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Certification Statement Please quote on this form. if applicable, net prices for the item(s) listed. Return signed original and retain a copy for your files. Prices should include all costs, including transportation to destination. The City reserves the right to accept or reject all or any part of this submission. Prices should be firm for a minimum of 180 days following the time set for closing of the submissions. In the event of errors in extension of totals, the unit prices shall govern in determining the quoted prices. We (I) certify that we have read your solicitation, completed the necessary documents, and propose to furnish and deliver, F.O.B. DESTINATION, the items or services specified herein. The undersigned hereby certifies that neither the contractual party nor any of its principal owners or personnel have been convicted of any of the violations, or debarred or suspended as set in section 18-107 or Ordinance No. 12271. All exceptions to this submission have been documented in the section below (refer to paragraph and section). EXCEPTIONS: We (I) certify that any and all information contained in this submission is true; and we (I) further certify that this submission is made without prior understanding, agreement, or connection with any corporation, 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 conditions of this solicitation and certify that I am authorized to sign this submission for the submitter. Please print the following and sign your name: PROPOSER NAME• son k ADDRESS. Ji ? - \n PHONE: 110 r 49K " 00e 0 FAX: -,;,g'1,-8"��8� EMAIL: Gi rt :Qcrt�V:C'S.Cr'm CELL(Optional)- SIGNED BY: TITLE: ec-2;CIP0 DATE. 1 1 - FAILURE TO COMPLETE, SIjN. ANI) RETURN THIS FORM SHALL. DISOU-ALIFI' THIS RESPONSE. Page 2 of 44 Certifications Legal Name of Finn: (-ncae\-‘C `P02;3o Tn esfo- ono,i -En( Entity Type: Partnership, Sole Proprietorship, Corporation, etc. e CCX cXn c� n Year Established: \got+ Federal Employer Identification Number (FEIN) Office Location: City of Miami, Miami -Dade County, or Other Siruac L Occupational License/Business Tax Receipt Number: ICCf s—CIO() Occupational License/Business Tax Receipt Issuing Agency: Occupational License/Business Tax Receipt Expiration Date: Will [Subcontractor(s) be used? (Yes or No) Nc If subcontractor(s) will be utilized, provide their name, address and the the portion of the work they \N ill be responsible for under this contract (a copy of their license(s) must be submitted with your bid response): 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. nn urn N o. ( (75Q383, 1‘) , 11 /3/I1 If Bidder has a Local Office. as defined under Chapter 18/Articlle I11, 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) Page 3 of 44 1\I 1 A Reference No. 1: Name of Company/Agency for which bidder is currently providing the services/goods asdescribed +in this solicitation, or has provided such services/goods in the past: f L. Reference No. 1: Address, City, State, and Zip for above referenced company/agency listed: qNCO Q5-r -. to13 {,���,; 331,ig Reference No. 1: Name of Contact Person and Telephone Number for above referenced No. 1 c , !La (30S) 4'1 I - a9 3°1 Reference No. 1: Date of Contract or Sale for above referenced No. 1 +0 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: 14� e0 b0 Reference No. 2: Address, City, State, and Zip for above referenced company/agency listed: (98' 1 (_) n- -er\cr 1-cn\Ae elnr ,'L_ -33 'o 1 Reference No. 2: Name of Contact Person and Telephone Number for above referenced No. 2 Reference No. 2: Date of Contract or Sale for above referenced No. 2 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: Reference No, 3: Address. City, State, and Zip for above referenced company/agency listed: 13 a© (53. (Jce,)o Cs ?i ,) 8, - 4 . Lao Agsc_ \P, L Reference