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Home My WebLink AboutFausnight Stripe and Line Inc. Piggyback Rider for Roadway Markings, Striping and Brick texture 2023 11 011 Piggyback Rider City of Winter Springs and Fausnight Stripe and Line, Inc. Page 2 of 16 Government Contract shall remain firm throughout the duration of the Initial Term. Thereafter, should the Contractor desire to request price increases, Contractor shall do so in accordance with Exhibit “2” no more frequently than once per year at the time of extension for an additional one- year term. Any price increase shall not exceed the prior twelve (12) months CPI-All Urban Consumers (CPI-U) adjustment. Price increases agreed to by the Original Government Agency after the Effective Date of this Agreement shall not be binding upon the City of Winter Springs unless an Amendment to this Agreement is properly executed by an authorized representative of the City of Winter Springs. c) Order of Precedence. The Original Government Contract shall be amended to provide that the Contract Documents shall consist of: (1) this Rider; (2) the Original Government Contract, together with all exhibits, attachments, and duly executed amendments; and (3) Solicitation No. IFB-604562-23/LNF documents together with all addenda thereto issued by the Original Government Agency; and (4) any and all Specifications, Amendments, Task Orders, Change Orders, and Field Orders issued after the Effective Date of this Agreement by the City of Winter Springs. The order of precedence will be as follows in the event of a conflict among the Contract Documents: properly executed Change Orders, Field Orders, and Amendments issued after the Effective Date of this Agreement; this Rider; the Original Government Contract; and Invitation to Bid for Original Solicitation No. IFB-604562-23/LNF documents, with all addenda thereto. Price increases agreed to by the Original Government Agency after the Effective Date of this Agreement shall not be binding upon the City of Winter Springs unless an Amendment to this Agreement is properly executed by an authorized representative of the City of Winter Springs. d)Insurance. Certificate Holder address shall read: City of Winter Springs Attn: Finance Department 1126 East State Road 434 Winter Springs, FL 32708 The remainder of the insurance requirements presented in the Exhibit “A” and Exhibit “B” shall be unchanged. e) Public Records. Section 25(e) of Exhibit “A” is amended to provide: IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO ITS DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS AGREEMENT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS AT: City Clerk, City of Winter Springs, 1126 East State Road 434, Winter Springs, FL 32708 or City-Clerk- Department@winterspringsfl.org or (407) 327-6560. 2 Piggyback Rider City of Winter Springs and Fausnight Stripe and Line, Inc. Page 3 of 16 Section 25(e) is further amended to provide as follows: If Contractor fails to comply with this Section, and the City must enforce this Section, or the City suffers a third party award of attorney’s fees and/or damages for violating Chapter 119, Florida Statutes, due to Contractor’s failure to comply with this Section, the City shall collect from Contractor prevailing party attorney’s fees and costs, and any damages incurred by the City, for enforcing this Section against Contractor. And, if applicable, the City shall also be entitled to reimbursement of all attorneys’ fees and damages which the City had to pay a third party because of the Contractor’s failure to comply with this Article. The remainder of the Section shall be unchanged. f)Project Price. The amount set forth in each Task Order shall not exceed fifty thousand dollars ($50,000) without prior authorization of the City Commission. The remainder of the Original Government Contract’s Price Terms shall be unchanged. g) Miscellaneous. The following provisions are hereby added to or modified from the Original Government Contract. To the extent the terms and conditions below may conflict with terms and conditions contained in Exhibit “A” or Exhibit “B,” the terms and conditions as set forth below shall control. i. Notices to the City shall be delivered to: City Manager City of Winter Springs, Florida 1126 East State Road 434 Winter Springs, FL 32708 Any Notice given as provided herein shall be deemed received as follows: if delivered by personal service, on the date so delivered; if delivered to an overnight courier service, on the business day immediately following delivery to such service; and if mailed, on the third business day after mailing. ii.The City intends to avail itself of the benefits of Section 768.28, Florida Statutes and any other statutes and common law governing sovereign immunity to the fullest extent possible. Neither this provision nor any other provision of this Agreement shall be construed as a waiver of the City’s right to sovereign immunity under Section 768.28, Florida Statutes, or other limitations imposed on the City’s potential liability under state or federal law. Contractor agrees that City shall not be liable under this Agreement for punitive damages or interest for the period before judgment. Further, City shall not be liable for any claim or judgment, or portion thereof, to any one person for over two hundred thousand dollars ($200,000.00), or any claim or judgment, or portion thereof, which, when totaled with all other claims or judgments paid by the State or its agencies and subdivisions arising out of the same incident or occurrence, exceeds three hundred 3 Piggyback Rider City of Winter Springs and Fausnight Stripe and Line, Inc. Page 4 of 16 thousand dollars ($300,000.00). Nothing in this Agreement is intended to inure to the benefit of any third party for the purpose of allowing any claim which would otherwise be barred under the doctrine of sovereign immunity or by operation of law. This paragraph shall survive termination of this Agreement. iii.Should either party bring an action to enforce any of the terms of this Agreement, each party shall bear its own costs and expenses of such action including, but not limited to, reasonable attorney’s fees, whether at settlement, trial or on appeal. This provision does not apply to Contractor’s surety. i v.The parties agree that should any dispute arise between them regarding the terms or performance of this Agreement, both parties will participate in mediation. The parties agree to equally share the cost of the mediator. Should the parties fail to resolve their differences through mediation, then any cause of action filed hereunder shall be filed in the Circuit or County Court for Seminole County, Florida. The Contractor’s surety is bound by this provision. v.Any delay or failure of either party in the performance of its required obligations hereunder shall be excused if and to the extent caused by acts of God, fire, flood, windstorm, explosion, riot, war, sabotage, strike (except involving Contractor’s labor force), extraordinary breakdown of or damage to City’s facilities, court injunction or order, federal and/or state law and/or regulation, or order by any other regulatory agency, provided that the prompt notice of such delay is given by such party to the other and each of the parties hereto shall be diligent in attempting to remove such cause or causes. If any circumstance of Force Majeure remains in effect for sixty (60) days or longer, either party may terminate this Agreement. Monetary damages will not be awarded to Contractor in the event of Force Majeure. vi.The Contractor shall seek prior written approval from the City for any lane closure requests before closing, blocking, or barricading any lanes of traffic on roadways within the City. vii.The Contractor shall seek prior written approval from the City prior to performing work in a City right-of-way. The Contractor recognizes that it may need to obtain a right-of-way permit prior to conducting any work in a City right-of-way. The Contractor agrees to obtain a right-of-way permit and to abide by all terms and conditions contained therein. viii.The Contractor may be required to submit a Performance and Payment Bond prior to execution of any Task Order at the request of the City’s Engineer, but shall be required to do so for any project exceeding the cost of $200,000.00 as required by section 255.20, Florida Statutes. The Contractor shall utilize the Performance and Payment Bond forms attached to this Agreement as Exhibit “C.” ix.The Contract shall be governed by the laws of the State of Florida. Venue for any action arising out of or relating to this Contract shall lie in Seminole County, Florida for state court actions and Orlando, Florida for federal court actions. The Contractor’s surety is bound by this provision if a Performance and Payment Bond is required. 4 5 Piggyback Rider City of Winter Springs and Fausnight Stripe and Line, Inc. Page 6 of 16 EXHIBIT A ORIGINAL GOVERNMENT CONTRACT 6 Seminole County Clerk of the Circuit Court and Comptroller eCertified at 09/12/2023 09:13:18 -04:00 eCertified Id: 03C4-24I0-0D5L Page 1 of 36 7 Seminole County Clerk of the Circuit Court and Comptroller eCertified at 09/12/2023 09:13:18 -04:00 eCertified Id: 03C4-24I0-0D5L Page 2 of 36 8 Seminole County Clerk of the Circuit Court and Comptroller eCertified at 09/12/2023 09:13:18 -04:00 eCertified Id: 03C4-24I0-0D5L Page 3 of 36 9 Seminole County Clerk of the Circuit Court and Comptroller eCertified at 09/12/2023 09:13:18 -04:00 eCertified Id: 03C4-24I0-0D5L Page 4 of 36 10 Seminole County Clerk of the Circuit Court and Comptroller eCertified at 09/12/2023 09:13:18 -04:00 eCertified Id: 03C4-24I0-0D5L Page 5 of 36 11 Seminole County Clerk of the Circuit Court and Comptroller eCertified at 09/12/2023 09:13:18 -04:00 eCertified Id: 03C4-24I0-0D5L Page 6 of 36 12 Seminole County Clerk of the Circuit Court and Comptroller eCertified at 09/12/2023 09:13:18 -04:00 eCertified Id: 03C4-24I0-0D5L Page 7 of 36 13 Seminole County Clerk of the Circuit Court and Comptroller eCertified at 09/12/2023 09:13:18 -04:00 eCertified Id: 03C4-24I0-0D5L Page 8 of 36 14 Seminole County Clerk of the Circuit Court and Comptroller eCertified at 09/12/2023 09:13:18 -04:00 eCertified Id: 03C4-24I0-0D5L Page 9 of 36 15 Seminole County Clerk of the Circuit Court and Comptroller eCertified at 09/12/2023 09:13:18 -04:00 eCertified Id: 03C4-24I0-0D5L Page 10 of 36 16 Seminole County Clerk of the Circuit Court and Comptroller eCertified at 09/12/2023 09:13:18 -04:00 eCertified Id: 03C4-24I0-0D5L Page 11 of 36 17 Seminole County Clerk of the Circuit Court and Comptroller eCertified at 09/12/2023 09:13:18 -04:00 eCertified Id: 03C4-24I0-0D5L Page 12 of 36 18 Seminole County Clerk of the Circuit Court and Comptroller eCertified at 09/12/2023 09:13:18 -04:00 eCertified Id: 03C4-24I0-0D5L Page 13 of 36 19 