Loading...
HomeMy WebLinkAbout2022 08 08 Consent 304 - West WRF Temporary Belt Press Contract Modification • CONSENT AGENDA ITEM 304 n, CITY COMMISSION AGENDA I AUGUST 8, 2022 REGULAR MEETING 1959 TITLE West WRF Temporary Belt Press Contract Modification SUMMARY Invitation to Bid (ITB) #07-21 JN for the West Water Reclamation Facility Temporary Belt Press was awarded on September 27, 2021 to Merrell Bros, Inc. This temporary belt press is needed during rehabilitation of treatment Unit #1 to maintain mixed liquor inventory. During the cleaning and rehabilitation of treatment Unit #1, treatment Unit #2 will treat 100% of the flow coming into the facility. The treatment process is sensitive to changes in mixed liquor inventory and a high inventory can impact final effluent quality. The rental press will allow continual processing of solids and finer adjustments to the treatment process resulting in more reliability. Due to labor and supply chain challenges, in particular effluent piping, valves and skilled labor to complete infrastructure improvements to provide resilience and reliability, the rehabilitation of treatment Unit #1 has taken longer than anticipated. The temporary belt press is necessary during the cleaning and rehabilitation of treatment Unit #1 to assist in maintaining the reclaimed water (RCW) distribution system, and to provide additional resilience while remaining rehabilitation work on Unit #1 is completed. The temporary belt press rental needs to be extended for an additional six months at a cost of$12,450 per month per the contract terms (total of $74,700). This timeframe will allow for the preparation of the facility for cleaning during July, cleaning of the West WRF Unit # 1 in August, and conduct repairs from September through November, with a one month contingency as needed through December 2022. RECOMMENDATION Staff recommends the City Commission approve a contract modification to Merrell Brothers, Inc. in the amount of$74,700 ($12,450 per month) for a total of six months. Additionally, authorization for the City Manager and City Attorney is requested to prepare and execute any and all applicable contract documents consistent with this Agenda item. 1 + , CONSENT AGENDA ITEM 306 CITY COMMISSION AGENDA I SEPTEMBER 27, 2021 REGULAR MEETING TITLE West WRF Temporary Belt Press, Vendor Selection and Award SUMMARY The West WRF is located in the western part of the City and provides wastewater treatment service and reclaimed water to the City's reclaimed water distribution system. A temporary belt press is needed during rehabilitation of treatment Unit #1 to maintain mixed liquor inventory. During the cleaning and rehabilitation of treatment Unit #1, treatment Unit #2 will treat 100% of the flow coming into the facility. The treatment process is sensitive to changes in mixed liquor inventory and a high inventory can impact final effluent quality. The rental press will allow continual processing of solids and finer adjustments to the treatment process resulting in more reliability. Invitation to Bid (ITB) #07-21 JN for West Water Reclamation Facility Temporary Belt Press was advertised on September 3, 2021 and bids received on September 17, 2021 . The ITB outlined the equipment specifications and performance requirements. The prices are based on mobilization to the West WRF, demobilization from the West WRF, and a six (6) month rental with the option to rent the equipment longer if required. A total of three bids were received as shown in the Bid Tabulation below: VENDOR MOB/DEMOB MONTHLY COST TOTAL COST COST Merrell Bros, Inc. $8,975 $12,450 $83,675 Charter Machine $16,500 $19,500 $133,500 Company Eagle Dynamic $28,000 $17,675 $134,050 Solutions, LLC Preparation for cleaning and construction of the treatment Unit #1 repairs is anticipated to begin in October with repairs completed by March 2022. The belt press will be delivered to the West WRF as soon as practical. 182 RECOMMENDATION Staff recommends the City Commission award a contract to Merrell Bros, Inc. in the amount of$83,675 plus a two month project contingency ($12,450 per month) for a total of$108,575 for the rental of a temporary belt press. Additionally, in the event an agreement with the first ranked proposer is unable to be completed, authorize the City Manager and City Attorney to negotiate with the second ranked proposer, which is Charter Machine Company. in the amount of $133,500 plus a two month project contingency for a total of$172,500. Finally, authorization for the City Manager and City Attorney is requested to prepare and execute any and all applicable contract documents consistent with this Agenda item. 183 WEST WRF TEMPORARY BELT PRESS 00300-1 SECTION 00300 MANDATORY BIDFORMS (Mandatory Forms must be submitted with the bid. Failure to submit forms may disqualify the proposer from the ITB.) PANT I GENERAL 1.01 Description The following Bid is hereby made to the City of Winter Springs, hereafter called the OWNER. Bid is submitted by: Legal Name(indicate whether sole proprietorship,partnership, or corporation): Chctf}ef c�lne Qonpajply LorTeIr"+i-DA Address: WeSte�_f�ye Mc�vc� eIN 0TV0 Contact Name: AnCC�hn oA ' Gell Contact Phone Number: (73$k) S49 -4`100 Q73?� y2§_ ^7Y89 Contact E-Mail Address: Ghc�sb � CA\al'tctmac�iAC. GoM 1.02 The Undersigned: A. Acknowledges receipt of 1. Project Manual for WEST WRF TEMPORARY BELT PRESS, 2. Addenda: Number dated Number . dated B. Has examined the site and all Bidding Documents and understands that in submitting his Bid, he waives all right to plead any misunderstanding regarding the same. C. Agrees: September 2021 Mandatory Bid Forms 184 WEST WRF TEMPORARY BELT PRESS 00300-2 1. To hold this Bid open for 60 calendar days after the bid opening date. 2. To furnish the goods and/or services specified in this 1TB at the prices quoted in my responsive bid and in compliance with the Bidding Documents. 3. To accept the provisions of the Instructions to Bidders. 4. To negotiate a contract with the OWNER incorporating the bid amounts.if selected on the basis of this Bid. 5. To receive a City Purchase Order issued by the OWNER at the submitted Bid.Price. 6. To accomplish the work in accordance with the contract documents and this Project Manual. 7_ To deliver the equipment as required by the specifications and as indicated in his proposal document. D. Certifies: 1. That all information contained in this bid is truthful to the best of my knowledge and belief. 2. That I am duly authorized to submit this bid on behalf of the vendor and that the vendor is ready, willing, and able to perform if awarded the bid. 1.03 Stipulated Amount A. Base Bid Price I will provide the belt press under this project for a minimum Six-Month Total Rental Amount (Monthly Rent multiplied by 6)of. e*_llyharCal Seve4l t/6 Dollars($ ll7 00 and a One-Time belt press Mobilization/Demobilization Amount of.. S X]SCC/!f�10vS 4nC� T/�l�lUr�c �Dollars($_�� 540. ) The Bidder hereby agrees to perform all work as required by this Project Manual for the ,bllowing Unit Prices. Work for which there is not a Pay Item will be considered incidental to the Contract and no additional compensation will be allowed. The OWNER, at his sole option and discretion, may choose to add or deduct from the unit prices set forth below. The Bidder shall be paid for actual quantities completed in accordance with the contract documents. The following is the order of precedence which will be used in case of conflicts within the Bid Submittal provided by each Bidder: Unit Price, Total Price, Total Base Bid (See attached Bid Form). 1.04 Bid Submittals September 2021 Mandatory Bid Forms 185 WEST WRF TEMPORARY BELT PRESS 00300-3 A. Completed and signed bid price form and other Mandatory forms in this Section. B. I have attached all other Mandatory Forms in this Section. 1.05 Submittal RESPECTFULLY SUBMITTED,signed and sealed this /,,'A day of ,2021. Bidder Title �IC6���li(1' � ATTEST: SECRETARY SEAL September 2021 Mandatory Bid Forms 186 WEST WRF TEMPORARY BELT PRESS 00300-4 BID TABULATION The Bidder hereby indicates the following total units and total prices which represent all materials, labor, equipment, transportation, performance of all operations relative to performance of the project, overhead, and costs of all kinds and profit to complete the work items in accordance with the Project Manual,plans,and permits. Work for which there is not a listed item below shall be considered incidental to the Contract and no additional compensation will be allowed. The detailed Schedule of Values shall be provided by the lowest responsible bidder and be included with their executed contract, as attached. ITEM No. DESCRIPTION QUANTITY I UNITS UNIT COST TOTAL COST Belt Press I Mobilization/Demobilization I LS Q�! 