HomeMy WebLinkAboutNielson and Company, Inc [The New Forida Industrial Electric Inc.] May 2021 Nielson, Wojtowicz, Neu & Associates
a Member of Nielson and Company, Inc.
1126 Central Avenue,Suite 200 St.Petersburg,FL 33705 Phone: (727)209-1803 Fax: (727)209-1335 www.nielsonbonds.com
**Bid Bond Attached**
To: The New Florida Industrial Electric, Inc. Date: 5/18/2021
Attn: Anne Fitzgerald
Attached,please find the bid bond for the following:
Bid Date: 5/21/2021 Estimated Bid Amt: $250,000**
Owner: City of Winter Springs
Project: Water treatment Plant No 2 Electrical ITB 02
**NOTE,should your bid exceed the above estimate by 10%or greater, we must be notified. Please call
(727)209-1803.
In order to maintain accurate records to better serve you, we request your assistance in
providing bid results once they become available.
Please complete this form and return via fax to(727)209-1335 or email to: eheard@nielsonbonds.com.
Results:
Contractor Name Bid Amount
Low Bidder $
2"d Bidder $
3rd Bidder $
*****If your bid exceeds the first three:
Thank you for your assistance&GOOD LU !
Sincerely,
Niefson, Wojtowicz, Ne c AssociateeTampa Bay
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READER OF THIS MESSAGE IS NOT THE INTENDED RECIPIENT(S)OR EMPLOYEE/AGENT RESPONSIBLE TO DELIVER IT TO
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ADDRESS.
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X:\CONTRACTOR\CLIENTS\S-T\THE NEW FLORIDA INDUSTRIAL ELECTRIC INC\BID RESULTS SHEET.D000NE
OF THE ABOVE NUMBERS
Water Treatment Plant No.2 Electrical Improvements 00410-1
SECTION 00410
BID BOND FORM
KNOW ALL MEN BY THESE PRESENTS, that we, the undersigned,
The New Florida Industrial Electric,Inc. as Principal, and Great American Insurance Company as
Surety, are hereby and firmly bound unto the CITY OF WINTER SPRINGS as OWNER, in the
penal Sum of Five Percent of Amount Bid Dollars ($ 5%amt bid ) for the
payments of which, well and truly to be made, we hereby jointly and severally bind ourselves,
our heirs, executors, administrators, successors, and assigns.
The condition of the above obligation is such that whereas the Principal has submitted to the
CITY OF WINTER SPRINGS a certain Bid, attached hereto and hereby made a part hereof to
enter into a contract in writing, for the Work described as:
Water Treatment Plant No.2 Electrical Improvements
NOW, THEREFORE, if the Principal shall not withdraw said Bid within 90 days after the
opening of the same, or in the alternate, if said Bid shall be accepted and the Principal shall
execute and deliver required certificates of insurance and a contract that, at minimum, includes
the terms of the Form of Agreement attached hereto (properly completed in accordance with said
Bid), and shall give bond with good and sufficient surety or sureties, as may be required, for the
faithful performance and proper fulfillment of such contract, then this obligation shall be void;
otherwise the same shall remain in force and effect and the sum herein stated shall be due and
payable to the CITY OF WINTER SPRINGS and the Surety herein agrees to pay said sum
immediately, upon demand of the CITY OF WINTER SPRINGS, in good and lawful money of
the United States of America, as liquidated damages for failure of the Principal; it being
expressly understood and agreed that the liability of the Surety for any and all claims hereunder
shall, in no event, exceed the penal amount of this obligation as herein stated.
The Surety, for value received, hereby stipulates and agrees that the obligations of said Surety
and its bond shall be in no way impaired or affected by an extension of the time within which the
OWNER may accept such Bid; and said Surety does hereby give waive notice of any such
extension.
IN WITNESS WHEREOF, the above bounded parties have executed this instrument under
their several seals this 21st day of May 12021 , the name and corporate
seal of each corporate body being hereto affixed and these presents duly signed by its
undersigned representative, pursuant to authority of its governing body.
The New Florida Industrial Electric Inc.
V�
(Principal (Seal)
April 2021 Bid Bond Form
4
Water Treatment)Plant No.2 Electrical Improvements 00410-2
(Witness) Me)
104 Commerce Street,Lake Mary FL 32746
(Address)
Great American Insurance Company •,�• .
(Surety) (Seal)
Eileen Heard
(Witness) Kevin Wojtowicz,Attorn ytm-fact and Florida Licensed .