Seminole County Clerk of the Circuit Court and Comptroller eCertified at 09/12/2023 09:13:18 -04:00 eCertified Id: 03C4-24I0-0D5L Page 14 of 36 20 Seminole County Clerk of the Circuit Court and Comptroller eCertified at 09/12/2023 09:13:18 -04:00 eCertified Id: 03C4-24I0-0D5L Page 15 of 36 21 Seminole County Clerk of the Circuit Court and Comptroller eCertified at 09/12/2023 09:13:18 -04:00 eCertified Id: 03C4-24I0-0D5L Page 16 of 36 22 Seminole County Clerk of the Circuit Court and Comptroller eCertified at 09/12/2023 09:13:18 -04:00 eCertified Id: 03C4-24I0-0D5L Page 17 of 36 23 Seminole County Clerk of the Circuit Court and Comptroller eCertified at 09/12/2023 09:13:18 -04:00 eCertified Id: 03C4-24I0-0D5L Page 18 of 36 24 Seminole County Clerk of the Circuit Court and Comptroller eCertified at 09/12/2023 09:13:18 -04:00 eCertified Id: 03C4-24I0-0D5L Page 19 of 36 25 Seminole County Clerk of the Circuit Court and Comptroller eCertified at 09/12/2023 09:13:18 -04:00 eCertified Id: 03C4-24I0-0D5L Page 20 of 36 26 Seminole County Clerk of the Circuit Court and Comptroller eCertified at 09/12/2023 09:13:18 -04:00 eCertified Id: 03C4-24I0-0D5L Page 21 of 36 27 Seminole County Clerk of the Circuit Court and Comptroller eCertified at 09/12/2023 09:13:18 -04:00 eCertified Id: 03C4-24I0-0D5L Page 22 of 36 28 Seminole County Clerk of the Circuit Court and Comptroller eCertified at 09/12/2023 09:13:18 -04:00 eCertified Id: 03C4-24I0-0D5L Page 23 of 36 29 Seminole County Clerk of the Circuit Court and Comptroller eCertified at 09/12/2023 09:13:18 -04:00 eCertified Id: 03C4-24I0-0D5L Page 24 of 36 30 Seminole County Clerk of the Circuit Court and Comptroller eCertified at 09/12/2023 09:13:18 -04:00 eCertified Id: 03C4-24I0-0D5L Page 25 of 36 31 Seminole County Clerk of the Circuit Court and Comptroller eCertified at 09/12/2023 09:13:18 -04:00 eCertified Id: 03C4-24I0-0D5L Page 26 of 36 32 Seminole County Clerk of the Circuit Court and Comptroller eCertified at 09/12/2023 09:13:18 -04:00 eCertified Id: 03C4-24I0-0D5L Page 27 of 36 33 Seminole County Clerk of the Circuit Court and Comptroller eCertified at 09/12/2023 09:13:18 -04:00 eCertified Id: 03C4-24I0-0D5L Page 28 of 36 34 Seminole County Clerk of the Circuit Court and Comptroller eCertified at 09/12/2023 09:13:18 -04:00 eCertified Id: 03C4-24I0-0D5L Page 29 of 36 35 Seminole County Clerk of the Circuit Court and Comptroller eCertified at 09/12/2023 09:13:18 -04:00 eCertified Id: 03C4-24I0-0D5L Page 30 of 36 36 Seminole County Clerk of the Circuit Court and Comptroller eCertified at 09/12/2023 09:13:18 -04:00 eCertified Id: 03C4-24I0-0D5L Page 31 of 36 37 Seminole County Clerk of the Circuit Court and Comptroller eCertified at 09/12/2023 09:13:18 -04:00 eCertified Id: 03C4-24I0-0D5L Page 32 of 36 38 Seminole County Clerk of the Circuit Court and Comptroller eCertified at 09/12/2023 09:13:18 -04:00 eCertified Id: 03C4-24I0-0D5L Page 33 of 36 39 Seminole County Clerk of the Circuit Court and Comptroller eCertified at 09/12/2023 09:13:18 -04:00 eCertified Id: 03C4-24I0-0D5L Page 34 of 36 40 Seminole County Clerk of the Circuit Court and Comptroller eCertified at 09/12/2023 09:13:18 -04:00 eCertified Id: 03C4-24I0-0D5L Page 35 of 36 41 Seminole County Clerk of the Circuit Court and Comptroller eCertified at 09/12/2023 09:13:18 -04:00 eCertified Id: 03C4-24I0-0D5L Page 36 of 36 42 Piggyback Rider City of Winter Springs and Fausnight Stripe and Line, Inc. EXHIBIT B SOLICITATION NO. IFB-604562-23/LNF 43 INVITATION FOR BID IFB-604562-23/LNF IFB-604562-23/LNF - TERM CONTRACT FOR ROADWAY MARKINGS, STRIPING AND BRICK TEXTURE SURFACING 1301 East Second St. Sanford, FL 32771 RELEASE DATE: June 2, 2023 DEADLINE FOR QUESTIONS: July 19, 2023 RESPONSE DEADLINE: August 2, 2023, 2:00 pm RESPONSES MUST BE SUBMITTED ELECTRONICALLY TO: 44 IFB #IFB-604562-23/LNF Title: IFB-604562-23/LNF - Term Contract for Roadway Markings, Striping and Brick Texture Surfacing 2 https://secure.procurenow.com/portal/seminolefl 45 Seminole County IFB #IFB-604562-23/LNF IFB-604562-23/LNF - Term Contract for Roadway Markings, Striping and Brick Texture Surfacing TABLE OF CONTENTS I. Introduction ............................................................................................................ II. Scope of Services .................................................................................................. III. Instructions to Bidders ........................................................................................... IV. Instructions for the Preparation of Bids .................................................................. V. Pricing Proposal .................................................................................................... VI. Evaluation Phases ................................................................................................. Attachments: B - Draft Agreement (IFB-604562-23) C - IFB-604562-23 Price Proposal 46 IFB #IFB-604562-23/LNF Title: IFB-604562-23/LNF - Term Contract for Roadway Markings, Striping and Brick Texture Surfacing 1 1. INTRODUCTION The Bidder is expected to completely analyze the information contained in this Invitation for Bid (IFB) as guidance for the preparation of their written submittal. The Bidder’s written bid should be specific, detailed, and complete to demonstrate the Bidder’s understanding of the requested work clearly and fully and/or delivery requirements. 1.1. Summary Contractor will provide all materials, delivery, labor, transportation, coordination and incidentals necessary to perform services and to furnish products as specified in the IFB documents. 1.2. Background This is an indefinite quantity contract for the goods and services specified. The quantities of goods and services specified are estimates only and are not purchased by this Contract. Delivery or performance shall be only as authorized by orders in accordance with the terms of this Contract. The County may issue orders requiring delivery to multiple destinations or performance at multiple locations. 1.3. Contact Information Leticia Figueroa Senior Procurement Analyst 1301 East Second Street Sanford, FL 32771 Email: lfigueroa@seminolecountyfl.gov Phone: (407) 665-7119 Department: Resource Management - Purchasing & Contracts 1.4. Timeline Release Project Date June 2, 2023 Question Submission Deadline July 19, 2023, 10:00am Proposal Submission Deadline August 2, 2023, 2:00pm 47 IFB #IFB-604562-23/LNF Title: IFB-604562-23/LNF - Term Contract for Roadway Markings, Striping and Brick Texture Surfacing 2 2. SCOPE OF SERVICES 2.1. Scope of Services Contractor will provide all materials, delivery, labor, transportation, coordination and incidentals necessary to perform services and to furnish products as specified in the IFB documents. This is an indefinite quantity contract for the goods and services specified. The quantities of goods and services specified are estimates only and are not purchased by this Contract. Delivery or performance shall be only as authorized by orders in accordance with the terms of this Contract. The County may issue orders requiring delivery to multiple destinations or performance at multiple locations. No work will begin until a Release Order has been issued to the contractor. The Order for each project will contain a start date and completion date. Each Order will be treated as a standalone project. Contractor Responsibility, Compliance and Specifications: 1. The Contractor and Subcontractors must be FDOT certified. Certification shall remain in effect during the term of the contract. 2. Contractor will be responsible for supervising, directing, and sufficiently performing all work competently and efficiently, devoting such attention thereto and applying such skills and expertise as may be necessary to perform the work in accordance with the contract documents, including all applicable standards and specifications. 3. Contractor will be solely responsible for all means, methods, techniques, scheduling, sequences, and procedures of construction, for providing adequate safety precautions, for coordinating all portions of the work under the contract documents, traffic control, and for enforcement of order and cooperation among contractor’s employees and all subcontractors and suppliers. 4. Contractor will be responsible to see that the finished work complies accurately with the contract documents and specifications. 5. All materials and services provided through this contract shall conform and adhere to the latest edition of the Seminole County and Florida Department of Transportation Standards; including the Seminole County Land Development Code, Seminole County Traffic Ordinance, FDOT Roadway and Traffic Design Standards and Standard Specifications for Roadway and Bridge Construction. In addition, this contract shall conform to A.A.S.H.T.O. design standards and the Manual on Uniform Traffic Control Devices (MUTCD). All materials used shall be FDOT approved and / or on the FDOT Approved Products List (APL) or FDOT Qualified Products List (QPL), unless otherwise approved by Seminole County. 48 IFB #IFB-604562-23/LNF Title: IFB-604562-23/LNF - Term Contract for Roadway Markings, Striping and Brick Texture Surfacing 3 6. In resolving conflicts, errors or discrepancies, the contract documents shall be construed as one- what is required by one document shall be construed as being required by all contract documents. If an issue of priority is due to a conflict or discrepancy between express provisions of the contract documents and any referenced specifications, manuals, or codes of any technical society, organization or association, the provisions of the contract documents will take precedence if they are more stringent or presumptively cause a higher level or performance. If there is any conflict or discrepancy between standard specifications, manuals, or codes of any technical society, organization or association, or between laws or regulations, the provision with the higher cost requirement shall be binding on contractor, unless otherwise directed by the County. In accordance with the intent of the contract documents, Contractor recognizes and accepts that compliance with the priority order specified shall not justify increase in contract price. 7. Contractor shall acquire a Right of Way permit from the Seminole County Engineering Division prior to performing any work within County Right of Way. 8. Permitted lane closures require prior approval by the Seminole County Traffic Engineer or designee. Pay Item Notes: 1 – 11 and 193 FDOT pay items 700-1-11 through 700-1-14, 700-1-18, 700-1-50, 700-1-60, 700-3-101, 700-3-102, 705-11-1, 705-11-3 and QK-SEPR (traffic signs, delineators and Qwick Kurb Traffic Separator). These items shall be paid based on a furnish and install cost. 26 and 66 FDOT pay items 710-11-321 and 710-12-321 (Black paint) may be used for contrast markings per FDOT Index 17346. These items will be paid per liner foot of black paint installed. 