2 Belt press,per month rental 6 Month /q s-vo TOTAL Belt press,additional per month rental beyond 6 months As Needed / OQ To Be Determined (Rate may not exceed rate quoted for minimum QQ 6 month term.) ' TOTAL BID: / / 1 ,Z/ ,�/ / / Qi1e �yn4�t���1�/ �h�«��Iwl�+dard rV(kWf DOLLARS (I K Words) s --/33, g-m 010 September 2021 Mandatory Bid Forms 187 WEST WRF TEMPORARY BELT PRESS 00300-5 SCRUTINIZED COMPANY CERTIFICATION Florida Statutes, Sections 287.135 and 215.473 Pursuant to Section 287.135, Florida Statutes (2017), a company is ineligible to, and may not, bid on, submit a proposal for, or enter into or renew a contract with the City for goods or services of (a) Any amount if, at the time of bidding on, submitting a proposal for, or entering into or renewing such contract, the company is on the Scrutinized Companies that Boycott Israel List, created pursuant to s. 215.4725, or is engaged in a boycott of Israel; or (b) One million dollars or more if, at the time of bidding on, submitting a proposal for,or entering into or renewing such contract,the company: 1. Is on the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List, created pursuant to s. 215.473;or 2. Is engaged in business operations in Cuba or Syria. Subject to limited exceptions provided in state law,the City will not'contract for the provision of goods or services with any scrutinized company referred to above. The Contractor must submit this required certification form attesting that it is not a scrutinized company and is not engaging in prohibited business operations. The following shall be grounds for termination of the contract at the option of the awarding body: The company is found to have submitted a false certification; been placed on the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List;been placed on the Scrutinized Companies that Boycott Israel List or is engaged in a boycott of Israel;or been engaged in business operations in Cuba or Syria. The City shall provide notice, in writing, to the Contractor of any determination concerning a false certification. The Contractor shall have five (5) days from receipt of notice to refute the false certification allegation. If such false certification is discovered during the active contract term, the Contractor shall have ninety (90) days following receipt of the notice to respond in writing and demonstrate that the determination of false certification was made in error. If the Contractor does not demonstrate that the City's determination of false certification was made in error then the City shall have the right to terminate the contract and seek civil remedies pursuant to Section 287.135,Florida Statutes. THIS CERTIFICATION FORM MUST BE COMPLETED AND INCLUDED IN YOUR BID RESPONSE. FAILURE TO SUBMIT THIS FORM AS INSTRUCTED SHALL RENDER YOUR BID SUBMITTAL NON-RESPONSIVE. a. The Vendor, owners, or principals are aware of the requirements of Section 287.135,Florida Statutes; and September 2021 Mandatory Bid Forms 188 WEST WRF TEMPORARY BELT PRESS 00300-6 b. The Vendor,owners,or principals are eligible to participate in this solicitation and not listed on the Scrutinized Companies that Boycott Israel List or engaged in a boycott of Israel; and c. For contracts of one million dollars or more,the Vendor, owners, or principals are eligible to participate in this solicitation and not listed on the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List and, further, are not engaged in business operations in Cuba or Syria; and d. If awarded the Contract, the Vendor, owners, or principals will immediately notify the City in writing if any of its company, owners,or principals: are placed on the Scrutinized Companies that Boycott Israel List,the Scrutinized Companies with Activities in Sudan List, or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List; engage in a boycott of Israel; or engage in business operations in Cuba or Syria. r //''JJ (Authorized Signature)', n Wglfer )ryeLl-lC Y/: (Printed Name and Title) �n4�f� �4 ♦AC' �I"'►�Mr (Name of Vendor) STATE OF COUNTY OF 177, Al�eseA The foregoing instrument was acknowledged before me by means of physical presence or (__) online notarizat* n, this /37�4 day of fi e� �j- . 2021, by W4 f fr/ 'vt�n�.th the 11.-re A".f,i&ti of crtCr C'?ACi;Ir �o^R4h y a ( who is personally known to me or (_) who produced as identification. nv� '2 A� Notary Public II Print Name: , 0 CL V1 yl 1 1 S My Commission expires: C a ga Lf September 2021 Mandatory Bid Forms 18'9 WEST WRF TEMPORARY BELT PRESS 00300-7 NON-COLLUSION AND CONTINGENT FEES AFFADAVIT State of Florida County of S'C M i being first duly sworn,deposes and says that: / y� / He / She is [ Pres1 o%7 of CX I/- ,"/-144, e 1;,04Y the Proposer that has submitted the attached Bid; He/ She is fully informed respecting the preparation and contents of the attached Bid and of all pertinent circumstances respecting such Bid; Such Bid is genuine and is not a collusive or sham Bid; Neither the said proposer nor any of its officers, partners, owners, agents, representatives, employees or parties in interest, including this affiant, has in any way colluded, conspired, connived or agreed, directly or indirectly with any other proposer, firm or person to submit a collusive or sham Bid in connection with the contract for which the attached Bid has been submitted or to refrain from bidding in connection with such Contract, or has in any manner, directly or indirectly, sought by agreement or collusion or communication or conference with any other Proposer, firm or person to fix the price or prices in the attached Bid or of any other Proposer, or to fix any overhead, profit or cost element of the Bid price or the Bid price of any other Proposers, or to secure through any collusion, conspiracy, connivance or unlawful agreement any advantage against the City of Winter Springs or any person interested in the proposed Contract; 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 Proposer or any of its agents,representatives, owner's employees, or parties in interest, including this affiant; and The proposer nor any of its officers, partners, owners, agents, representatives, employees or parties in interest, including this affiant, have not employed or retained any company or person, other than a bona fide employee working solely for the proposer to solicit or secure this agreement and that proposer has not paid or agreed to pay any person, company, corporation, individual, or firm, other than a bona fide employee working solely for the proposer any fee, commission,percentage, gift, or other consideration contingent upon or resulting from the award or making of this agreement. For the breach or violation of this provision,the City shall have the right to terminate the agreement without liability and, at its discretion, to deduct from the contract price, or otherwise recover,the full amount of such fee, commission,percentage, gift,kir l consideration. uthor zed ignatu e) / (Printed Nie and/Title) CRarf<r4Cl�ldr! (Name of Vendhr) i September 2021 Mandatory Bid Forms 110 WEST WRF TEMPORARY BELT PRESS 00300-5 STATE OF COUNTY Of /77. dWItsex The foregoing instrument was acknowledged before me by means of ( physical presence or (__j online otarization, this � day of t ftr+6er , 2021, by ;,4 C _ the of ( .who is pers pally known to me or (_) who produced as identification. -------------- Notary lic Print Name: 0 u V1 VI My Commission expires: 0 S 0-7le )L,,?q September 2021 Mandatory Bid Forms 111 WEST WRF TEMPORARY BELT PRESS 00300-9 DRUG-FREE WORKPLACE CERTIFICATION In accordance with Florida Statues 287.087, preference shall be given to businesses with drug-free workplace programs. Whenever two or more bids 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 bid received from a business that certifies that it has implemented a drug-free workplace program shall be given preference in the award process. Established procedure for processing the bids will be followed if none of the tied vendors have a drug-free work place program. In order to have a drug-free workplace program, a business shall: a. 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. b. Inform employees about the danger of drug abuse in the workplace,the business's policy maintaining a 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. c. Give each employee engaged in providing the commodities or contractual services that are under bid a copy of the statement specified in subsection(a). d. In the statement specified in subsection(a),notify the employees that, as a condition of working on the commodities or contractual services that are under bid/proposal,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 contender 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. e. 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. f. Make a 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. Car 7`ei- /)�-i c .neo.-yoo v (Company)— "I'a- —<, a�� r / P (Signature&Title) September 2021 Mandatory Bid Forms 112 WEST WRF TEMPORARY BELT PRESS 00300-10 CONFLICT OF INTEREST CERTIFICATION Before me, the undersigned authority, personally appeared, who was duly sworn, deposes, and 'll states: J� I am the Aie /rtS/dt�f of_���/ //iV�7'At with a local office in G vtf1lA �.3 and principal office in �e kdew� /1/. r. City and State City and State The above-named entity is submitting an ITB for the City of Winter Springs described as: City of Winter Springs ITB#07-21 JN WEST WRF TEMPORARY BELT PRESS RENTAL The Affiant has made diligent inquiry and provides the information contained in this Affidavit based upon his own knowledge and thereof the following; a. The Affiant states that only one submittal for the above bid is being submitted and that the above-named entity has no financial interest in other entities submitting bids for the same project. b. Neither the Affiant nor the above-named entity has directly or indirectly entered into any agreement,participated in any collusion, or otherwise taken any action in restraints of free competitive pricing in connection with the entity's submittal for the above bid. This statement restricts the discussion of pricing data until the completion of negotiations if necessary and execution of the Contract for this project. c. Neither the entity nor its affiliates,nor anyone associated with them, is presently suspended or otherwise ineligible from participation in contract letting by any local, State,or Federal Agency. d. Neither the entity, nor its affiliates, nor anyone associated with them have any potential conflict of interest due to any other clients, contracts,or property interests for this project. e. I certify that no member of the entity's ownership or management is presently applying for an employee position or actively seeking an elected position with the City of Winter Springs. f. I certify that no member of the entity's ownership or management,or staff has a vested interest in any aspect of the City of Winter Springs. September 2021 Mandatory Bid Forms 113 WEST WRF TEMPORARY BELT PRESS 00300-11 g. In the event that a conflict of interest is identified in the provision of services, I,on behalf of the above-named entity,will immediately notify the City of Winter Springs. /I L �:� n �732)sNS-yy06(73�y9y- qSW (Authorized Signature) Name of Business Phone&Fax Number W47fer- rvtli^r,c� gS- Alesfer *e 1*1j1ek,,n, /V.,T: O?9VO (Printed Name and Title) Business Mailing Address City, State,Zip September 2021 Mandatory Bid Forms 114 WEST WRF TEMPORARY BELT PRESS 00300-12 CERTIFICATION A: (Debarment, Suspension and other responsibility matters—Primary Covered Transactions) The prospective primary participant certifies to the best of its knowledge and belief that its principals: a. Are not presently debarred, suspended,proposed for debarment,declared ineligible,or voluntarily excluded from covered transactions by any Federal debarment or agency; b. Have not within a three-year period preceding this proposal,been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public(Federal, State,or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement,theft, forgery, bribery, falsification, or destruction of records, making false statements,or receiving stolen property; C. Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity(Federal, State, or local)with commission of any of the offenses enumerated in paragraph(1)(b) of this certification; and d. Have not within a three-year period preceding this application/proposal had one or more public transactions(Federal, State,or local)terminated for cause or default. Where the prospective primary participant is unable to certify to any of the statements in this certification,such prospective participant shall attach an explanation of this proposal. Instructions for Certification (A) By signing and submitting this proposal,the prospective primary participant is providing the certification set out below; a. The inability of a person to provide the certification required below will not necessarily result in denial of participation in this covered transaction. The prospective participant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the department or agency's determination whether to enter into this transaction. However, failure of the prospective primary participant to furnish a certification or any explanation shall disqualify such person from participation in this transaction. b. The certification in this clause is a material representation of fact upon which reliance was placed when the department or agency determined to enter into this transaction. If it is later determined that the prospective primary participant knowingly rendered an erroneous September 2021 Mandatory Bid Forms 115 WEST WRF TEMPORARY BELT PRESS 00300-13 certification, in addition to other remedies available to the Federal Government,the department or agency may terminate this transaction for cause or default. C. The prospective primary participant shall provide immediate written notice to the department or agency to which this proposal is submitted if at any time the prospective primary participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. d. The terms covered transaction,debarred, suspended, ineligible, lower tier covered transaction, participant,person, primary covered transaction,principal,proposal,and voluntarily excluded, as used in this clause,have the meanings set out in the Definitions and Coverage sections of the rules implementing Executive Order 12549. You may contact the department or agency to which this proposal is being submitted for assistance in obtaining a copy of these regulations. e. The prospective primary participant agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency entering into this transaction. f. The prospective primary participant further agrees by submitting this proposal that it will include the clause titled"Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion—Lower Tier Covered Transaction,"provided by the department or agency entering into this covered transaction,without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. g. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction,unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines this eligibility of its principals. Each participant may, but is not required to,check the Non- procurement List. h. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. i. Except for transactions authorized under paragraph(6)of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible,or voluntarily excluded from participation in this September 2021 Mandatory Bid Forms 116 WEST WRF TEMPORARY BELT PRESS 00300-14 transaction, in addition to other remedies available to the Federal Government,the department or agency may terminate this transaction for cause of default. Certification B: (Debarment,Suspension,Ineligibility and Voluntary Exclusion—Lower Tier Covered Transactions) a. The prospective lower tier participant certifies,by submission of this proposal,that neither it nor its principals is presently debarred, suspended,proposed for debarment, declared ineligible,or voluntarily excluded from participation in this transaction by any Federal department or agency. b. Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. Instructions for Certification(B) By signing and submitting this proposal,the prospective lower tier participant is providing the certification set out below. a. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification,in addition to other remedies available to the Federal Government,the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. b. The prospective lower tier participant shall provide immediate written notice to the person to whom this proposal is submitted if at any time the prospective lower tier participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. C. The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction,participant,person,primary covered transaction,principal,proposal,and voluntarily excluded,as used in this clause, have the meanings set out in the Definitions and Coverage sections of rules implementing Executive Order 12549. You may contact the person to which this proposal is submitted for assistance in obtaining a copy of these regulations. d. The prospective lower tier participant agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible,or voluntarily excluded from participation in this covered transaction,unless authorized by the department or agency with which this transaction originated. September 2021 Mandatory Bid Forms 117 WEST WRF TEMPORARY BELT PRESS 00300-15 e. The prospective lower tier participant further agrees by submitting this proposal that it will include this clause title"Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion—Lower Tier Covered Transaction,"without modification, in all lower tier covered transactions and in all solicitation for lower tier covered transactions. f. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principles. Each participant may but is not required to, check the Non- procurement List. g. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. h. Except for transactions authorized under paragraph(5)of these instructions, if a participant in a lower covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government,the department or agency with which this transaction originated may pursue available remedies including suspension and/or debarment. Applicant: r I Date: Charie f Ma h f r1 c r�D►7, ,qt I3/Signature of Authorized Certifying Official: le: p viCC [ rPSI'd eA END OF SECTION September 2021 Mandatory Bid Forms 118 WEST WRF TEMPORARY BELT PRESS 00300-1 SECTION 00300 MANDATORY BID FORMS (Mandatory Forms must be submitted with the bid. Failure to submit forms may disqualify the proposer from the ITB.) PART 1 GENERAL L2011IS11VAL 1.01 Description The following Bid is hereby made to the City of Winter Springs, hereafter called the OWNER. Bid is submitted by: Legal Name (indicate whether sole proprietorship, partnership, or corporation): .Q Cly �l�]GtC1'1 S°�ccl DAIS Ll—� A ess: - -a 5 Pierce, COu Y , C—Vm ri OR -36s d C ntact Name: ftUSI GA � A/Ci�f' Glon/ ontacthone Number: 0 o p �(o o —--7 377 rXf. c UO I56—E4 2 C ntact E-Mail Address: (. D N(�l° u o PFJ °� ��"�2�i��Nl�l���u�T16NS • ca+� 1.02 The Undersigned: A. Acknowledges receipt of: 1. Project Manual for WEST WRF TEMPORARY BELT PRESS. 2. Addenda: Number t , dated Number , dated B. Has examined the site and all Bidding Documents and understands that in submitting his Bid, he waives all right to plead any misunderstanding regarding the same. C. Agrees: September 2021 Mandatory Bid Forms 119 WEST WRF TEMPORARY BELT PRESS 00300-2 1. To hold this Bid open for 60 calendar days after the bid opening date. 2, To furnish the goods and/or services specified in this ITB at the prices quoted in my responsive bid and in compliance with the Bidding Documents. 3, To accept the provisions of the Instructions to Bidders. 4, To negotiate a contract with the OWNER incorporating the bid amounts, if selected on the basis of this Bid. S, To receive a City Purchase Order issued by the OWNER at the submitted Bid Price. 6, To accomplish the work in accordance with the contract documents and this Project Manual. 7. To deliver the equipment as required by the specifications and as indicated in his proposal document. D. Certifies: 1. That all information contained in this bid is truthful to the best of my knowledge and belief. 2. That I am duly authorized to submit this bid on behalf of the vendor and that the vendor is ready, willing, and able to perform if awarded the bid. 1.03 Stipulated Amount A. Base Bid Price I will provide the belt press under this project for a minimum Six-Month Total Rental Amount (Monthly Rent multiplied by 6) of- ON f: j`� ON6 HWYAiD A*b St)( V*4.fWtoFa� (15 I 010 I o and a One-Time belt press Mobilization/Demobilization Amount of.. 'f""Wr f 61601_7'** 4Nb Dollars ($ 2 �?