, may not submit a bid
on a contract with a public entity for the construction or repair of a public building or public work, may not submit
bids on leases of real property to public entity, may not be awarded or perform work as a contractor, supplier, sub-
contractor, or consultant under a contract with a public entity , and may not transact business with any public
entity in excess of the threshold amount provided in Sec. 287.017, for CATEGORY TWO for a period of 36 months
from the date of being placed on the convicted vendor list.
Envirowaste Services Group, Inc.
Name of Business
By:
Signature
Eduardo Barba, President
Name and Title, Typed or Printed
4 SE lst Street, Second Floor
Sworn to and subscribed before me
this / 3 day of ,20 / 7
Mailing Address Notary ublic
Miami, FL 33131 STATE OF Florida
City, State and Zip Code
(305) 637-9665
Telephone Number
,f:
JELEANY MESA
MY COMMISSION # EE862392
s EXPIRES November 15.2014
(407)3964tM3 No ypv,meda.00m
11 /15/2014
My Commission Expires
ACKNOWLEDGEMENT OF ADDENDUMS: ISSUED ADDENDUMS MUST BE SIGNED AND SUBMITTED WITH BID.
52
STATE OF Florida
COUNTY OF Miami -Dade
SS:
)
CERTIFICATE OF AUTHORITY
(IF CORPORATION)
I HEREBY CERTIFY that a meeting of the Board of Directors of EnviroWaste Services Group, lac.
a Corporation existing under the laws of the State of Florida , held on Sy - 2 t , 20 //
the following resolution was duly passed and adopted:
"RESOLVED, that, as President of the Corporation, be and is hereby authorized to execute the Proposal dated,
r f `) 20 f `% , to the City of Doral and this Corporation and that their execution thereof,
attested by the Secretary of the Corporation, and with the Corporate Seal affixed, shall be the official act and deed
of this Corporation."
I further certify that said resolution is now in full force and effect.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed the official seal of the Corporation this / `' . day
of J14+ , 20 1./ .
Secretary:
(SEAL)
53
CERTIFICATE OF AUTHORITY
(IF PARTNERSHIP)
STATE OF
SS:
COUNTY OF
1 HEREBY CERTIFY that a meeting of the Partners of
a Corporation existing under the laws of the State of , held on , 20 the
following resolution was duly passed and adopted:
"RESOLVED, that, , as of the
Partnership, be and is hereby authorized to execute the Proposal dated,
20 , to the City
of Doral and this partnership and that their execution thereof, attested by the
shall be the official act and deed of this Partnership."
I further certify that said resolution is now in full force and effect.
IN WITNESS WHEREOF, I have hereunto set my hand this , day of , 20
Secretary:
(SEAL)
54