12-25 and 27 FDOT pay items 710-11-121 through 710-11-125, 710-11-131, 710-11-141, 710-11-143, 710-11-190, 710-11-221, 710-11-224, 710-11-231, 710-11-241 710-11-290 and 710-11-421 (standard paint) shall be paid per linear foot of markings installed. 28 - 51 FDOT pay items 710-11-160A through 710-11-160W and 710-11-170, 710-11-170A and 710-11-180 (standard paint) shall be paid on a per message or symbol basis. 52 – 65 and 67 FDOT pay items 710-12-121 through 710-12-125 and 710-12-131, 710-12-141, 710-12-143, 710-12-190, 710-12-221, 710-12-224, 710-12-231, 710-12-241, 710-12-290 and 710-12-421 (durable paint) shall be paid per linear foot of markings installed. 68 – 91 FDOT pay items 710-12-160A through 710-12-160W and 710-12-170, 710-12-170A and 710-12-180 (durable paint) shall be paid on a per message or symbol basis. 92 – 104 FDOT pay items 711-11-121 through 711-11-125, 711-11-131, 711-11-141, 711-11-143, 711-11-221, 711-11-224, 711-11-231, 711-11-241, 711-11-421 (standard thermoplastic) shall be paid per linear foot of markings installed. 49 IFB #IFB-604562-23/LNF Title: IFB-604562-23/LNF - Term Contract for Roadway Markings, Striping and Brick Texture Surfacing 4 105 – 128 FDOT pay items 711-11-160A through 711-11-160W, 711-11-170, 711-11-170A and 711-11-180 (standard thermoplastic) shall be paid on a per message or symbol basis. 129 FDOT pay item 711-17 (Removal of existing thermoplastic markings) Contractor shall exercise caution while performing and shall not damage the underlying riding / road surface. 130 – 142 FDOT pay items 711-12-121 through 711-12-125, 711-12-131, 711-12-141, 711-12-143, 711-12-221, 711-12-224, 711-12-231, 711-12-241 and 711-12-421 (refurbished thermoplastic) shall be paid per linear foot of markings installed. shall follow the FDOT Standard Specification for Road and Bridge Construction, section 711-4.2.2 Refurbishing Existing Traffic Striping and Markings. 143 – 166 FDOT pay items 711-12-160A through 711-12-160W, 711-12-170, 711-12-170A, 711-12-180, (refurbished thermoplastic) shall be paid on a per message or symbol basis. shall follow the FDOT Standard Specification for Road and Bridge Construction, section 711-4.2.2 Refurbishing Existing Traffic Striping and Markings. 167 – 172 and 192 FDOT pay items 711-14-660, 711-14-660A, 523-1, 527-2-1, 527-2-2, 527-2-3 and 523-1-TPXD (route shields, preformed red, preformed pattern pavement markings and detectable warning mats or warning devices. shall meet all FDOT / ADA manufacturer and installation requirements. Use brick red Detectable Warning Systems Mats or equivalent. 177 – 181 FDOT pay items 999A through 999E (Lay-out Striping, Message, and Symbol and Clearing Dirt / Grass from edge line) shall be used per the County’s Discretion. Typical layout and clearing shall be included in other pay items per FDOT standards. 50 IFB #IFB-604562-23/LNF Title: IFB-604562-23/LNF - Term Contract for Roadway Markings, Striping and Brick Texture Surfacing 5 3. INSTRUCTIONS TO BIDDERS 3.1. Contact All prospective Bidders are hereby instructed not to contact any member of the Seminole County Board of County Commissioners, the County Manager or Deputy Manager, or any Seminole County Staff members other than the noted Purchasing & Contracts Division (herein referred to as ‘PCD’) Contact Person, PCD ADMIN, regarding this IFB or their written bid at any time prior to the posting on the COUNTY’S Website of the recommendation and intent to award by County staff for this project. Any such contact shall be cause for rejection of your bid. Interpretation of this clause will be solely at the discretion of the COUNTY. 3.2. Pre-Proposal Conference There will not be a Pre-Proposal Conference for this IFB. 3.3. Public Opening Electronic bids shall be received by PCD online in accordance with the instructions in this solicitation documents, unless otherwise revised via posted Addenda. Persons with disabilities needing assistance to participate in the Public Opening should call the noted PCD Contact Person at least forty-eight (48) hours in advance of the Public Opening at (407) 665-7116.The Public Opening via ZOOM https://us06web.zoom.us/j/84499184101?pwd=UVhDbk9IS3lnZkZUMW9WV01vWlp3UT09 / Meeting ID: 844 9918 4101 / Passcode: 760550 3.4. Delays The COUNTY, at its sole discretion, may delay the scheduled due date and time for submission, if it is to the advantage of the COUNTY to do so. The COUNTY will post all changes in the scheduled due date and time for submission by written addendum posted to the COUNTY’s Website: (https://secure.procurenow.com/portal/seminolefl) 3.5. Bid Submission and Withdrawal The COUNTY will accept bids electronically via the COUNTY’s e-Procurement Portal until 2:00 pm on Wednesday, August 2, 2023. Bids received after the scheduled due date and time for submission shall not be considered. Bids submitted in any other format other than via the COUNTY’S e-Procurement Portal, including but not limited to, hard copy (mailed or hand delivered), facsimile, or emailed submittals, will not be accepted, nor considered. The scheduled due date and time for submission will be scrupulously observed. Companies shall register on the COUNTY’S e-Procurement Portal. Once registered, Companies may view and click "Follow" to be a prospective Bidder for this solicitation and will appear on the Follower’s list. Bidders that fail to Follow this project will not receive automatic addenda notifications, nor will they be able to draft a response in the COUNTY’S e-Procurement Portal, and therefore will be unable to participate or be considered for this IFB. If a Bidder encounters technical difficulties using the COUNTY’S e-Procurement Portal, or needs assistance using the Portal, Bidders may access the Help Center for vendor training guides provided by OpenGov-Procurement, the Software Administrator. Proposers may also contact the Software Administrator using the real-time chat 51 IFB #IFB-604562-23/LNF Title: IFB-604562-23/LNF - Term Contract for Roadway Markings, Striping and Brick Texture Surfacing 6 function on the COUNTY’S e-Procurement Portal (located in lower right-hand corner of the screen), or via email at support@procurenow.com for support. The COUNTY will not be responsible for untimely submissions due to personal or company internet or hardware limitations, settings or restrictions, internet speed, power outage, network connection, or use of a malfunctioning electronic device, or the like, neither the COUNTY, nor the Software Administrator, will be held responsible. Bidders shall be solely responsible for ensuring the capability of their computer system while responding to this solicitation, and for the stability of their internet service. Uploading large documents may take significant time depending on the size of the file(s) and the Internet connection speed that the Bidder is using to submit a response. Failure of the Bidder to successfully submit an electronic proposal before the deadline indicated herein shall be at the Bidder's sole risk, and no relief will be given for late and/or improperly submitted bids. Once file(s) have been uploaded and the Submission Status shows as “Submitted” the submission is complete. At that point, the Bidder will also receive an email confirmation from the COUNTY’s e-Procurement Portal. Telephone confirmation of timely receipt of any submittal should be made by calling (407) 665-7116, before the 2:00 pm deadline. The Bidder is required to submit ONE (1) ELECTRONIC FORMATTED file of their complete written bid. Bidders may withdraw their bid electronically via the COUNTY’S e-Procurement Portal at any time prior to the scheduled due date and time for submission. 3.6. Inquiries All Bidders should carefully examine the IFB documents. Any ambiguities or inconsistencies shall be brought to the attention of PCD Contact Person in writing via the Q&A tab in the COUNTY’S e-Procurement Portal prior to the scheduled due date and time for submission. Failure to do so, on the part of the Bidder, shall constitute an acceptance by the Bidder of any subsequent decision made by the COUNTY. Any questions concerning the intent, meaning and interpretations of the IFB documents including the attached Draft Agreement, shall be requested in writing, and received no later than 10:00 am on Wednesday, July 19, 2023. Written requests shall be submitted via the COUNTY’S e-Procurement Portal The COUNTY will not be responsible for oral instructions made by employees of the COUNTY or its authorized representatives in regard to this IFB. If the Q&A deadline has passed, a Bidder may contact the COUNTY directly if necessary at pcdadmin@seminolecountyfl.gov. The COUNTY reserves the right to reject any questions sent after the Q&A deadline. 3.7. Addenda Should revisions to the IFB documents become necessary, the COUNTY will post Addenda information on the COUNTY's e-Procurement Portal. The COUNTY’s e-Procurement Portal will issue an automated email notification to all “Followers” on the IFB’s Followers list. All Bidders should check the COUNTY's Website or notify PCD ADMIN to verify information regarding Addenda. Failure to do so may result in rejection of the Bidder’s submitted bid and a determination as “Non-Responsive”. By execution of the Formal Notice for this IFB, the Bidder acknowledges receipt of all Addenda issued under this solicitation. Addenda information will be posted on the COUNTY’s Website (https://secure.procurenow.com/portal/seminolefl). It is the sole responsibility of the Bidder to ensure that they obtain information related to any Addenda. 