No. 3: Name of Contact Person and Telephone Number for above referenced No. 3 cC)anrian- %tcc f q54 ea-6-fg" Reference No. 3: Date of Contract or Sale for above referenced No. 3 Page 4 of 44 Line: 1 Description: Police Vehicle Decals, Police Department Seal: 2" Diameter Seal Refer to Section 3. Specifications, for more details. Category: 25528-00 Unit of Measure: Each Unit Price: $ Line: 2 Number of Units: 1 Total: $ 0" Jo, Description: Police Vehicle Decals, Police Department Seal: 3" Diameter Seal Refer to Section 3. Specifications, for more details. Category: 25528-00 Unit of Measure: Each Unit Price: $ t . 5D 0 Line: 3 Number of Units: 1 Total: $ (). 5 0 Description: Police Vehicle Decals, Police Department Seal: 10" Diameter Seal Refer to Section 3. Specifications, for more details. Category: 25528-00 Unit of Measure: Each Unit Price: $ c . ge Number of Units: 1 Total: $ (9- Zg/ Line: 4 Description: Police Vehicle Decals, Police Department Seal: 12" Diameter Seal Refer to Section 3. Specifications, for more details. Category: 25528-00 Unit of Measure: Each Unit Price: $ �J• Line: 5 Number of Units: 1 Total: $_j 'c3C Description: Police Vehicle Decals, Police Department Seal: 13" Diameter Seal Page 5 of 44 Refer to Section 3. Specifications, for more details. Category: 25528-00 Unit of Measure: Each Unit Price: $ A.50 Line: 6 Number of Units: 1 Total: $ 4. i C Description: Police Vehicle Decals, Police Department Seal: 13.5" Diameter Seal Refer to Section 3. Specifications, for more details. Category: 25528-00 Unit of Measure: Each Unit Price: $ 10. ei Line: 7 Number of Units: 1 Total: $ 10.4 Description: Police Vehicle Stripes (per roll for one car) Refer to Section 3. Specifications, for more details. Category: 25528-00 Unit of Measure: Each Unit Price: $ '311 .00) Number of Units: 1 Total: $ Line: 8 Description: Police Vehicle Roof Numbers Refer to Section 3. Specifications, for more details. Category: 25528-00 Unit of Measure: Each Unit Price: $ 4. 0o Line: 9 Number of Units: 1 Total: $ 4.00 Description: Police and General Fleet Vehicles Side and Rear Numbers Refer to Section 3. Specifications, for more details. Category: 25528-00 Page 6 of 44 Unit of Measure: Each Unit Price: $ ( Number of Units: 1 Total: $ 0 c c Line: 10 Description: Police Vehicle Trunk Lettering: MIAMI Refer to Section 3. Specifications, for more details. Category: 25528-00 Unit of Measure: Each Unit Price: $ . Line: 11 Number of Units: 1 Total: $ 1 ,o< Description: Police Vehicle Trunk Lettering: POLICE Refer to Section 3. Specifications, for more details. Category: 25528-00 Unit of Measure: Each Unit Price: $ 1. Qp Line: 12 Number of Units: 1 Total: $ . q D Description: Police Vehicle Right and Left Quarter Panels Lettering: POLICE Refer to Section 3. Specifications, for more details. Category: 25528-00 Unit of Measure: Each Unit Price: $ S .9 Line: 13 Number of Units: 1 Total: $ -C 5 Description: Police Vehicle Right and Left Quarter Panels Lettering: "Professional Law Enforcement" Refer to Section 3. Specifications, for more details. Category: 25528-00 Unit of Measure: Each Page 7 of 44 Unit Price: $.(�`� Line: 14 Number of Units: 1 Total: $J Description: Price per Square Foot of 3M brand 680 Scotchlite High Performance Reflective Vinyl Film with Scotchlite Controltac Adhesive backing. (NO SUBSTITUTION) Refer to Section 3. Specifications, for more details. Category: 25528-00 Unit of Measure: Square Foot Unit Price: $ Aq Line: 15 Number of Units: 1 Total: $ Description: Screen Print Labor for 3M brand 680 Scotchlite High Performance Reflective Vinyl Film with Scotchlite Controltac Adhesive backing. Refer to Section 3. Specifications, for more details. Category: 25528-00 Unit of Measure: Hour Unit Price: $ jD .00 Line: 16 Number of Units: I Total: $ a . CO Description: Production Labor Cost for 3M brand 680 