_J 00O 1. The Bidder hereby agrees to perform all work as required by this Project Manual for the following Unit Prices. Work for which there is not a Pay Item will be considered incidental to the Contract and no additional compensation will be allowed. The OWNER, at his sole option and discretion, may choose to add or deduct from the unit prices set forth below. The Bidder shall be paid for actual quantities completed in accordance with the contract documents. The following is the order of precedence which will be used in case of conflicts within the Bid Submittal provided by each Bidder: Unit Price, Total Price, Total Base Bid (See attached Bid Form). 1.04 Bid Submittals September 2021 Mandatory Bid Forms 220 WEST WRF TEMPORARY BELT PRESS 00300-4 BID TABULATION The Bidder hereby indicates the following total units and total prices which represent all materials, labor, equipment, transportation, performance of all operations relative to performance of the project, overhead, and costs of all kinds and profit to complete the work items in accordance with the Project Manual, plans,and permits. Work for which there is not a listed item below shall be considered incidental to the Contract and no additional compensation will be allowed. The detailed Schedule of Values shall be provided by the lowest responsible bidder and be included with their executed contract, as attached. ITEM No. DESCRIPTION QUANTITY I UNITS UNIT COST TOTAL COST Belt Press I Mobilization/Demobilization 1 LS n 000 2,g') bUWA 2 Belt press,per month rental 6 Month 1-71 (o-76 1 0�) 067) TOTAL= �IJ- 0 Belt press,additional per month rental beyond 6 months As Needed �� To Be Determined (Rate may not exceed rate quoted for minimum 6 month term.) TOTAL BID: W fl FT`F ffaftk o Tf-h 6" Four- you C W DOLLARS (In Words) s 134 , on September 2021 Mandatory Bid Forms 221 WEST WRF TEMPORARY BELT PRESS 00300-3 A. Completed and signed bid price form and other Mandatory forms in this Section. B. I have attached all other Mandatory Forms in this Section. 1.05 Submittal �{- RESPECTFULLY SUBMITTED, signed and sealed this day of SSI'` ', 2021. Bidder By: M ARW tj BVDJA)N jr Title S I D 6&IT- ATTEST: SECRETARY SEAL September 2021 Mandatory Bid Forms 222 WEST WRF TEMPORARY BELT PRESS 00300-5 SCRUTINIZED COMPANY CERTIFICATION Florida Statutes, Sections 287.135 and 215.473 Pursuant to Section 287.135, Florida Statutes (2017), a company is ineligible to, and may not, bid on, submit a proposal for, or enter into or renew a contract with the City for goods or services of: (a) Any amount if, at the time of bidding on, submitting a proposal for, or entering into or renewing such contract, the company is on the Scrutinized Companies that Boycott Israel List, created pursuant to s. 215.4725, or is engaged in a boycott of Israel; or (b) One million dollars or more if, at the time of bidding on, submitting a proposal for, or entering into or renewing such contract, the company: 1. Is on the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List, created pursuant to s. 215.473; or 2. Is engaged in business operations in Cuba or Syria. Subject to limited exceptions provided in state law, the City will not contract for the provision of goods or services with any scrutinized company referred to above. The Contractor must submit this required certification form attesting that it is not a scrutinized company and is not engaging in prohibited business operations. The following shall be grounds for termination of the contract at the option of the awarding body: The company is found to have submitted a false certification; been placed on the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List; been placed on the Scrutinized Companies that Boycott Israel List or is engaged in a boycott of Israel; or been engaged in business operations in Cuba or Syria. The City shall provide notice, in writing, to the Contractor of any determination concerning a false certification. The Contractor shall have five (5) days from receipt of notice to refute the false certification allegation. If such false certification is discovered during the active contract term, the Contractor shall have ninety (90) days following receipt of the notice to respond in writing and demonstrate that the determination of false certification was made in error. If the Contractor does not demonstrate that the City's determination of false certification was made in error then the City shall have the right to terminate the contract and seek civil remedies pursuant to Section 287.135, Florida Statutes. THIS CERTIFICATION FORM MUST BE COMPLETED AND INCLUDED IN YOUR BID RESPONSE. FAILURE TO SUBMIT THIS FORM AS INSTRUCTED SHALL RENDER YOUR BID SUBMITTAL NON-RESPONSIVE. a. The Vendor, owners, or principals are aware of the requirements of Section 287.135,Florida Statutes; and September 2021 Mandatory Bid Forms 223 WEST WRF TEMPORARY BELT PRESS 00300-6 b. The Vendor, owners, or principals are eligible to participate in this solicitation and not listed on the Scrutinized Companies that Boycott Israel List or engaged in a boycott of Israel; and c. For contracts of one million dollars or more,the Vendor, owners, or principals are eligible to participate in this solicitation and not listed on the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List and, further, are not engaged in business operations in Cuba or Syria; and d. If awarded the Contract, the Vendor, owners, or principals will immediately notify the City in writing if any of its company, owners, or principals: are placed on the Scrutinized Companies that Boycott Israel List, the Scrutinized Companies with Activities in Sudan List, or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List; engage in a boycott of Israel; or engage in business operations in Cuba or Syria. (Authorized Signature) M6t11/1 t7 &0wr1 Jr. (Printed Name and Title) (Name of Vendor) STATE OF . �- COUNTY OF C fi �— The foregoing instrument was acknowledged before me by means of (x ) physical presence or (___) online notarization, this vi of N1mj; 2021, by r the ClI dof -c o a�'VI i o � ia known to m who is personallynowe or (__) who produced as identification. Notary Public Lynn R. Felberg I ,, Notary Public Print Name: ID's r Columbia County, GEORGIA My Commission expires: 3 September 2021 Mandatory Bid Forms 224 WEST WRF TEMPORARY BELT PRESS 00300-7 NON-COLLUSION AND CONTINGENT FEES AFFADAVIT State of Florida County of X01 being first duly sworn, and says that: He / She is MW N f. UMJ J'2,Pktclw4r f .6"L-e N Nt�- see Proposer that has submitted the attached Bid; He / She is fully informed respecting the preparation and contents of the attached Bid and of all pertinent circumstances respecting such Bid; Such Bid is genuine and is not a collusive or sham Bid; Neither the said proposer nor any of its officers, partners, owners, agents, representatives, employees or parties in interest, including this affiant, has in any way colluded, conspired, connived or agreed, directly or indirectly with any other proposer, firm or person to submit a collusive or sham Bid in connection with the contract for which the attached Bid has been submitted or to refrain from bidding in connection with such Contract, or has in any manner, directly or indirectly, sought by agreement or collusion or communication or conference with any other Proposer, firm or person to fix the price or prices in the attached Bid or of any other Proposer, or to fix any overhead, profit or cost element of the Bid price or the Bid price of any other Proposers, or to secure through any collusion, conspiracy, connivance or unlawful agreement any advantage against the City of Winter Springs or any person interested in the proposed Contract; 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 Proposer or any of its agents, representatives, owner's employees, or parties in interest, including this affiant; and The proposer nor any of its officers, partners, owners, agents, representatives, employees or parties in interest, including this affiant, have not employed or retained any company or person, other than a bona fide employee working solely for the proposer to solicit or secure this agreement and that proposer has not paid or agreed to pay any person, company, corporation, individual, or firm, other than a bona fide employee working solely for the proposer any fee, commission, percentage, gift, or other consideration contingent upon or resulting from the award or making of this agreement. For the breach or violation of this provision,the City shall have the right to terminate the agreement without liability and, at its discretion, to deduct from the contract price, or otherwise recover, the full amount of such fee, commission,percenta . gift, or consideration. ` (Authorized Signature) M w n Wyvn (Printed Name and Title) DYVAM UC QAg ,-T(N1 ' (Name of Vendor) September 2021 Mandatory Bid Forms 225 WEST WRF TEMPORARY BELT PRESS 00300-8 STATE OF 9 f l CIL- COUNTY OF p rVl, 1 The foregoing instrument was acknowledged before me by means of physical presence .or ( ) online notarization, this 115 day of1, by AlafW4) n Jr. the {�!Z°$j`� of (_ who is personally known to me or (__) who produced as identification. Notary ublic Lynn P. Felberg Print Name: No — tary Public Columbia County, GEOR©IA My Commission expires: Z September 2021 Mandatory Bid Forms 226 WEST WRF TEMPORARY BELT PRESS 00300-9 DRUG-FREE WORKPLACE CERTIFICATION In accordance with Florida Statues 287.087, preference shall be given to businesses with drug-free workplace programs. Whenever two or more bids 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 bid received from a business that certifies that it has implemented a drug-free workplace program shall be given preference in the award process. Established procedure for processing the bids will be followed if none of the tied vendors have a drug-free work place program. In order to have a drug-free workplace program, a business shall: a. 