Resident Agent
(Address 1000 Central Ave,#200,St.Petersburg FL 33 m
END OF SECTION
April 2021 Bid Bond Form
GREAT AMERICAN INSURANCE COMPANY®
Administrative Office: 301 E 4TH STREET Y CINCINNATI,OHIO 45202 • 513-369-5000 • FAX 513-723-2740
The number of persons authorized by
this power of attorney is not more than THREE
No.O 21600
POWER OF ATTORNEY
KNOW ALL NI EN BYTHESE PRESENTS: That the GREAT AMERICAN INSURANCE COMPANY,a corporation organized and existing under
and by virtue of the laws of the State of Ohio,does hereby nominate,constitute and appoint the person or persons named below,each individually if more than
one is named,its trite and lawful attomey-in-fact,for it and in its name,place and stead to execute our behalf of the said Company,as surety,any and all bonds,
undertakings and contracts of suretyship,or other written obligations in the nature thereof,provided that the liability of the said Company on any such bond,
undertaking or contract of suretyship executed under this authority shall not exceed the limit stated below.
Name Address Limit of Power
KEVIN WOJTOWICZ ALL OF ALL
EILEEN C.HEARD ST.PETERSBURG,FLORIDA $100,000,000
JESSICA P.RENO
This Power of Attorney revokes all previous powers issued on behalf of the attorneys)-in-fact named above.
IN WITNESS WHEREOF the GREATAMERICAN INSURANCE COMPANY has caused these presents to be signed and attested by its appropriate
officers and its corporate seal hereunto affixed this 9TH day of FEBRUARY 2021
Attest GREAT AMERICAN INSU ANCE COMPANY
As.ri.viuni Scrreiun L)Amwial Senior'i'irc l',oidew
STATE OF OHIO,COUNTY OF HAMILTON-ss: MARK wCARiO(an-art-2405)
On this 9TH day of FEBRUARY 2021 ,before me personally appeared MARK VICARIO,tome known,
being duly sworn,deposes and says that he resides in Cincinnati,Ohio,that lie is a Divisional Senior Vice President of the Bond Division of Great American
Insurance Company,the Company described in and which executed the above instrument,that he knows the seal ofthe said Company;that the seal affixed to the
said instrument is such corporate seal.that it was so affixed by authority of his office under the By-Laws of said Company,and that he signed his name thereto
by like authority.
-N 111. SUSAN A KOHORST
�~c. '= Notary Public /
r- State o Ohio
= 1L9~ My Comm.,Expires
May 18,2025
This Power ofAttomey is granted by authority of the following resolutions adopted by the Board of Directors of Great American Insurance Company
by unanimous written consent dated June 9,2008.
RESOLVED: That the Divisional President,the several Divisional Senior Vice Presidents,Divisional Vice Presidents and Divisonal Assistant Vice
Presidents,or am One of their,be and hereby is authorized,front brie to time, to appoint one or more Attai•nevs-in•Fact to execute oil behalit'oflhe Compam',
cis sitrert%aiiv and all bonds,undertakings and contracts of'suren'ship,or other written obligations in the nature thereoj,'to prescribe their respective duties and
the respective limits of their aulho•in% and to revoke mnY such appointment at am•time.
RESOL 6'ED FURTHER: That the Coinpanv seal and the signature of anv of the aforesaid officers and anv Secretary or Assistant Secretary of the
Compam•nun'be affixed bvjac•simile to any power of attorney or certificate of either given for the execution ojanv bond undertaking,contract of suretyship,
or other written obligation in the nature thereof such signature and seal when so used being herebv adopted by the Company'as the original signature of such
officer and the original seal of the Conipanv. to be valid and binding upon the Compam•with the same force and effect as though mantially affixed
CERTIFICATION
1,STEPHEN C.BERAHA,Assistant Secretary of Great American Insurance Company,do hereby certify that the foregoing Power of Attorney and
the Resolutions of the Board of Directors of June 9,2008 have not been revoked and are now in full force and effect.
Signed and sealed this; day of
•• Assistant Secrelnn
S1029AH(03/20) '
Water Treatment Plant No. 2 Electrical Improvements 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
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):
The New Florida Industrial Electric, Inc.
Address:
104 Commerce Street, Lake Mary, FL 32746
Contact Name:
Bob Kingston
Contact Phone Number:
407-792-8319
Contact E-Mail Address:
Bob.KingstonQa fie-inc.com
1.02The Undersigned:
A. Acknowledges receipt of:
1. Project Manual for WATER TREATMENT PLANT NO. 2
ELECTRICAL IMPROVEMENTS, March 2021.
2. Drawings for WATER TREATMENT PLANT NO. 2, February
2021.
3. Addenda:
Number 1 , dated 4/22/2021
Number 2 , dated 5/6/2021 Number 3, Dated 5-18-21
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
April 2021 Mandatory Bid Forms
Water Treatment Plant No.2 Electrical Improvements 00300-2
the same.