Scotchlite High Performance Reflective Vinyl Film with Scotchlite Controltac Adhesive backing. Refer to Section 3. Specifications, for more details. Category: 25528-00 Unit of Measure: Hour Unit Price: $ 19.00 Line: 17 Number of Units: 1 Total: $ j 0 . : Description: Price per Square Foot of Refiexite DayBright High Performance Reflective Vinyl Film with UV Coat, NASDAR 9727 Mixing Overprint Clear Non Gas Resistant. Refer to Section 3. Specifications, for more details. Category: 25528-00 Unit of Measure: Square Foot Page 8 of 44 Unit Price: $� l 6 Line: 18 Number of Units: 1 Total: $ Description: Screen Print Labor for Reflexite DayBright High Performance Reflective Vinyl Film. Refer to Section 3. Specifications, for more details. Category: 25528-00 Unit of Measure: Hour Unit Price: $ 00 Number of Units: 1 I otai: $ CDC) Line: 19 Description: Production Labor Cost for Reflexite DayBright High Performance Reflective Vinyl Film. Refer to Section 3. Specifications, for more details. Category: 25528-00 Unit of Measure: Hour Unit Price: $ D. co Line: 20 Number of Units: I Total: $ 10 cJ Description: Police Vehicle Rear Center Door: LIEUTENANT must measure no more than 2" in height. Material shall be ready -to -install: 3M brand 680 Scotchlite High Performance Reflectii e VinylFilm with Scotchlite Controltac Adhesive backing. (NO SUBSTITUTION) Refer to Section 3. Specifications, for more details, Category: 25528-00 Unit of Measure: Each Unit Price: $ i Line: 21 Number of Units: I Total: $ (0), i J Description: Police Vehicle Rear Center Door: SERGEANT must measure no more than 2" in height. Material shall be ready -to -install: 3M brand 680 Scotchlite High Performance Reflective VinylFilm with Scotchlite Controltac Adhesive backing. (NO SUBSTITUTION) Refer to Section 3. Specifications, for more details. Page 9 of 44 Category: 25528-00 Unit of Measure: Each Unit Price: $ Number of Units: 1 Total: $ o Line: 22 Description: Police Vehicle Rear Center Door: K-9 UNIT must measure no more than 2" in height. Material shall be ready -to -install: 3M brand 680 Scotcblite High Performance Reflective VinylFilm with Scotcblite Controltac Adhesive backing. (NO SUBSTITUTION) Refer to Section 3. Specifications, for more details. Category: 25528-00 Unit of Measure: Each Unit Price: $ . k O Line: 23 Number of Units: 1 Total: $ 0 - 0 Description: Police Vehicle Rear Center Door: LIEUTENANT must measure no more than 2" in height. Material shall be ready -to -install: Reflexite DayBright High Performance Reflective Vinyl Film.(NO SUBSTITUTION) Refer to Section 3. Specifications, for more details. Category: 25528-00 Unit of Measure: Each Unit Price: $ ,9. SO Line: 24 Number of Units: 1 Total: $ g0 Description: Police Vehicle Rear Center Door: SERGEANT must measure no more than 2" in height. Material shall be ready -to -install: Reflexite DayBright High Performance Reflective Vinyl Film. (NO SUBSTITUTION) Refer to Section 3. Specifications, for more details. Category: 25528-00 Unit of Measure: Each Unit Price: $ , 4n Line: 25 Number of Units: 1 Total: $ .Q. `'l Page 10 of 44 Description: Police Vehicle Rear Center Door: K-9 UNIT must measure no more than 2" in height. Material shall be ready -to -install: Reflexite DayBright High Performance Reflective Vinyl Film.