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. b. Inform employees about the danger of drug abuse in the workplace, the business's policy maintaining a 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. c. Give each employee engaged in providing the commodities or contractual services that are under bid a copy of the statement specified in subsection(a). d. In the statement specified in subsection (a), notify the employees that, as a condition of working on the commodities or contractual services that are under bid/proposal, 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 contender 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. e. 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. f. Make a 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. (Company) (Si n ture &Tit 11 v1 n K1111m September 2021 Mandatory Bid Forms 227 WEST WRF TEMPORARY BELT PRESS 00300-10 CONFLICT OF INTEREST CERTIFICATION Before me, the undersigned authority, personally appeared, who was duly sworn, deposes, and states: I am the N15c wTS a l u-l`10 of 15AO LE U`{IWEM(C, with a local office in and principal office in 6YAN S (77 City and State City and State The above-named entity is submitting an ITB for the City of Winter Springs described as: City of Winter Springs ITB #07-21 JN WEST WRF TEMPORARY BELT PRESS RENTAL The Affiant has made diligent inquiry and provides the information contained in this Affidavit based upon his own knowledge and thereof the following; a. The Affiant states that only one submittal for the above bid is being submitted and that the above-named entity has no financial interest in other entities submitting bids for the same project. b. Neither the Affiant nor the above-named entity has directly or indirectly entered into any agreement,participated in any collusion, or otherwise taken any action in restraints of free competitive pricing in connection with the entity's submittal for the above bid. This statement restricts the discussion of pricing data until the completion of negotiations if necessary and execution of the Contract for this project. c. Neither the entity nor its affiliates, nor anyone associated with them, is presently suspended or otherwise ineligible from participation in contract letting by any local, State, or Federal Agency. d. Neither the entity, nor its affiliates, nor anyone associated with them have any potential conflict of interest due to any other clients, contracts, or property interests for this project. e. I certify that no member of the entity's ownership or management is presently applying for an employee position or actively seeking an elected position with the City of Winter Springs. f. I certify that no member of the entity's ownership or management, or staff has a vested interest in any aspect of the City of Winter Springs. September 2021 Mandatory Bid Forms 228 WEST WRF TEMPORARY BELT PRESS 00300-11 g. In the event that a conflict of interest is identified in the provision of services, I, on behalf of the above-named entity, will immediately notify the City of Winter Springs. NAM 77 WS o���o X737 (Authorized Signature) Name of Business Phone&Fax NumbertoOZ19-Eqq Z M61ryt7 &INh Jr. deff 57(6 PIr_r&,- C;'• Cv6031 Com. 3ID&-Oc) (Printed Name and Title) Business Mailing Address City, State, Zip September 2021 Mandatory Bid Forms 229 WEST WRF TEMPORARY BELT PRESS 00300-12 CERTIFICATION A: (Debarment, Suspension and other rest)onsibilih- matters—Primary Covered Transactions) The prospective primary participant certifies to the best of its knowledge and belief that its principals: a. Are not presently debarred, suspended,proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal debarment or agency; b. Have not within a three-year period preceding this proposal, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public(Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement,theft, forgery, bribery, falsification, or destruction of records, making false statements, or receiving stolen property; C. Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity(Federal, State, or local)with commission of any of the offenses enumerated in paragraph(1) (b) of this certification; and d. Have not within a three-year period preceding this application/proposal had one or more public transactions (Federal, State, or local)terminated for cause or default. Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation of this proposal. Instructions for Certification (A i By signing and submitting this proposal,the prospective primary participant is providing the certification set out below; a. The inability of a person to provide the certification required below will not necessarily result in denial of participation in this covered transaction. The prospective participant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the department or agency's determination whether to enter into this transaction. However, failure of the prospective primary participant to furnish a certification or any explanation shall disqualify such person from participation in this transaction. b. The certification in this clause is a material representation of fact upon which reliance was placed when the department or agency determined to enter into this transaction. If it is later determined that the prospective primary participant knowingly rendered an erroneous September 2021 Mandatory Bid Forms 230 WEST WRF TEMPORARY BELT PRESS 00300-13 certification, in addition to other remedies available to the Federal Government, the department or agency may terminate this transaction for cause or default. C. The prospective primary participant shall provide immediate written notice to the department or agency to which this proposal is submitted if at any time the prospective primary participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. d. The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction, participant,person,primary covered transaction,principal, proposal, and voluntarily excluded, as used in this clause,have the meanings set out in the Definitions and Coverage sections of the rules implementing Executive Order 12549. You may contact the department or agency to which this proposal is being submitted for assistance in obtaining a copy of these regulations. e. The prospective primary participant agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency entering into this transaction. f. The prospective primary participant further agrees by submitting this proposal that it will include the clause titled"Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion—Lower Tier Covered Transaction,"provided by the department or agency entering into this covered transaction,without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. g. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines this eligibility of its principals. Each participant may, but is not required to. check the Non- procurement List. h. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. i. Except for transactions authorized under paragraph (6) of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this September 2021 Mandatory Bid Forms 231 WEST WRF TEMPORARY BELT PRESS 00300-14 transaction, in addition to other remedies available to the Federal Government, the department or agency may terminate this transaction for cause of default. Certification B: (I)ebarment, Suspension,Ineligibility and Voluntary Exclusion—Lower Tier Covered Transactions) a. The prospective lower tier participant certifies,by submission of this proposal, that neither it nor its principals is presently debarred, suspended,proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. b. Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. Instructions for Certification i B s By signing and submitting this proposal, the prospective lower tier participant is providing the certification set out below. a. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government,the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. b. The prospective lower tier participant shall provide immediate written notice to the person to whom this proposal is submitted if at any time the prospective lower tier participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. C. The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction, participant,person,primary covered transaction,principal,proposal, and voluntarily excluded, as used in this clause,have the meanings set out in the Definitions and Coverage sections of rules implementing Executive Order 12549. You may contact the person to which this proposal is submitted for assistance in obtaining a copy of these regulations. d. The prospective lower tier participant agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated. September 2021 Mandatory Bid Forms 232 WEST WRF TEMPORARY BELT PRESS 00300-15 e. The prospective lower tier participant further agrees by submitting this proposal that it will include this clause title"Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion—Lower Tier Covered Transaction,"without modification, in all lower tier covered transactions and in all solicitation for lower tier covered transactions. f. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principles. Each participant may but is not required to, check the Non- procurement List. g. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. h. Except for transactions authorized under paragraph (5) of these instructions, if a participant in a lower covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government,the department or agency with which this transaction originated may pursue available remedies including suspension and/or debarment. Applicant: Date: 6#-4t,e DlNhh6G SOL�GTio1U�/Marys et&dn i) t e of Auth ert ying Off Title: END OF SECTION September 2021 Mandatory Bid Forms 233 EAGLE DYNAMIC SOLUTIONS 15 September 2021 City of Winter Springs, FL- City Hall ATTN: Holly Queen 1126 East S.R. 434 Winter Springs, FL 32708 Subject: Bid No. ITB 07-21 JN —West WRF Temporary Belt Press Rental To whom it may concern: Eagle Dynamic Solutions is pleased to submit a bid for the rental of a belt press to dewater biosolids from a domestic wastewater treatment facility. Eagle will provide a 2M trailer mounted belt press equipped with complete controls, hydraulics, a polymer feed system, a sludge feed pump, and a sludge cake conveyor capable of loading tractor trailers. Eagle will also provide 1 set of filter belts (on press) and a spare set of belts. This pricing is included in the monthly rental cost. Please see the below proposed pricing for the complete scope mentioned in the bid. Please contact me at 706-955-5152 or aconcepcion@eagledynamicsolutions.com if you have any questions or if I can be of further assistance. Sincerely, Angelica Concepcion Technical Sales Representative P.O. Box 2990,5105 Pierce Court, E E : \� Evans,GA 30809 www.eagledynamicsolutions.com 706.860.7737 ) (; 0 Dredging Separations Beneficial Reuse Materials Handling Transportation& 234 Have Materials Selas In Plant Services Recycling t Disposal DYNAMIC SOLATIONS 1qW410W Eagle Dynamic Solutions to provide: - (1) trailer mounted 2M belt press with press belts - Conveyor to load a tractor trailer - Technician to commission, train - Spill containment - Spare set of belts - 8k lull or equivalent for setup/ breakdown (available for EDS technician to use) City of Winter Haven, FL to provide: - Electrical supply& hook up: 480V 3 phase @ 100 amps - Clean wash water supply: 100 gpm @ 80 psi - Filtrate discharge acceptance - Dewatered cake disposal - Emulsion polymer - Routine maintenance (cleaning, greasing, oil, etc.) Rates Mobilization, set up, break down, & demobilization_.. ................$28,000 lump sum Monthly Rental 2M Belt Press (6 month minimum rental)___________________ ___________________________________$15,675 per month Conveyor (6 month minimum rental).......................................................$2,000 per month Total Monthly Rental............................................................................$17,675 per month Additional set of belts after 1St set & spare set are used__________________ $4,000 lump sum P.O. Box 2990, 5105 Pierce Court, �,�L� s \ Evans,GA 30809 , w www.eagiedynamicsolutions.com 706.860.7737 - Dredgirg Separatiu., Beneficial Reuse Materials Handling Transportation& 235 Raw Materials Sales In Plant Services Rerycling/Dispaaal EAGLE DYNAMIC SOLUTIONS 1q%iW Terms& Conditions 1. Pricing is effective for 90 days from date listed above. 2. Rental period is based on 24 hours per day, 30 days per month. 3. Executed lease agreement (attached) 4. Security deposit due prior to shipment of rental units. 5. Security deposit can be used to repair damaged equipment or applied to outstanding balance at the end of the project only after all other invoices have been paid and equipment has been deemed not damaged by EDS. 6. Rentals rates are FOB Evans, GA. 7. Technician rate based on 12 hours per day; includes wages, per diem, housing, and vehicle. Anticipate 1 day travel each way. To be invoiced weekly for charges. 8. Terms Net 30. 9. Mobilization and Demobilization includes transportation to & from project site. It does not include technician fee. 10. Technician rates do not reflect any prevailing wage rates. 11. All terms and conditions are based on equipment availability. 12. In the event equipment is returned to EDS and additional deconning is necessary, deconning will be charged at a rate of$1,000 per day. 13. If payment is with a credit card, a 3.5%transaction fee applies to any credit card payments. P.O. Box 2990,5105 Pierce Court, 1 f _�\ r, �i 1 • Imo' Evans,GA 30809 'j---"�-'� ,�- www.eagledynamicsolutions.com 706.860.7737 Dredging Separations Beneficial Reuse Materials Handling Transportation& 236 naw materials Sales In Flant Services Rer,cling I Disposal WEST WRF TEMPORARY BELT PRESS 00300-1. SECTION 00300 MANDATORY BID FORMS (Mandatory Farms trust be submitted with the bid. Failure to submit forms may disqualify the proposer from the ITB.) PART I GENERAL 1.01 Description The following laid is hereby made to the City of Winter Springs, hereafter called the OWNER. Bid is subinitted by: Legal Name(indicate whether sole proprietorship, partnership,or co oratio : ('hIWCA t. ( LOS. .Address: 1 Contact Name: Contact Phone Number: Contact E-Mail Address: as*n. C. errs it Itsros.cc,h _. 1:.02 The Undersigned: A. Acknowledges receipt of L Project Manual for WEST WRF TEMPORARY BELT PRESS. 2. Addenda: Number , i . , dazed 910 zt. Number_____,dated I .. B. Has examined the siie and all Bidding Documents and understands that in. subfnitting his Bid, he Waives all right to plead any misunderstandingregarding the same. C: Agrees: SeptemberI021 Mandatory Bid Forms 237 WEST WRF TEMPORARY BUTTRESS 00300-2 1. To hold this Bid open for 60 calendar days after the bid opening date. 3. To furnish the goods:and/or services:specified in this ITB at the prices quoted in my responsive bid and in compliance with the Bidding Documents. 3. To accept the provisions of the Instructions to Bidders. 4. To negotiate a contract with the OWNER incorporating the bid amounts, if selected on the basis of this Bid. 5. To receive a City Purchase Order issued by the OWNER at the submitted Bid Price. 0. To accomplish the work in accordance with the contract documents and this.Project Manual. 7. To deliver the equipment as required by the specifications and as indicated in his proposal document, D. Certifies: 1. That all information contained in this bid is truthful to the best of my knowledge and belief. 2. That I am duly authorized to submit this`bid on behalf of the vendor and that the vendor is ready,willing,and able to perform,if awarded the bid. 1.0-1 Stipulated Amount. A, Base Bid Price I will provide the belt press under this project for a minimum Sia-Month Total Rental Amount (Monthly Rent multiplied by 6)of- OV Hoes+gp,sE r +oua►Do]lars($_-74., 1d t?.ccs and a One-Time belt press Mobilization/Deniobilizatidn Amount of-. sv,,6,i PO4 Dollars The Bidder hereby agrees to perform all work as requited by this Project Manual for the following Unit Prices. Work for which there is not a Pay Item will be considered incidental to the Contract and no additional compensation will be allowed.. The OWNER, at his sole option and discretion, may choose to add or deduct from the unit prices set forth below. The Bidder: shall: be paid for actual .quantities completed i- accordance with the contract documents. The following is the order of precedence which will be used in case of conflicts within the Bid Submittal provided by each Bidder, Unit Price, Total Price, Total Base Bid (bee attached Bid Form). L01 Bid Submittals September U21 Mandatory Bid Forms 238 WEST WRF TEMPORARY BELT PRESS 00300-3 A. Completed and signed bid priep form and a:then Mandatory forms in this Section. B. I have attached all.other-Mandatory: 1~orms in this Section. 1.05 Submittal RESPECTFULLY SUBMITTED,signed.and sealed this n day of . ,2021. Bidder By: —l'itle .ss:jfss _ o _ ATTEST SECRETARY SEAL ........... •�,ff r � �..__.Mrd•: % 4 r �IJlju�ftjl1 S tember;20Zi Mandatory Bid Forms 239 WEST WRF TEMPORARY BELT PRESS 00300-4 BID TABULATION The Bidder hereby indicates tate following total units and total prices whish represent:all:materials; labor, equipment, transportation, .performance. of all operations relative to perforntance of the project,overhead, and costs,of ali kinds and profit to complete the work items in accordance with the Project Manual,plans,and permits; Work for which theree is not a Listed item below shall be.considered .incidental to the Contract:and no additional compensation will be allowed. The detailed Schedule of'V'alues shall be provided by the lowest responsible bidder and be included with their executed contract, as attached. rTEx NO. DESCRIPTION UAN-11TY VNITS UNIT CIMT '1OTAL COST Belt Press I Mobilization/Demobilization 1 IS 2 &lt press,per month rental fi Mkfttth TOTAL ]Belt press,atiditionul or month rtontat ba d b motttlts (Rate may not exceed tate°quoteci for i ininrucn As Needed l� tt rs p.cy Cy To Be Determined 6 month term.) TOTAL; BID: xt�>;��i r -r x►trr sr u�c �n+1 fs+u� DOLLARS (In Wards,) $ 43 3,t0"15.0 o :September 2021 Mandatory Bid Forms. 240 WEST WRF TEMPORARY BELT PRV-SS 1103410=5 `SCRUTINIZED COMPANY CERTIFICATION Florida,Statutes, S"tions 287.135 and,215.473 Pursuant to Section 287.135, Florida Stables (2017), a company is ineligible to, and may not, bid:on,,submit a.proposal for,or enter into,or.renew a contract with the City for.gpods or services of (it) Any amount if,:!( the time of bidding on, submitting a proposal for, or entering into or .renewing ;such contract. the company is on the Scrutinized Companies that ,Boycott Israel fist, created pursuant to s. 2.15.4725, or is. engat ,d -in a boycott of Israel:of (b) One million dollars or more if, at the time of bidding on, submitting a proposal for,or entering into or renewing such contract,,the company:. I, ls- on the Scrutinized Companies with Activities in, Sudan Last or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List, created pursuant to s.215.473;oir 2. Is engaged in business operations in Cuba()r Syria. Subject to limited exceptions.provided in state law,the City will.not contract for the provision of goods or services with any,scrutinized company referred to move. The. 