C. Agrees:
1. To hold this Bid open for 90 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 regarding
disposition of Bid Security.
4. To enter into and execute a contract with the OWNER, if awarded on
the basis of this Bid.
5. To accomplish the work in accordance with the contract documents.
6. To complete the work within 120 calendar days of date of the Notice to
Proceed(Final Completion).
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/contractor and
that the vendor/contractor is ready, willing, and able to perform if awarded the bid.
1.03 Stipulated Amount
A. Base Bid Price
I will provide the services under this pro'e1 ct for a Total Base Bid Amount of:
l� Dollars ($
The Bidder hereby agrees to perform all work as required by the Contract Documents for the
following Unit Prices. All work required to be performed by the Contract Documents is to be
included within the following Pay Items, inclusive of furnishing all manpower, equipment,
materials and performance of all operations relative to construction of the project. 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 contract work at 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
A. Bids must be submitted in triplicate on the Bid Form.
B. I have attached the required Bid Security to this Bid.
April 2021 Mandatory Bid Forms
Water Treatment Plant No.2 Electrical Improvements 00300-3
C. I have attached all other Mandatory Forms in this Section.
1.05 Submittal
RESPECTFULLY SUBMITTED, signed and sealed this 1 9th day of May , 2021.
Bidder
By:
f1ti Title Corporate Secretary
ATTEST: SECRETARY SEAL
April 2021 Mandatory Bid Forms
Water Treatment Plant No.2 Electrical Improvements 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 construction 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,
r� r
ITEIftC1L� �� � DE�C1t�IPTION � ' � �'�tJ[�tI"1` � C2�`At#��Tl� ��,�l�t" p � AM0I7151T
GENERAL
1 Mobilization/General Conditions LS 1
2 Project Closeout/Record Drawings LS 1
SITE WORK
3 Landscaping LS 1 5 3_7g-00
4 Demolition LS 1 ,����/� a
CONCRETE
5 Pump Building Restoration LS 1 �LI,�j' ,00
6 Generator Slab LS 1 'q,670.®d
ELECTRICAL
7 Electrical LS 1
8 VFD LS 1 y�L� 00
Handling, installation and Start-up of
9 ODP Equipment LS 1 �1t(��j,00
CONSTRUCTION GRAND TOTAL
TOTAL BID:
r #&"Ad Ixon/ DOLLARS
(In Words)
April 2021 Mandatory Bid Forms
Water Treatment Plant No. 2 Electrical Improvements 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
o£
(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
April 2021 Mandatory Bid Forms
Water Treatment Plant No.2 Electrical Improvements 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 -ist;
engage in a boycott of Israel; or engage in business operations ' Cuba or •ia.
--/ -
(Authorized Signature)
Anne Fitzgerald,Corporate Secretary
(Printed Name and Title)
The New Florida Industrial Electric, Inc
(Name of Vendor)
STATE OF Florida
COUNTY OF Seminole
The foregoing instrument was acknowledged before me by means of (�
physical presence or (_) online notarization, this 19th day of May
2021, by Anne Fitzgerald the Corporate Secretary of
The New Florida Industrial Electric, Inc a
✓ who is personally known to me or (_) who produced
as identification.
[:Z--: ,,s MARTHASCHARDIN
_ MY COMMISSION#GG109862o;= EXPIRES;August 4,2021
ga�dedThruNotaryPublicUnderwriters Notary Public
Print Name: k.c-'+�'
My Commission expires:
April 2021 Mandatory Bid Forms
Water Treatment Plant No.2 Electrical Improvements 00300-7
NON-COLLUSION AND CONTINGENT FEES AFFADAVIT
State of Florida
County of Anne Fitzgerald ,being first duly sworn, deposes and says that:
He / She is Corporate Secretary of The New Florida Industrial Electric, Inc , 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, co is ion, percentage, gift, or
consideration.
(Authorized Signature)
Anne Fitzgerald, Corporate Secretary
(Printed Name and Title)
The New Florida Industrial Electric, Inc
(Name of Vendor)
STATE OF Florida
April 2021 Mandatory Bid Forms
Water Treatment Plant No.2 Electrical Improvements 00300-5
COUNTY OF Seminole
The foregoing instrument was acknowledged before me by means of l r V physical
presence or (___) online notarization, this 19th day of May , 2021, by
Anne Fitzgerald the Corporate Secretary of
The New Florida Industrial Electric, Inc a
✓ who is personally known to me or (__) who produced
as identification.