52 IFB #IFB-604562-23/LNF Title: IFB-604562-23/LNF - Term Contract for Roadway Markings, Striping and Brick Texture Surfacing 7 3.8. Selection Process and Award The award will be made in the best interest of the COUNTY, as determined by the COUNTY, based upon the low total price and/or line-item by line-item, to the Lowest Responsible Bidder(s) that meet the requirements listed in this solicitation. The COUNTY will determine the method that will more benefit the organization. The Bidder(s) understands that this Bid does not constitute an agreement or a contract with the Bidder. The COUNTY reserves the right to reject all bids/proposals, make multiple awards (award to more than one vendor), make a partial award, to waive formalities, to re-solicit and advertise for new bids/proposals, or to cancel the project in its entirety. In evaluating Bids, the COUNTY shall consider the information provided by the Apparent Low Bidder as described in these "INSTRUCTIONS TO BIDDERS." Any of the following causes may be considered as sufficient grounds for disqualification of a Bidder or the rejection of a Bid: (a) Submission of more than one (1) Bid for the same Work by any entity under the same or different names. (b) Evidence of collusion among Bidders. (c) Submission of an unbalanced Bid in which prices quoted for some items are out of proportion to the prices quoted for other or similar items in the same Bid. (d) Lack of responsibility as shown by past Work from the standpoint of life safety including, but not limited to, strict adherence to all maintenance of traffic requirements of COUNTY, workmanship, progress and financial irresponsibility. (e) Uncompleted Work for which the Apparent Low Bidder is committed by contract which might hinder or prevent the prompt completion of Work under this Bid if an Agreement would have been awarded to the Apparent Low Bidder. (f) Falsification of any entry made on the Bid Documents shall be deemed a material irregularity and will be grounds, at the COUNTY's option, for disqualification of the Apparent Low Bidder or rejection of the Bid. (g) This section shall be construed liberally to benefit the public and not the Apparent Low Bidder; however, any other evidence which may hinder or otherwise delay completion of the Project may be grounds for disqualification. (h) Non-compliance with the submittal requirements of these Instructions to Bidders. AWARD CRITERIA: The recommendation of award will be based on, but not limited to the following criteria: (a) The ability, capacity, and skill of the Apparent Low Bidder to perform the Work. (b) Whether the Apparent Low Bidder can perform the Work promptly, or within the time specified, without delay or interference. (c) The character, integrity, reputation, judgment, and efficiency of the Apparent Low Bidder. 53 IFB #IFB-604562-23/LNF Title: IFB-604562-23/LNF - Term Contract for Roadway Markings, Striping and Brick Texture Surfacing 8 (d) The quality of performance of previous contracts or services to Seminole County or any other agency or client. (e) The previous and existing compliance by the Apparent Low Bidder with Chapter 220, Seminole County Purchasing Code & Procedures, the life safety requirements of COUNTY, and other laws and ordinances, regulations. (f) The sufficiency of the financial resources and ability of the Apparent Low Bidder to perform the Work. (g) The quantity, availability, and adaptability of the Apparent Low Bidder to perform the Agreement or service to the particular needs of the COUNTY. (h) The ability of the Apparent Low Bidder to retain employees for the purpose of this Work. (i) The experience of the Apparent Low Bidder performing in a similar manner as required by this Agreement. Minimum of three (3) satisfactory years shall be required. (j) The type, structure, and experience of the local or branch management proposed. (k) Quality Control Program. (l) Claims and Litigation filed against the Apparent Low Bidder or filed by the Apparent Low Bidder for equitable adjustment, contract claim or litigation in the past five (5) years. (m) Reprimand of any nature or suspension by the Department of professional Regulation or any other regulatory agency or professional association within the last five (5) years. 3.9. Bid Preparation Costs Neither the COUNTY nor its representatives shall be liable for any expenses incurred in connection with preparation of a response to this IFB. Proposers should prepare their proposals simply and economically, providing a straightforward and concise description of the Proposer's ability to meet the requirements of this IFB 3.10. Accuracy of Bid Information By submission of a bid, Bidder acknowledges that they have carefully examined the IFB documents and agrees to furnish the services/products specified in the solicitation at the prices, rates or discounts as proposed. Bidders agree that their bid will remain firm for a period of up to one hundred twenty (120) days to allow the County adequate time to evaluate the submittals. By submission of a bid, Bidder agrees to abide by all conditions of this bid and understands that a background investigation may be conducted by the Seminole County Sheriff’s Department prior to award. Bidder certifies that all information contained in their bid is truthful to the best of their knowledge and belief. Bidder further certifies that they are duly authorized to submit this bid on behalf of the vendor/Bidder as its act and deed and that the vendor/Bidder is ready, willing, and able to perform if selected. 54 IFB #IFB-604562-23/LNF Title: IFB-604562-23/LNF - Term Contract for Roadway Markings, Striping and Brick Texture Surfacing 9 3.11. Insurance A misstatement or omission of a material fact, whether intentional or not, regarding the Proposer's insurance coverage, policies or capabilities may be grounds for rejection of the Bidder’s submitted proposal and rescission of any ensuing Award Agreement. The COUNTY recommends that all Bidders review the insurance requirements listed within the Draft Term Contract with their insurance carriers. A copy of the insurance certificate shall be furnished to the COUNTY prior to the final execution of the COUNTY’s Award Term Contract. The COUNTY reserves the right to reject the award to any Bidder that fails to provide the insurance as required within the COUNTY’s Term Contract. 3.12. Licenses Bidders, both corporate and individual, must be fully licensed and certified for the type of work to be performed in the State of Florida at the time of submittal of Bid. Should the Bidder not be fully licensed and certified, its bid shall be rejected. Any permits, licenses, or fees required shall be the responsibility of the Bidder. No separate or additional payment will be made for these costs. Adherence to all applicable code regulations, Federal, State, County, City, etc., are the responsibility of the Bidder. The following licensing requirements shall apply when the applicable Florida Statute mandates specific licensing for Contractors engaged in the type of work covered by this solicitation. (a) State of Florida, Department of Professional Regulation, Construction Industries Licensing Board and licensed by other federal, state, regional, county or municipal agencies having jurisdiction over the specified construction work; (b) Said licenses shall be in the Bidder's name as it appears on the Official Bid Form. Bidder shall supply appropriate license numbers, with expiration dates, as part of their bid. Failure to hold and provide proof of proper licensing, certification and registration may be grounds for rejection of the bid; (c) Bidder shall provide copies of all applicable licenses with their Bid Proposal; and (d) Subcontractors contracted by the Prime Contractor shall be licensed in their respective fields to obtain construction permits from the County. 3.13. Occupational Safety and Health Act (O.S.H.A.) In instances where such is applicable due to the nature of the bid matter with which this bid package is concerned, all material, equipment, etc., as proposed and offered by Bidders must meet and conform to all O.S.H.A. requirements; the Bidder's signature upon the bid proposal form being by this reference considered a certification of such fact. 3.14. Posting of the IFB's Recommendation and Intent to Award The recommendation and intent to award for this IFB will be posted on the COUNTY’s Website (https://procurement.opengov.com/portal/seminolefl) prior to submission for final approval of award. Failure to file a protest with the COUNTY’s Purchasing & Contracts Manager within the time prescribed in the COUNTY's Purchasing Code, Policies and Procedures shall constitute a waiver of proceedings. 55 IFB #IFB-604562-23/LNF Title: IFB-604562-23/LNF - Term Contract for Roadway Markings, Striping and Brick Texture Surfacing 10 3.15. Public Records Upon recommendation and intent to award this IFB as posted to the COUNTY’s website or thirty (30) calendar days after closing, bids are considered “public records" and shall be subject to the public disclosure regulations consistent with Chapter 119, Florida Statutes. Bidders must invoke the exemptions to disclosure provided by law in their response to the solicitation and must identify the data or other materials to be protected by separate envelope, and must state the reasons why such exclusion from public disclosure is necessary pursuant to the COUNTY’s, “Compliance With Public Records Law” Form, which is required as part of the IFB documents. Ownership of all data, material, and documentation originated and prepared for the County pursuant to the IFB shall belong exclusively to the County and be subject to public inspection in accordance with the Public Records Law. Trade secrets or proprietary information submitted by a Bidder shall not be subject to public disclosure under the Public Records Law; however, the Bidder must invoke the protection of this section prior to or upon submission of the data or other materials, and must identify the data or other materials to be protected and state the reasons why protection is necessary. 3.16. Prohibition Against Contingent Fees It shall be unethical for any person to be retained, or to retain any company or person, other than a bona fide employee working solely for the Bidder to solicit or secure the Term Contract for this IFB, and that it has not paid or agreed to pay any person, company, corporation, individual or firm, other than a bona fide employee working solely for the Bidder, any fee, commission, percentage, gift, or other consideration contingent upon or resulting from award or making of this Term Contract. For the breach or violation of this provision, the COUNTY shall have the right to terminate the Term Contract at its sole discretion, without liability and to deduct from the Term Contract price, or otherwise recover, the full amount of such fee, commission, percentage, gift, or consideration. 3.17. Acceptance/Rejection/Disqualification The COUNTY reserves the right to accept and make award to those Bidders, who in the opinion of the COUNTY, will be in the best interest of and/or the most advantageous to the COUNTY. The COUNTY reserves the right to reject all bids/proposals, make multiple awards (award to more than one vendor), make a partial award, to re-solicit and advertise for new bids/proposals, or to cancel the project in its entirety. The COUNTY reserves the right to reject the bid of any Bidder who has previously failed in the proper performance of an award or to deliver on time agreements of a similar nature or who, in the COUNTY's opinion, is not in a position to perform properly under this award. The COUNTY reserves the right to inspect all facilities of Bidders to make a determination as to the available resources to perform properly under this award. The COUNTY reserves the right to waive any irregularities, informalities, and technicalities and may, at its discretion, issue a re-procurement. More than one (1) bid from an individual, firm, partnership, corporation, or association under the same or different names will not be considered. Reasonable grounds for believing that a Bidder is involved in more than one proposal submittal will be cause for rejection of all bids in which such Bidders are believed to be involved. Any or all bids will be rejected if there is reason to believe that collusion exists between Bidders. Bids in which the prices obviously are unbalanced will be subject to rejection. 