'Contractor must submit this required certification form attesting that it is not a.scrutinized.company and is not engaging in prohibited business operations. The following shall be grounds for termination of the contract at the option of the awarding 16ody. The company,is (bund to have submitted a false certification. been placed on the Scrutinized Companies with Activities in Sudan list or the Scrutinized Companies with.Activities-mi tate Irate Petroleum Energy Sector list,been placod on.the Scrutinized Companies that Ibycott Wael List or is engaged in a boycott of Israel,or been on84ged in business operations in Cuba or Syria. The City shall provide notice, in writing, to the Contractor of any determination concerning a false certification, The Contrtor shall have five (5) days from receipt of notice to refute the false certification allegation, N such false certification is discovered during the active contract term,,tate Contractor shall We ninety (90) days following receipt of the notice to respond in writing And detnongtraw that the determination of false certification was made in error. If the Contractor dates not demon*ate that the.City'.q determinaVoo of false certi rication was trade in error then the City shall have the right to terminate the contract and seek civil remedies pursuant to Section 251,135,Florida Statutes, THIS CERTIFICATION FORM MUST$E COMPLETED AND :INCLUDED IN YOUR $ID :RESPONSE. FAILURE. TO SUBMff THIS: FORM :AS INSTRUCTED SHALL RENDER V0VR BID SUBMIrfAL NON-RESPONSIVE. a. The Vendor,owners;or`pnncipals are aware oftlte requirements of Section.2$:7.116,.Florida Statutes; and SepteMber2021 Mandatory Bid Forms 241 WEST WRF TEMPORARY BELT PRESS 00300-6 b. The Vendor, owners,or principals are eligible to participate in this:solicitation!and not,l'isted on the Scrutinized Companies:that Boycott Israel List or engaged in a boycott of Israel;and c. For contracts of one trillion dollars or inorexthe Vendor, owners, or principals are eligible to participate in this solicitation and not listed on the Scrutinized Companies with Activities in Sudan list or the Scrutinized Companies with Activities in the.Iran Petroleun :Energy Sector List and,further,are not engaged in business operations in Cuba.or Syria;and d. If awarded the Contract,the Vendor, owners,or principals will immediately notify the City in Writing if any of:its company,owners, or principals:. are placed on-the Scrutinized Companies that Boycott Israel List, the Scrutinized Companies with Activities in Sudan List,or the Scrutinized Companies With Activities in.the Iran Pctroleutt3 Energy Sector List; engage in a boycott of Israel; or engage in business operations.in Cuba or Syria. (Authorized Signature) (Printed Name and Title) (Name of Vendor) STATE or._ZA _.. Cor NTY or The. foregoing instrument was acknowledged before me, by means of �) physical presence or ( r�riGine notar'iza#tort, this t ^^ day of , .2021, by L>4Src'A,a �w�A - —_� lbe `c quo - - of a {� who is personally known 'to me or t..� who produced as identification. ��s11 r,rr r ity„3>. r t A r r M: Notary .. ublic ww �, ;'c Print Name:_fXT� ? , ,z y My Commission expires: 1 n ?Jd1^.7.3 ititi� September 2021 Mandatory Did Forms 242 WEST WRF TEMPGRARY BELT PRESS 00300-7 NON-COLLUSION AND CONTINGENT FEES AFFADAM State of Mos ift T"K^*A County, of .. t4o"A0.0 being first dully sworn,deposes and says that: :He is r-ozee !&JISA of the Proposer that has-SUbm fitted the attached Bid. He/ She is fully informed respecting the preparation and contents of the attached Bid and of all pertinent circumstances respecting such Rid, Such Bid is genuine and is not a collusive or sham BW; Neither the said proposer nor any of its officers, partners, owners, agents, reMsefttfttives; employees or parties in interest, including- this afriant, has in soy way colluded, conspi connived or agreed, directly orind' irecfly:with oily other proposer, firm or person to submit a collusive or sham Bid in connection with the contract for which the attached Bid has been submitted or to-reftin from hidoing in connection with such Contract; or has in any manner, directly or indirectly,sought by agreement or collusion or communication or conference with: any other Proposer,firm or person to fix the price or prices:in the attached Bid or of any other 'Proposer, or to fix any overhead, profit or cost element of the Rid price or the Bid price of any other Proposers, or to secure through any collusion, conspiracy, connivance or. vniawful �,W.M. agreement any advantage against the City 6f , i r Springs or any person. interested in the proposed Contract; The price or pricesquoted in. the attached Bid are f4ir and proper and are not, tainted by any collusion,conspiracy,connivance or unlawful agreement on the part,of the Proposer or any of its agents,re—prescritgOves,owner's employees,or patties in interest, including this affiant- and The proposer nor any of its officers, partners, owners, Ag4mts, representatives, employees or parties in interest, including this affiant, have ttot eniployed or retained any company or person, other than a bona, fide employee working solely for the :proposer to, solicit, or secure this agreement and that proposer has not paid or' agreed to pay any person, compaqy,, corporation, individuaL or firm. other than a bona fide employee working solely for the .p"poser any fee commission,- percentage,git or other consideration contingent upon or resulting from the aorard, .or making of this agreement. For the breach or violation of this provision,,the City shall.have the right to terminate the agre merit without liability and, at its discretion, to deduct from the 0 wit contract price, or otherwise recover,the M amount of such fee,commission,pe on.t. gift'.or ,consideration. Withorized Signature). 0,A (Printed Name and Title) (Name of Vendor) September 2021 Mandatory Hid Forms 243 WEST WRF TEMPORARY BELT PROS 003110-8 S*rA'rE OF COUNTY of - The foregoing instrument was acknowledged before me by means of (fit } physical prcgence of (___) online. notarization, this � day of- ssos+s _2DZ1, by g5nx,j SmyafA the C.&D.p. of who is-personally known to me or who produced As identification- `��1�11t11/i/Iq/� 91 JAC �,�� 1• 16*A1�13.& Ifsatary b C NO S ;req ,�y. = Print Name:.O JACS\SCMJ Z -- -.'xpr'•'�i � ;' ' :� My Commission eXpires: ti �t3 � swe>i ir' 262.1 Mandatory Bid Forms 244 WEST WRF TEMPORARY BELT PRESS 00300-9 DRUG-FREE WORKPLACE CERTIFICATION' In accordance with Florida Statues-2- 87,087,preference shall be.given to businesses with drug-free workplace programs. Whenever two or more bids 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 contractuaLservices, a bid received from a business that c.extifles that ithas implemented 4 drug-fteo workplace program shall be given preference in the award process. Established procedure for processing the bids,will be followed if none of the tied vendors have a drug-free work place program. In order to have a drug-free workplace program,a business shall- a. Publish a statement notifying.employees that the Unlaw. fiil manufacture,distribution, d u Dispensing,possession,or use oa.controlled substance is prohibited in the workplace and specifying the actions that will be taken against employees for violations ofauch , g .9ai prohibition. b. Inform employees about the danger of drug abuse.in the workplacethe businesss policy maintaining a drug-free workplace, arty-available drugcounseling,rehabilitation; and employee assistance programs,and the-Denalti"- that may be imposed upon employees for drug abuse violations. c. Give-eacIvernployee engaged in providing the commodities or contractual services, that am-under bid a copy of the statement specified in subsection(a). d- In the statement specified in subsection(a), notify the enVloy- cesthat,as a condition of working,an the commodities or contractual services that are under bid/proposal, 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 contender to,any violatio"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)43(s after such conviction. e. Impose a sanction on,or require the satisfactory participation in a drug abase.assistance or rehabilitation program if such is in the employee's community, by any employee who is so convicted. E Make a good faith effort to continue to maintain a drug-free workplace through implementation lementation of this section. As the person,authorized to sign the statement,.I certify that this firm complies fully with the above requirements, (Company) (Signature A Title) 8"tem6e,r4021 Mandatory Bid Forms 245 WEST WRIfTEMPORARV BELT PRESS 00300-10 CONFLICT OFINTEREST CERTIFICATION Before me, the undersignedd authority. personally appeared. who, was du y: swom deposes,and states: I am the i?.kg��Eos s=K with a local office in __pL j and principal office in AL City and State City and State The above-named entity is-,submitting:an J[TB for the City-of Whiter Spnifigs,described as, City of Winter spriAgs ITB-N 07-21 A WEST WRF TEMPORARY BELT PRXM RENTAL The Affiant has made diligent inquiry and provides the itifiJonation contained in this Affidavit based upon!his own knowledge and thereof the followmig, a. The Affiant states that only one Wbmittalfor the above bid is being submitted and that the kbovew:nam,ed entity has no financial interest in other entities submitting bids for the same Project.; b, Neither the Affiant nor the above-named entity has directly or indirectly entered into any agroement, participated it any collusion,or otherwise taken any action in restraints of free..competitive pricing:in connection with the entity's submittal for thevd-bi , This 440. id statement restricts the discussion of pricing data until the completian of negotiations if necessary and execution of the Contract for this project. e. Neither the entity n6r itsaffiliates,noranyone associated with them,is presimtly suspended or otherwise ieligihle from participation in contraot letting by any local, State, or Federal Agency. d. Neither the entity,nor its affiliates,nor anyone associated with them.have any potential conflict of interest due to any other clients,contract%or property interests for this project.. e. Ucettifv that wmember of the entity's ownership or management is prcsently applying ibr an employee position or actively seeking an elected position with the City of Winter spilngs. f, I certify that no member of the entity's ownership or management,or staff has a vested interest in any aspect of the City, of Winter Springs. September 2021 Mandatory Bid Forifts. 246 WEST WRF TEMPORARY BELT PRESS .00300-11 g. In the event that a conflict of interest is identified in.the provision of services, 1,on behalf of the above-najned entity, will immediately notify the City of,Winter Springs. '57+4-Wil wllft 7%17S (Authorized Signature) Name of Business Phone&FaX Number i>JsTT-j St xrA CAO.O. $41{L—w-- Sao-4UO'*A'A'T-j 01LOM .