(NO SUBSTITUTION) Refer to Section 3. Specifications, for more details. Category: 25528-00 Unit of Measure: Each Unit Price: $ Line: 26 Number of Units: l Total: $ ! , on Description: Police Vehicle Rear Bumper Center: DOT Traffic Tape must measure 2" x 29" (11" red/ 7" white/ 11" red). Material shall be ready -to -install: 3M Reflective Conspicuity Marking Series #983-32. (NO SUBSTITUTION) Refer to Section 3. Specifications, for more details. Category: 25528-00 Unit of Measure: Each Unit Price: $ ) . �1 Line: 27 Number of Units: 1 Total: $ Description: Police Vehicle Rear Bumper Left/Right: DOT Traffic Tape must measure 2" x 18" (7" N hitei 11" red). Material shall be ready -to -install: 3M Reflective Conspicuity Marking Series #983-32. (NO SUBSTITUTION) Refer to Section 3. Specifications, for more details. Category: 25528-00 Unit of Measure: Each Unit Price: $ 1 • a 0 Line: 28 Number of Units: l Total: $ . Q Description: Police and General Fleet Vehicle Trunk: American Flag must measure 4" x 2.30". Material shall be ready -to -install: Screen printed Red/Blue on 3M brand 680 Scotchlite High Performance Rellectiv a Vinyl Film with Scotchlite Controltac Adhesive Refer to Section 3. Specifications, for more details. Category: 25528-00 Unit of Measure: Each Unit Price: $ c9. 56 Number of Units: 1 Total: $ c2, 3 Page 11 of 44 Line: 29 Description: General Fleet Vehicle Decals, City Seal: 2" Diameter Seal Refer to Section 3. Specifications, for more details. Category: 25528-00 Unit of Measure: Each Unit Price: $ C J. Number of Units: 1 Total: $ Line: 30 Description: General Fleet Vehicle Decals, City Seal: 4" Diameter Seal Refer to Section 3. Specifications, for more details. Category: 25528-00 Unit of Measure: Each Unit Price: $ . A D Number of Units: 1 Total: $ (� Line: 31 Description: General Fleet Vehicle Decals, City Seal: 10" Diameter Seal Refer to Section 3. Specifications, for more details. Category: 25528-00 Unit of Measure: Each Unit Price: $ 1. i Line: 32 Number of Units: 1 Total: $ Description: General Fleet Vehicle Decals, City Seal: 12" Diameter Seal Refer to Section 3. Specifications, for more details. Category: 25528-00 Unit of Measure: Each Unit Price: $ CI . 51 Number of Units: 1 Total: $ q . 1 Page 12 of 44 Line: 33 Description: General Fleet Vehicle Decals, City Seal: 15" Diameter Seal Refer to Section 3. Specifications, for more details. Category: 25528-00 Unit of Measure: Each Unit Price: $ . ©O Number of Units: 1 Total: $. 00 Line: 34 Description: General Fleet Vehicle Decals, Lettering: STAY BACK 50 FEET Refer to Section 3. Specifications, for more details. Category: 25528-00 Unit of Measure: Each Unit Price: $ 1 7. Line: 35 Number of Units: 1 Total: $ 7. QQ Description: General Fleet Vehicle Decals, Individual Numbers (0-9) Refer to Section 3. Specifications, for more details. Category: 25528-00 Unit of Measure: Each Unit Price: $ r , (-10 Line: 36 Number of Units: 1 Total: $ (:). 50 Description: General Fleet Vehicle Decals, Individual Letters (A-Z) Refer to Section 3. Specifications, for more details. Category: 25528-00 Unit of Measure: Each Unit Price: $ ( / • '� Line: 37 Number of Units: 1 Total: $ a Description: Fire Vehicle Decals, Fire Department Seal: 2" Diameter Seal Page 13 of 44 Refer to Section 3. Specifications, for more details. Category: 25528-00 Unit of Measure: Each Unit Price: $ CD • P.P, Line: 38 Number of Units: 1 Total: $ 0• Description: Fire Vehicle Decals, Fire Department Seal: 4" Diameter Seal Refer to Section 3. Specifications, for more details. Category: 25528-00 Unit of Measure: Each Unit Price: $ . GO Line: 39 Number of Units: 1 Total: $ C • 60 Description: Fire Vehicle Decals, Fire Department Seal: 10" Diameter Seal Refer to Section 3. Specifications, for more details. Category: 25528-00 Unit of Measure: Each Unit Price: $ k 3.pS Line: 40 Number of Units: 1 Total: $ '. cE. Description: Fire Vehicle Decals, Fire Department Seal: 12" Diameter Seal Refer to Section 3. Specifications, for more details. Category: 25528-00 Unit of Measure: Each Unit Price: $ 1 . 25 Line: 41 Number of Units: 1 Total: $ K S 1 Description: Labor Rate for Installation of Decals and Striping at City's General Services Administration (GSA) Facility. Refer to Section 3. Specifications, for more details. Page 14 of 44 Category: 25528-00 Unit of Measure: Flour Unit Price: $ j�• ©C� Number of Units: 1 Total: $ )0- CO Page 15 of 44