56 IFB #IFB-604562-23/LNF Title: IFB-604562-23/LNF - Term Contract for Roadway Markings, Striping and Brick Texture Surfacing 11 3.18. Additional Terms and Conditions Unless expressly accepted by the County, only the terms and conditions in this document shall apply: No additional terms and conditions included with the bid response shall be considered. Any and all such additional terms and conditions shall have no force and effect, and are inapplicable to this bid if submitted either purposely through intent or design, or inadvertently appearing separately in transmittal letters, specifications, literature, price lists or warranties. It is understood and agreed that the general and/or any special conditions in these Bid Documents and any addenda issued under this solicitation are the only conditions applicable to this bid and the Bidder's authorized signature on the Bid Response Form attests to this. Exceptions to the terms and conditions will not be accepted. 3.19. Responsibility The County reserves the right, before award, to require a Bidder to submit such evidence of his qualifications as it may deem necessary, and may consider any evidence available such as financial, technical, and other qualifications and abilities of the Bidder, including past performance and experience with the County. This information may be used to determine the Bidder’s responsibility. 3.20. Bids to Remain Firm All Bids shall remain firm for a minimum of one hundred twenty (120) days after the day of the Bid opening to allow for the evaluation and selection process and proper execution of the Agreement. Extensions of time when Bids shall remain opened beyond the one hundred twenty- day period may be made only by mutual agreement between Seminole County and the Selected Bidder. The successful Contractor must maintain the bid prices firm for a minimum of one (1) year after the contract is executed. No cost increase will be authorized during the first year of the agreement. 3.21. Purchasing Code Seminole County Code Chapter 220 (Purchasing Code), Administrative Code Section 3.55 (Purchasing Policy), and County Manager Policies apply to this IFB in their entirety. 3.22. Affirmation By submission of a bid, the Bidder affirms that their bid is made without prior understanding, agreement or connection with any corporation, firm, or person submitting a bid for the same materials, supplies, equipment or services, and is in all respects fair and without collusion or fraud. The Bidder agrees to abide by all conditions of this IFB and the resulting Term Contract. 3.23. Mistakes in the Bid Bidders are expected to examine the terms and conditions, specifications, delivery schedule, bid prices, extensions and all instructions pertaining to supplies and services. Failure to do so will be at Bidder's risk. In the event of extension error(s), the unit price will prevail, and the Bidder's total offer will be corrected accordingly. Written amounts shall take precedence over numerical amounts. In the event of addition errors(s), the unit price, and extension thereof, will prevail and the Bidder's total offer will be corrected accordingly. Bids having erasures or corrections must be initialed in ink by the Bidder. 57 IFB #IFB-604562-23/LNF Title: IFB-604562-23/LNF - Term Contract for Roadway Markings, Striping and Brick Texture Surfacing 12 3.24. Governmental Restrictions In the event that any governmental restrictions are imposed which would necessitate alteration of the material quality, workmanship or performance of the items offered on this bid prior to their delivery, it shall be the responsibility of the Bidder to notify the Purchasing and Contracts Division at once, indicating in his/her letter the specific regulation which required an alteration, including any price adjustments occasioned thereby. The County reserves the right to accept such alteration or to cancel the contract or purchase order at no further expense to the County. 3.25. Drug-Free WorkPlace Compliance Bidder shall comply with Section 287.087, Florida Statutes, and failure to comply shall result in rejection/disqualification of the bid and all agreements as a result of this solicitation. 3.26. Public Entity Crime Any Person or affiliate, as defined in Section 287.133, Florida Statutes, shall not be allowed to contract with the COUNTY, nor be allowed to enter into a subcontract for Work on this Project, if such a person or affiliate has been convicted of a public entity crime within three (3) years from the date this Project was advertised for Proposal, or if such person or affiliate was listed on the State's convicted vendor list, within three (3) years of the date this Project was advertised, whichever time period is greater. A public entity crime means a violation of any state or federal law with respect to and directly related to the transaction of business with any public entity or agency (federal, state or local), including but not limited to, any contract for the construction or repair of a public building or public work involving antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, forgery, falsification of records, receiving stolen property or material misrepresentation. Any Agreement with the COUNTY obtained in violation of this Section shall be subject to termination for cause. A sub-contractor who obtains a subcontract in violation of this Section shall be removed from the Project and promptly replaced by a sub-contractor acceptable to the COUNTY. 3.27. Uniform Commercial Code The Uniform Commercial Code (Florida Statutes, Chapter 672) shall prevail as the basis for contractual obligations between the Bidder and the County for any terms and conditions not specifically stated in this solicitation. 3.28. Proprietary/Restrictive Specifications Bidder, who feels the specifications contained herein are proprietary or restrictive in nature, thus potentially resulting in reduced competition, must notify the Purchasing and Contracts Division of their rejection upon receipt of this IFB and prior to the due date. 3.29. Payment Terms/Discounts The County’s payment terms are in accordance with Section 218, Part VII, Florida Statutes, Florida Prompt Payment Act. Cash discounts for prompt payment shall not be considered in determining the lowest net cost for evaluation purposes. 58 IFB #IFB-604562-23/LNF Title: IFB-604562-23/LNF - Term Contract for Roadway Markings, Striping and Brick Texture Surfacing 13 3.30. Price Redeterminations 1. During the Renewal Term: Petitions for price redeterminations must be made at the time of County’s notification to the Contractor of the renewal period. Any such petition must be made pursuant to the provisions of this Section and only for those price redetermination categories specified herein. Unless otherwise expressly set forth in this document, no other price redeterminations will be allowed. All price redeterminations will be approved by a duly executed amendment to the Contract to reflect the new prices for the renewal term. 2. Outside the Renewal Term: Petitions for price redeterminations must be made within thirty (30) days of the anniversary date of the Contract. Any such petition must be made pursuant to the provisions of this Section and only for those price redetermination categories specified herein. Unless otherwise expressly set forth in this document, no other price redeterminations will be allowed. All price redeterminations will be approved by a duly executed amendment to the Contract. BASIS FOR PRICE REDETERMINATIONS. The Contractor may petition the Purchasing and Contracts Division for price redetermination based on the increased costs of wages, fuel, or materials. Price redeterminations will be based solely upon changes in pricing or costs documented by either the Employment Cost Index (ECI) or Producer Price Index (PPI), whichever is applicable, as published by the Bureau of Labor Statistics. The base index number for the ECI will be for the quarter in which the solicitation opens. The base index number for the PPI will be for the month the solicitation opens. Any subsequent price redeterminations will use the last price redetermination approved for that price redetermination category as the "base index number." The County shall have the right to audit the Contractor's records, including, but not limited to, payroll, materials, and fuel cost records, to verify or otherwise investigate the validity of any price redetermination request. WAGE PRICE REDETERMINATION. When requesting a price redetermination based upon an increase in wage costs, the Contractor shall refer to and utilize the Pay & Benefits, Employment Cost Index, Private Industry, Compensation as prepared by the Bureau of Labor Statistics in the U.S. Department of Labor available at www.bls.gov. MINIMUM WAGE PRICE REDETERMINATION. If the minimum wage increases during the term of the Contract, including any renewal or extension period thereunder, the Contractor may petition the Purchasing and Contracts Division for price redetermination for those job categories where the pay to the Contractor's employee(s) is the current minimum wage. Upon verification of the information provided, the County will grant an increase of exactly the amount of the minimum wage increase (not the percentage increase). The Contractor must increase the pay to the employee(s) by the amount the Contractor has requested, which shall not exceed the amount of the minimum wage increase. The amount paid to the Contractor will be the increase plus any written and documented increase in FICA, Medicare, and Workers' Compensation insurance. The Contractor must supply written documentation of any other increase that is beyond the scope and control of the Contractor. All written documentation must satisfy the reasonable expectations of the Purchasing and Contracts Division. • Example: Minimum wage increases from $7.31 to $7.56 per hour. The Contractor may petition for an increase of $0.25 per hour to be paid to the affected employee(s) and shall provide 59 IFB #IFB-604562-23/LNF Title: IFB-604562-23/LNF - Term Contract for Roadway Markings, Striping and Brick Texture Surfacing 14 written and documented cost increases for FICA, Medicare and Workers' Compensation. The resulting increase in costs shall be incorporated into fees/rates billed to the County. If the Contractor bills the County at a higher price according to any price redetermination granted by the County, and the Contractor fails to increase the hourly rate