,.,< Y:;;''• MARTHASCHARDIN
W COMMISSION#GG 109862 Notary Public
EXPIRES:August 4,2021
'oP
l3ondea mru Notary P, undennicers Print Name: ac"" Sc�x-fAt/1
My Commission expires: , 4 , z-fi-LA
April 2021 Mandatory Bid Forms
Water Treatment Plant No. 2 Electrical Improvements 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.
The New Florida Industrial Electric, Inc
(Company)
OE�T�_ Cc�r
(Signature & Title)
April 2021 Mandatory Bid Forms
Water Treatment Plant No.2 Electrical Improvements 00300-10
CONFLICT OF INTEREST CERTIFICATION
Before me, the undersigned authority, personally appeared, who was duly sworn,
deposes, and states:
The New Florida Industrial Electric, Inc
I am the Corporate Secretary of with a local office in
Lake Mary, Florida and principal office in Lake Mary, Florida
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 #02-21 DS
WATER TREATMENT PLANT NO. 2 ELECTRICAL IMPROVMENTS
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.
April 2021 Mandatory Bid Forms
Water Treatment Plant No.2 Electrical Improvements 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.
The New Florida Industrial Electric, Inc 407-331-1551, NA
(Authorized Signature) Name of Business Phone &Fax Number
Anne Fitzgerald, Corporate Secretary 104 Commerce Street Lake Mary, FL 32746
(Printed Name and Title) Business Mailing Address City, State, Zip
April 2021 Mandatory Bid Forms
Water Treatment Plant No.2 Electrical Improvements 00300-12
FLORIDA TRENCH SAFETY ACT CERTIFICATION
Bidder acknowledges that the Bidder must comply with the Florida Trench Safety Act and
applicable trench safety standards. Included in the various items of the proposal and in the
Total Bid Price are costs for complying with the Florida Trench Safety Act(90-96, Laws of
Florida) effective October 1, 1990. The bidder further identifies the costs to be summarized
below. The separate item identifying the cost of compliance with trench safety standards
shall be based on the linear feet of trench to be excavated. The separate item for special
shoring requirements, if any, shall be based on the square feet of shoring used. Every
separate item shall indicate the specific method of compliance as well as the cost of that
method.
Item Trench Safety Unit of Unit Unit Cost Extended Cost
Measure Description Measure
N/A
This amount disclosed as the cost of compliance with the applicable trench safety
requirement does not constitute the extent of the Contractor's obligation to comply with said
standards. Contractor shall expend additional sums, at no additional cost to the OWNER
(except as may otherwise be provided) which are necessary to so comply.
Acceptance of the bid to which this certification and disclosure applies in no way represents
that the OWNER or its representatives have evaluated and thereby determined that the above
costs are adequate to comply with the applicable trench safety requirements nor does it in any
way relieve the bidder, as Contractor, of its sole responsibility to comply with the applicable
trench safety requirements.
The Now Florida Industrial Electric, Inc
Name Firm
Authorized Signature
Date: 5/19/2021
This document shall be submitted with the Bid packet. Failure to complete the above may
result in the bid being declared non-responsive.
April 2021 Mandatory Bid Forms
Water Treatment Plant No.2 Electrical Improvements 00300-13
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,
malting 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
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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
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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.
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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:
Anne Fitzgerald 5/19/2021
Signa � f Authorized Certifying Official: Title:
Corporate Secretary
END OF SECTION
April 2021 Mandatory Bid Forms
INDUSTaIAL
FdMW ELECT;41C:
May 18, 2021
Corporate Statement
The New Florida In ustrial Electic, Inc. is a Florida Corporation.
1
i
Anne Fitzgerald
Corporate Secretary
Corporate Seal
�� FLORIDA Sanford, FL 32771 INDUSTRIAL ELECTRIC
291 Specialty Point
S'"ce,9as (407)331-1551
THE NEW FLORIDA INDUSTRIAL ELECTRIC, INC., DBA
FLORIDA INDUSTRIAL ELECTRIC
CORPORATE RESOLUTION
CORPORATE SIGNATURE AUTHORIZATION
BE IT RESOLVED: That the President, Conrad D. Eigemann, Jr., Executive Vice President, Michael J.
Scharf and Secretary Anne Fitzgerald and any one of them acting individually, be and they are hereby
authorized to sign any and all bids or other securities now or hereafter in the name of this Corporation.
I, Anne Fitzgerald, Secretary to The New Florida Industrial Electric, Inc., dba Florida Industrial Electric,
hereby certify that the foregoing is true and a complete copy of a resolution duly adopted by the Board
of Directors of the said corporation at a meeting duly held on July 20, 2012 at which a quorum was
present and voting throughout, and that the same has not been repealed or amended, and remains in full
force and effect and does not conflict with the by-laws of said corporation.
Printed Name
C-
ZS� 9
Secretary Date
(CORPORATE SEAL)