-rwq6qo( (Printed Name and Title) Business Mailing Address City,State,Zip September 3#}31 Mandatory Bid Forms 247 WEST WRF TEMPORARY BELT PRESS 0030042 CERTIFICATION A (Debarment, Suspension and other responsibility matters—Primaj2 Covered Transactions) The prospective primary participant certifies to the best of its knowledge and belief that its principals: a. Are not presentiy,debarred.suspended,proposed for debarment,declared ineligible,or voluntarily excluded frm covered transactions by any Federal debarment or agency. b. Have not within a three-year period preceding this proposal,been convicted ofor had a civil judgment rendered against them for commission oMaud or a criminal offense in. connection with obtaining,attempting to obtain. orperforrcting a p6 ie(I,ederal,State,or local) transaction or contract under a.public transaction;violation of Federal or State antitrust statutes or wmmission of ombezzlerneM theft,.fbTgery, bribery, falsification; or destruction of records,. making false statements,or receiving stolen.property; c, Are not presently indicted for or otherwise criminally or civilly charged by 4, governmental entity(Federal„State or local)with commission of any of the offenses:enumerated in paragraph(1)(b)of this certification:and. d. Have not within a three-year period preceding this application/proposal had one or more public transactions(Federal,State,-or local)terminated foucause or default. Where the prospective primary participant is unable to certify to:atly of the statements in this certification,such prospective participant shall attach an explanation of this proposal. Instructions for Qyrtifuation(A) By signing and submitting ibis.proposal,the prospective primary participant is providing the certification set out below; a. The inability of a.person toprovide the certification required.below will not necessarily result in denial of participation in-this covered transaction. The prospective.participant shall submit an explanation of why it cannot provide the certification set:out below. The certification or explanation will be considered.in connection with the department or-agency's determination, whether to enter into this transaction. However,failure of the prospective.primary participant to fu isti.a.certifications or any explanation shall disqualify such person from participation in this transaction. b. The cerd-fication in this clause is a material representation of fact upon which reliance vas placed when the department or agency determined to enter ituo this transaction. if it is later determinedthat the prospective primary:participant knowingly rendered an erroneous September 2021 Mandatory Bid Forms 248 WEST WRF`TEMPORARY BELT PRESS. 00300-13 certification, in addition to other remedies available to the Federal Governrntnt,the department or:agency may terminate this transaction for.cause or default. C. The prospocti.ve primary participant shall provide immediate written notice to thee department or agency to which this proposal is submitted if at any tithe the prospective primary participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed ei.rcumstonces. d, The terms covered transaction,debarred, suspended, ineligible,lower tier covered transaction;.participant,person; primary covered transaction,principal,proposal,and voluntarily excluded', as usedin this:clause, have the meanings set out in the Definitions and Coverage sections of the rules implementing Executive Order 1.2549. You may contaict.the department or agency to which this proposal is being submitted for:assistance in obtaining a copy of these regulations. C. 7'he prospective primary participant agrees by submitting this proposal that, should the Proposed covered transaction be entered into, it shall not knowingly enter into any louver tier .covered transaction with a person who is debarred,suspended,declared ineligible,:or voluntarily okeluded from participation in this covered transaction,unless authorized by the deparunent or agency entering into this transaction. f The prospective primary participant further agrees by sulinitting this proposal that it will include the clause titled.`Certification Regarding Debarment;Suspension,Ineligibility and Voluntary Exclusion—Lower Tier Covered Transaction,"provided by the department or agency entering into this covered transaction, without modilieatiop,in all lower tier covered transactions and in all solicitations for lower tier:covered transactions. g, A participant in a covered transaction may:rely upon'a certification of a prospective participant in a lower tier ce transaction thatt itis not debarred,suspends.ineligible,or voluntarily excluded from the covered.transaction;unless it knows that the.certification is erroneous. A participant may decide the:method and frequency by- which it determines this eligibility of its principals. Each participant may,.but is not required to,check the Non- procurement List. K Nothing contained in,the foregoing shall be construed to require establishment of a system of:records in order to render in good faith the certification acquired by this clause. 'Che knowledgeand information(if a participant is not.required.to exceed that which.is normally possessed by a prudent person in the ordinary course of business dealings. i. F xccpt for transactions authotized under paragraph(d)of these instructions, if a participant in a:covered transaction knowingly enters into a.tower tieucovered transaction with a. person who is suspended,debarred,ineligible,or voluntarily:excluded from participation in,this September 2011 Mandatory Bid Forms 249 WEST WRF TEMPORARY BELT PRESS 011300-14 transaction,in addition to other remedies available to the Federal Government,the department or agency may terminate this transaction for rause of default. Certification 8:.(Debarment,Suspension,Inelieibilihr and Voluntary Exclusion—Lower Tier Covered Transactions) a. Ther prospective lower tier participant certifies.by submission ofthis proposal,that neither.it;tier its principals is presently debarred,suspended,proposed for debarment,declared ineligible:,,or voluntarily exctaded from participation in this transaction by any Federal department or agency. b. VAere the prospective lower tier participant is unable to certify, to any.af the statements in.this certification,such,prospective participant shall_attach an explanation to this proposal.. Instructions.for Certifrcation.(.B) >3y signing and submitting this proposal,the prospective lower tier participant is providing the certification set out below. a. The certification in this clause is a material representation of tact upon which reliance was placed when this transaction was entered into. If it is later determined that the,prospective lower tier participant knowingly ren lerod on erroneous certification,.in addition to other remedies available to the:Federal Government,the deparirnent or agency with which this. transaction originated may pursue available remedies,including suspension and/or debarment. b. The prospective lower tier participant shall provide immediate written notice to the. pmort to whom this proposal is submitted if at any time the,prospective lower tier participant learns that its certification vas erroneous when submitted or has become orroneous by reason:of changed circumstances. 4, The terms covered transaction,debarred,suspended:Aneiigible,lower tier.covered transaction,participant,person_ primary covered transaction,principal,,:proposai,and.voltintarily excluded, as used in this clause,have the meanings set out"in the Definitions and Coverage sections ofrul'es implementiq Executive Order 12549. You may contact the person to which this proposal is submitted fir assistance in obtaining a:copy of these regulations. d. The.prospective lower tier participant agrees by submitting this proposal that, should the proposed covered transaction be entered into,,it shall not knowingly enter into any lower tier covered.transaction with a person who is debarred,.suspended,declared ineligible,or. Volurttarity excluded from participation in this covered transaction;:unless authorized by the department or agency with.which ibis transactiorl;originated. September 2021 Mandaitery Bid Forms 250 WEST WRF TEMPORARY BELT PRESS 00300-15 C. The prospective lower tier participant further agrees by submitting this proposal that it will include this clause title"Certification Regarding Debarment,Suspension, Ineligibility and Voluntary Exclusion—Lower Tier Covered'Transaction,"*thout modification, in all lower tier covered transactions and in all solicitation for lower tier covered transactions. f A participant in,a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred,suspended, ineligible,or voluntarily excluded from the covered transaction, unless it knows that the.certification is erroneous. A partieipantmay,decide.the method and f vquency.by which.It determines the eligibility of its principles. Bch participant.iziay but is not required to,check the.Non- procurement Dist. g. Nothing contained in the:foregoing shall be construed.to require establishment.of a system of.records`in Girder to render in good faith the.certification requirW by this clause. The knowledge and information of a.participantis not required to exceed that which is.nornial:ly possessed'by a prudent person in the ordinary course of business dealings.. h, :Exceptfor transactions authorwed muter paragraph(5)of then; instructions,if a. participant in:a.tower covered transaction knowingly enters into a lower tier covered transaction with a person.who is suspended,debarred, ineligible,or voluntarily-excluded from participation in this transaction,in addition to other remedies available to the Federal Governmerit,the department;or agency with which this transaction on'ginated may pursue available remedies including suspension and/or debarment. Applicant: - --- - Date: ... izsrvs. Signal orized'Certifying Official: Title: d a1 t'Ff d+sFr�if D��;c�ran.�r tr+5�.FCt.._ END OF SECTION September 2021 - Mandatory Bid Forms 251