paid to the employee for the same period, the Contractor will be considered in Contract default and the Contract will be immediately terminated. FUEL PRICE REDETERMINATION. If and when the price of fuel increases by a minimum of ten (10%) percent, the Contractor may petition the Purchasing and Contracts Division for a fuel price redetermination. As a condition of petitioning for a fuel price increase, the Contractor shall be required to petition for a fuel price redetermination decrease if and when the price of fuel decreases by a minimum often (10%) percent. Failure to make such petition may be grounds for Contract termination and shall entitle the County to a refund of the cumulative increase in pay to the Contractor due to any prior fuel price redetermination increase(s). Fuel price redetermination must be based solely upon changes as documented by the Producer Price Index (PPI) for the commodity "Gasoline - WPU057". MATERIALS PRICE REDETERMINATION. At the anniversary date of the Agreement, the Contractor may petition the Purchasing and Contracts Division for a materials price redetermination. As a condition of petitioning for a materials price increase, the Contractor shall be required to petition for a materials price redetermination decrease if/when the price of materials used by the Contractor in connection with the Contract decreases. Failure to make such petition may be grounds for Contract termination and shall entitle the County to a refund of the cumulative increase in pay to the Contractor due to any prior materials price redetermination increase(s). Materials price redetermination must be based solely upon changes as documented by the Producer Price Index (PPI) under Inflation & Prices, Industry Data, Construction Machinery Mfg. PCU 333120333120, as published by the Bureau of Labor Statistics. PRICE REDETERMINATION CALCULATION. All Price Redeterminations shall be calculated as follows: Example: Contractor indicated on the Submittal Form that fourteen percent (14%) of the cost to provide the product/service is directly attributed to the redetermination category (wages, fuel, or materials). PPI in the month the solicitation closed was 158.73 264.52 Current PPI is 264.52 -158.73 105.79 105.79 divided by 158.73 = .666% The unit cost of the service is $100.00 14% of $100.00 = $14.00 $14.00 x .666 = $9.32 The New Unit Price for the service is $109.32 ($100.00 + $9.32) 60 IFB #IFB-604562-23/LNF Title: IFB-604562-23/LNF - Term Contract for Roadway Markings, Striping and Brick Texture Surfacing 15 EXPIRATION UPON FAILURE TO AGREE TO PRICE REDETERMINATION. If the County and the Contractor cannot agree to a price redetermination pursuant to the terms and conditions of this Section, then the Contract will automatically expire without penalty or further expense to either party after a period of six (6) months following the Contractor's initial request for such price redetermination. Requests for price redeterminations not made in accordance with the provisions of this Section shall be deemed null and void and shall not be a valid reason or pretext for expiration or termination of the Contract. If the contract expires pursuant to the terms and conditions of this Section, the County reserves the right, at no expense, penalty, or consequence to the County, to award any remaining tasks thereunder to the next available most responsive and responsible Contractor. 3.31. Purchasing Agreements With Other Governmental Agencies All Applicants submitting a response to this solicitation agree that such response also constitutes a submittal to all governmental agencies within the State of Florida, under the same conditions, for the same contract price, and for the same effective period as this proposal, should the Applicant feels it is in their best interest to do so. Each governmental agency desiring to accept these submittals, and make an award thereof, shall do so independently of any other governmental agency. Each agency shall be responsible for its own purchases and each shall be liable only for materials and/or services ordered and received by it, and no agency assumes any liability by virtue of this solicitation. This agreement in no way restricts or interferes with the right of any governmental agency to re-solicit any or all items. 3.32. Quantities Seminole County will not be held to any maximum or minimum purchase quantities as a result of this solicitation and/or resulting contract. Seminole County reserves the right to purchase any; all, or none, of its requirements from vendors awarded a contract as a result of this solicitation. All quantities as shown are approximate and no guarantee is made. Except as this contract may otherwise provide, if the County’s requirements do not result in orders in the quantities described as “estimated” in the contract’s price schedule, that fact shall not constitute the basis for an equitable adjustment. 3.33. Price/Delivery Price(s) quoted must be the price(s) for new merchandise unless otherwise specified. Any bids containing escalator clauses will not be considered unless specifically requested in the bid specifications. Delivery shall be during the normal working hours of the user department, Monday through Friday, unless otherwise specified and incorporated into contract or purchase order document. F.O.B. POINT: The F.O.B. point shall be destination. The prices bid shall include all costs of loading, transporting, delivery and to designated point(s) within Seminole County. Deliveries resulting from this bid are to be made during the normal working hours of the County. Time is of the essence and the Contractor’s delivery date must be specified and adhered to. Should the Contractor, to whom the order or contract is awarded, fail to deliver on or before the 61 IFB #IFB-604562-23/LNF Title: IFB-604562-23/LNF - Term Contract for Roadway Markings, Striping and Brick Texture Surfacing 16 stated date, the County reserves the right to cancel the order or contract and make the purchase elsewhere and the Contractor will be required to compensate the County for the difference in price paid for the alternate product. The Contractor shall be responsible for making all claims against carriers for missing or damage items. Partial shipments will be acceptable unless otherwise stated. 3.34. Bid Forms All bids must be submitted on the County’s standard Bid Response Form. Bids on Bidder’s quotation forms shall not be accepted. 3.35. Method of Ordering The County shall issue Purchase Orders against the contract on an as needed basis for the supplies or services listed on the Bid Proposal Form. The County reserves the right to reject all bids/proposals, make multiple awards (award to more than one vendor), make a partial award, to re-solicit and advertise for new bids/proposals, or to cancel the project in its entirety. 62 IFB #IFB-604562-23/LNF Title: IFB-604562-23/LNF - Term Contract for Roadway Markings, Striping and Brick Texture Surfacing 17 4. INSTRUCTIONS FOR THE PREPARATION OF BIDS The Bidder(s) warrants its response to this Invitation for Bid to be fully disclosed and correct. The firm must submit a bid complying with this Invitation for Bid, and the information, documents and material submitted in the bid must be complete and accurate in all material aspects. Bidders are advised to carefully follow the instructions listed below to be considered fully responsive to this Bid. Bidders are further advised that lengthy or overly verbose or redundant submissions are not necessary. Compliance with all requirements will be solely the responsibility of the Bidder. Failure to provide requested information may result in disqualification of response. 4.1. Type of Business* ☐ Corporation ☐ Joint Venture ☐ Partnership ☐ Proprietorship *Response required 4.2. Type in your Legal Entity Name Here.* This name will be verified against the Secretary of State website. *Response required 4.3. Federal Employer ID Number (FEIN)* *Response required 4.4. Incorporated in the State of ________.* Ex.) Florida *Response required 4.5. List of Principals* *Response required 4.6. Upload evidence of authority to do business in the State of Florida.* Acceptable form of evidence includes Secretary of State download, or Certificate of Status. *Response required 4.7. Past Performance* Vendor must submit a minimum of three (3) references of current clients; each reference must include client information, contact person, telephone number and current email address, and a brief summary of the contract awarded. *Response required 4.8. Summary of Litigation* *Response required 63 IFB #IFB-604562-23/LNF Title: IFB-604562-23/LNF - Term Contract for Roadway Markings, Striping and Brick Texture Surfacing 18 4.9. License Sanctions* Regulatory/license agency sanctions within the past 5 years. (If Proposer prefers to upload a file, upload in next question and enter "see file upload" in this field) *Response required 4.10. License Sanctions Regulatory/license agency sanctions within the past 5 years. 4.11. Confidential File(s) In compliance with Chapter 119, Florida Statutes, if Proposer must include confidential information that qualifies as “EXEMPT FROM PUBLIC RECORDS LAW" as part of their response to this RFP, it shall be uploaded here. If the company submits information exempt from public disclosure, the company must identify why the information is exempt from the Public Records Act, identifying the specific exemption section that applies to each. 4.12. W-9 Form* Please upload your current W9 form here *Response required 4.13. Insurance Confirmation (for the Insurance Agency to complete)* Proposer shall have their Insurance Agency complete this form. Once completed, Proposer shall submit it here. • INSURANCE_CONFIRMATION.docx *Response required 4.14. Certification* Pursuant to and in compliance with the Invitation to Bid, the undersigned Bidder agrees to perform the Work in strict conformity with Contract Documents, including any and all addenda, on file for the rates hereinafter set forth. The undersigned Proposer declares that the only persons/parties interested in this proposal as principals are those named herein; that this proposal is made without collusion with any person, firm or corporation; and proposes and agrees that, if the proposal is accepted, Proposer will execute an Agreement with the COUNTY and will furnish Insurance Certificates. Under penalties of perjury, I declare that I have read the foregoing Certification Form and that the facts stated in it are true to the best of my knowledge and belief. ☐ Please confirm *Response required 64 IFB #IFB-604562-23/LNF Title: IFB-604562-23/LNF - Term Contract for Roadway Markings, Striping and Brick Texture Surfacing 19 5. PRICING PROPOSAL Pursuant to and in compliance with the IFB Documents, the undersigned Bidder agrees to provide and furnish any and all of the labor, material, tools, equipment, incidentals and transportation services necessary to complete all of the Work required in connection with the IFB Documents for the amount hereinafter set forth. Bidder declares that the only persons or parties interested in this bid as principals are those named herein; that this bid is made without collusion with any person, firm or corporation; and he proposes and agrees, if the bid is accepted, that he/she will accept to enter into an Agreement with the COUNTY in the form set forth in the Purchase Order and solicitation Documents. Costs shall be inclusive of all direct and indirect costs including but not limited to, materials, labor, equipment, transportation, coordination and incidentals necessary for the performance of the work specified in the IFB documents. GOUP TOTALS **Excel Spreadsheet in Attachments Line Item Description Quantity Unit of Measure Unit Cost Total 1 Group I - Signing/Delineators 1 Group I 2 Group II - Standard Paint 1 Group II 3 Group III - Durable Paint 1 Group III 4 Group IV - Thermoplastic 1 Group IV 5 Group V - Miscellaneous 1 Group V TOTAL 65 IFB #IFB-604562-23/LNF Title: IFB-604562-23/LNF - Term Contract for Roadway Markings, Striping and Brick Texture Surfacing 20 6. EVALUATION PHASES No. Evaluation Criteria Scoring Method Weight (Points) 1. Availability of Items Pass / Fail 1 (20% of Total) 2. References Please check any references provided. Pass / Fail 1 (20% of Total) 3. Past Performance Pass / Fail 1 (20% of Total) 4. FDOT Certifications Pass / Fail 1 (20% of Total) 5. Price Proposal Pass / Fail 1 (20% of Total) 66 Piggyback Rider City of Winter Springs and Fausnight Stripe and Line, Inc. EXHIBIT C PERFORMANCE BOND FORM Bond No. __________________ BY THIS PERFORMANCE BOND, We ___________________, as Principal, whose address is ____________________________________ and telephone number is ______________ and ____________________, as Surety, whose address is ________________________________ and telephone number is _________________are bound to the City of Winter Springs, a Florida municipal corporation, as OWNER, whose address is 1126 E. State Road 434, Winter Springs, Florida 32708 and telephone number is 407-327-1800, in the initial sum of $ ________________________________ (110% of Contract Price), or such greater amount as the Contract may be adjusted from time to time in accordance with the Contract between the Principal and OWNER) (the “Penal Sum”). WHEREAS, the Principal has executed a contract with the OWNER, dated ______________, for the construction of the ___________________________________ project in the City of Winter Springs, Seminole County, Florida (the “Project”); and WHEREAS, the OWNER has required the Principal to furnish a performance bond in accordance with law and as a condition of executing the Contract with Principal; and WHEREAS, this bond is being entered into to satisfy the requirements of Section 255.05(1), Florida Statutes and the Contract referenced above, as the same may be amended, and additionally, to provide common law rights more expansive than as required by statute. NOW THEREFORE, the Surety and the Principal, both joint and severally, and for themselves, their heirs, administrators, executors, successors and assigns agree as follows: 1.CONTRACT INCORPORATED; SURETY AND PRINCIPAL BOUND FOR FULL PERFORMANCE. The Contract is incorporated by reference and made a part of this bond. The Surety and the Principal are bound for the full performance of the Contract including without exception all of the Contract Documents (as defined in the Contract) and all of their terms and conditions, both express and implied. Without limiting the Principal’s and Surety’s obligations under the Contract and this bond, the Principal and Surety agree: A.Promptly and faithfully perform their duties and all the covenants, terms, conditions, and obligations under the Contract including, but not limited to the insurance provisions, guaranty period and the warranty provisions, in the time and manner prescribed in the Agreement, and B.Pay OWNER all losses, damages, delay damages (liquidated or actual), expenses, costs 67 Piggyback Rider City of Winter Springs and Fausnight Stripe and Line, Inc. and attorneys’ fees under section 627.756, Florida Statutes, including costs and attorney’s fees on appeal that OWNER sustains resulting directly or indirectly from any breach or default by Principal under the Contract, and C.Satisfy all claims and demands incurred under the Contract, and fully indemnify and hold harmless the OWNER from all costs and damages which it may suffer by reason or failure to do so. 2.OWNER’S AFFIDAVIT OF CONTRACTOR BREACH OR DEFAULT. If the OWNER shall provide to Surety the written affidavit of the OWNER stating that the Principal is in breach or default of the Contract, and that such breach or default remains uncured by the Principal, then upon delivery of such affidavit to the Surety in the method for providing notices as set forth in Paragraph 7 below, Surety must promptly notify the OWNER in writing which action it will take as permitted in Paragraph 3. 3.SURETY’S OBLIGATION UPON DELIVERY OF OWNER’S AFFIDAVIT OF CONTRACTOR’S BREACH OR DEFAULT. Upon the delivery of the OWNER’s affidavit of breach or default by the Principal as provided in Paragraph 2 above, the Surety may promptly remedy the breach or default or must, within ten (10) days, proceed to take one of the following courses of action: A.Proceed Itself. Complete performance of the Contract including correction of defective and nonconforming Work through its own CONTRACTORs or employees, approved as being acceptable to the OWNER, in the OWNER’s sole discretion, provided, however, that OWNER’s discretion in approving the Surety’s CONTRACTOR will not be unreasonably withheld as to any CONTRACTOR who would have qualified to offer a proposal on the Contract and is not affiliated in any way with the Principal. During this performance by the Surety, the OWNER will pay the Surety from its own funds only those sums as would have been due and payable to the Principal under the Contract as and when they would have been due and payable to the Principal in the absence of the breach or default not to exceed the amount of the remaining Contract balance less any sums due the OWNER under the Contract. During this performance by Surety, any payment bond required under the Contract must remain in full force and effect; or B.Tender a completing CONTRACTOR acceptable to OWNER. Tender a CONTRACTOR, together with a contact for fulfillment and completion of the Contract executed by the completing CONTRACTOR, to the OWNER for the OWNER’s execution. OWNER’s discretion to approve Surety’s completing CONTRACTOR will not be unreasonably withheld as to any CONTRACTOR who would have qualified to offer a proposal on the contract and is not affiliated with the Principal. OWNER’s discretion to approve CONTRACTOR as the completing CONTRACTOR and to approve the tendered contract shall be in OWNER’s sole and absolute discretion. Upon execution by the OWNER of the contract for fulfillment and completion of the Contract, the completing 68 Piggyback Rider City of Winter Springs and Fausnight Stripe and Line, Inc. CONTRACTOR must furnish to the OWNER a performance bond and a separate payment bond, each in the form of those bonds previously furnished to the OWNER for the Project by the Principal. Each such bond must be in the Penal Sum of the full cost to complete the Contract. The OWNER will pay the completing CONTRACTOR from its own funds only those sums as would have been due and payable to the Principal under the Contract as and when they would have been due and payable to the Principal in the absence of the breach or default not to exceed the amount of the remaining Contract balance less any sums due the OWNER under the Contract. To the extent that the OWNER is obligated to pay the completing CONTRACTOR sums which would not have been due and payable to CONTRACTOR under the Contract (any sums in excess of the then remaining Contract balance less any sums due the OWNER under the Contract), the Surety must pay the OWNER the full amount of those sums at the time the completing CONTRACTOR tenders an invoice to the OWNER so that the OWNER can utilize those sums in making timely payment to the completing CONTRACTOR; or C.Tender the Full Penal Sum. Tender to the OWNER the full Penal Sum of the performance bond. The OWNER will refund to the Surety without interest any unused portion not spent by the OWNER procuring and paying a completing CONTRACTOR or completing the Contract itself, plus the cost allowed under Section 4, after completion of the contract for fulfillment and completion of the Contract and the expiration of any applicable warranties; or D.Other Acts. Take any other acts mutually agreed upon in writing by the OWNER and the Surety. E.IT SHALL BE NO DEFENSE TO SURETY’S OBLIGATION TO UNDERTAKE ONE OF THE PRECEDING COURSES OF ACTION THAT THE PRINCIPAL CONTENDS THAT IT IS NOT IN BREACH OR DEFAULT OF THE CONTRACT, OR THAT THE NOTICE OF BREACH OR DEFAULT WAS DEFECTIVE, OR THAT THE PRINCIPAL HAS RAISED ANY OTHER CLAIM OF DEFENSE OR OFFSET, PROVIDED ONLY THAT THE SURETY HAS RECEIVED THE AFFIDAVIT OF THE OWNER AS SPECIFIED IN PARAGRAPH 2. 4.SURETY’S ADDITIONAL OBLIGATIONS. In addition to those duties set forth herein above, the Surety must promptly pay the OWNER (i) all losses, costs and expenses resulting from the Principal’s breach(es) or default(s), including, without limitation, fees (including attorney’s fees pursuant to section 627.756, Florida Statutes and related costs), expenses and costs for architects, ENGINEERs, consultants, testing, surveying and attorneys, plus (ii) liquidated or actual damages, whichever may be provided for in the Contract, for lost use of the Project, plus (iii) re-procurement costs and fees and expenses, plus (iv) costs incurred at the direction, request, or as a result of the acts or omissions of the Surety; provided that in no event shall Surety’s liability exceed the Penal Sum of this Bond. 69 Piggyback Rider City of Winter Springs and Fausnight Stripe and Line, Inc. 5.SURETY’S WAIVER OF NOTICE. The Surety waives notice of any Modifications to the Contract, including changes in the Contract Time, the Contract Sum, the amount of liquidated damages, or the work to be performed under the Contract. 6.NO THIRD-PARTY BENEFICIARIES. The Surety provides this performance bond for the sole and exclusive benefit of the OWNER and OWNER’s heirs, administrators, executors, successors and assigns. No other party, person or entity has any rights against the Surety. 7.METHOD OF NOTICE. All notices to the Surety, the Principal or the OWNER must be given by Certified Mail, Return Receipt Requested, to the address set fourth for each party below: SURETY: Name: ____________________________________________________________ Attention: ____________________________________________________________ Street: ____________________________________________________________ City, State: ____________________________________________________________ Zip: ____________________________________________________________ PRINCIPAL: Name: ____________________________________________________________ Attention: ____________________________________________________________ Street: ____________________________________________________________ City, State: ____________________________________________________________ Zip: ____________________________________________________________ OWNER: The City of Winter Springs Attention: Shawn Boyle, City Manager 1126 E. State Road 434 Winter Springs, Florida 32708 (407) 327-5957 with a copy to: Anthony A. Garganese, City Attorney Brown, Garganese, Weiss & D’Agresta, P.A. 111 N. Orange Avenue, Suite 2000 Orlando, Florida 32802 (407) 425-9566 70 Piggyback Rider City of Winter Springs and Fausnight Stripe and Line, Inc. 8.STATUE OF LIMITATIONS. Any statutory limitation, which may be contractually superseded, to the contrary notwithstanding, any action hereon may be instituted so long as the applicable statute of limitations governing the Contract (including any warranty period) has not run or expired or within three (3) years following Final Completion of the Contract (including any warranty period) and acceptance of the Work performed under the Contract by the OWNER, whichever is longer. 9.RECITALS. The recitals contained in this Performance Bond are incorporated by reference herein and are expressly made a part of this Performance Bond. 10.GOVERNING LAW. This performance bond shall be governed by, and construed in accordance with, the laws of the State of Florida without regard to its conflict of laws provisions. 11.VENUE. In the event any legal action shall be filed upon this performance bond, venue shall lie exclusively in the Circuit Court for Seminole County, Florida. 12. MISCELLANEOUS. A.The Surety agrees that this performance bond shall afford the OWNER with all of the protections and rights afforded under Florida Statutes and under common law. B.This performance bond is issued in addition to any other bond or warranty required under the Contract including, but not limited to, any labor and materials payment bond and maintenance bond. Each bond issued under the Contract shall be construed as separate and distinct from each other. C.In the event that the Surety fails to fulfill its obligations under this performance bond, then the Surety shall also indemnify and hold the OWNER harmless from any and all loss, damage, cost and expense, including reasonable attorneys’ fees and costs for all trial and appellate proceedings, resulting directly or indirectly from the Surety’s failure to fulfill its obligations hereunder. This subsection shall survive the termination or cancellation of this performance bond. D.This performance bond shall remain in full force and effect until such time all the work, labor and materials under the Contract have been performed or provided to the OWNER’s complete satisfaction, through the expiration of all warranty periods. 71 Piggyback Rider City of Winter Springs and Fausnight Stripe and Line, Inc. Principal Surety _______________________________ ____________________________________ (Typed Firm Name) (Typed Firm Name) _______________________________ ____________________________________ (Seal) (Seal) By: By: _______________________________ ____________________________________ (Signature) (Signature) _______________________________ ____________________________________ (Printed Name) (Printed Name) ________________________________ ____________________________________ (Title) (Title) ________________________________ ____________________________________ ________________________________ ____________________________________ (Address) (Address) ________________________________ ____________________________________ (Date of Execution) (Date of Execution) 72 Piggyback Rider City of Winter Springs and Fausnight Stripe and Line, Inc. EXHIBIT C LABOR AND MATERIALS PAYMENT BOND Bond No. __________________ BY THIS LABOR AND MATERIALS PAYMENT BOND, We ___________________, as Principal, whose address is __________________________________ and telephone number is ______________ and ____________________, as Surety, whose address is ________________________________ and telephone number is _________________are bound to the City of Winter Springs, a Florida municipal corporation, as OWNER, whose address is 1126 E. State Road 434, Winter Springs, Florida 32708 and telephone number is 407-327-1800, in the initial sum of $ ________________________________ (110% of Contract Price), or such greater amount as the Contract may be adjusted from time to time in accordance with the Contract between the Principal and OWNER) (the “Penal Sum”). WHEREAS, the Principal has executed a contract with the OWNER, dated ______________, for the construction of the _________________________________________project in the City of Winter Springs, Seminole County, Florida (the “Project”); and WHEREAS, the OWNER has required the Principal to furnish a labor and materials payment bond in accordance with law and as a condition of executing the Contract with Principal; and WHEREAS, this bond is being entered into to satisfy the requirements of Section 255.05(1), Florida Statutes and the Contract referenced above, as the same may be amended, and additionally, to provide common law rights more expansive than as required by statute. NOW THEREFORE, the Surety and the Principal, both joint and severally, and for themselves, their heirs, administrators, executors, successors and assigns agree as follows: 1.CONTRACT INCORPORATED; SURETY AND PRINCIPAL BOUND FOR FULL PERFORMANCE. The Contract is incorporated by reference and made a part of this bond. The Surety and the Principal are bound to promptly make payments to all claimants, as defined in Section 255.05(1), Florida Statutes, supplying Principal with labor, materials, supplies, or rental equipment used directly or indirectly by Principal in the prosecution of the work provided under the Contract. Any such payments shall not involve the OWNER in any expense. 2.CLAIMS. Claims made under this bond shall be made pursuant to provisions of Section 73 Piggyback Rider City of Winter Springs and Fausnight Stripe and Line, Inc. 255.05, Florida Statutes, and applicable law. Therefore, a claimant, except a laborer, who is not in privity with the Principal shall, before commencing or not later than 45 days after commencing to furnish labor, services, or materials for the prosecution of the work, furnish the Principal with written notice that he or she intends to look to the bond for protection. A claimant who is not in privity with the Principal and who has not received payment for his or her labor, services, or materials shall deliver to the Principal and to the surety written notice of the performance of the labor or delivery of materials or supplies and of the nonpayment. The notice of nonpayment may be served at any time during the progress of the work or thereafter but not before 45 days after the first furnishing of labor, services, or materials, and not later than 90 days after the final furnishing of the labor, services, or materials by the claimant or, with respect to the rental equipment, not later than 90 days after the date that the rental equipment was last on the job site available for use. Any notice of nonpayment served by a claimant who is not in privity with Principal which includes sums for retainage must specify the portion of the amount claimed for retainage. 3.SURETY’S WAIVER OF NOTICE. The Surety waives notice of any modifications to the Contract, including changes in the Contract Time, the Contract Sum, or the labor, work, or materials required to be performed under the Contract. 4.BENEFICIARIES. The Surety provides this performance bond for the sole and exclusive benefit of the OWNER and OWNER’s heirs, administrators, executors, successors and assigns, as well as for the benefit of any claimants who have actually provided labor, material, rental equipment, or services under the Contract. 5.RECITALS. The recitals contained in this labor and materials payment bond are incorporated by reference herein and are expressly made a part of this bond. 6.GOVERNING LAW. This labor and materials payment bond shall be governed by, and construed in accordance with the laws of the State of Florida without regard to its conflict of laws provisions. 7.VENUE. In the event any legal action shall be filed upon this labor and materials payment bond, venue shall lie exclusively in the Circuit Court for Seminole County, Florida. 8.MISCELLANEOUS. 74 Piggyback Rider City of Winter Springs and Fausnight Stripe and Line, Inc. A.The Surety agrees that this labor and materials payment bond shall afford the OWNER and all claimants under the Contract with all of the protections and rights afforded under Florida Statutes and under common law. B.This labor and materials payment bond is issued in addition to any other bond or warranty required under the Contract including, but not limited to, any performance bond and maintenance bond. Each bond issued under the Contract shall be construed as separate and distinct from each other. C.In the event that the Surety fails to fulfill its obligations under this labor and materials payment bond, then the Surety shall also indemnify and hold the OWNER harmless from any and all loss, damage, cost and expense, including reasonable attorneys’ fees and costs for all trial and appellate proceedings, resulting directly or indirectly from the Surety’s failure to fulfill its obligations hereunder. This subsection shall survive the termination or cancellation of this labor and materials payment bond. D.This labor and materials payment bond shall remain in full force and effect until such time that the legal deadline for filing a claim hereunder has duly expired. Principal Surety _______________________________ ____________________________________ (Typed Firm Name) (Typed Firm Name) _______________________________ ____________________________________ (Seal) (Seal) By: By: _______________________________ ____________________________________ (Signature) (Signature) _______________________________ ____________________________________ (Printed Name) (Printed Name) ________________________________ ____________________________________ (Title) (Title) ________________________________ ____________________________________ ________________________________ ____________________________________ ________________________________ ____________________________________ (Address) (Address) ________________________________ ____________________________________ (Date of Execution) (Date of Execution) 75