HomeMy WebLinkAboutAaron's Backflow Services, Inc. Service Agreement for Cross Connection Control Program Management Services - 2026 02 03RFP 09-25-01 CS Cross-Connection Control Program Management Services
City of Winter Springs, Florida
1126 East State Road 434
Winter Springs, Florida 32708
REQUEST FOR PROPOSAL
PROPOSAL: RFP # 09-25-01 CS DATE: September 22, 2025
Sealed Proposals for the provision of service to provide Cross-Connection Control Program Management Services will be
received by the City of Winter Springs (CITY) Procurement Department, located at Winter Springs City Hall, 1126 East State
Road 434, Winter Springs, Florida 32708, until:
October 15, 2025
2:00 p.m., local time
FOR
Cross Connection Control Program Management Services
Said Proposals shall conform to the minimum requirements outlined in this Request for Proposal. The CITY reserves the
right to reject any and all offers and to waive minor informalities.
The CITY issues this Request for Proposal in order to select a Proposal(s) for further contract negotiation. Selection by the
CITY Commission may not result in the formation of a contract.
Submission and Receipt of RFPs:
Proposers shall submit their Proposal response to this RFP by:
Providing one (1) original, marked as such, three (3) copies, marked as such and one (1) electronic copy of your RFP
response to this office by the date and time indicated above.
The outside of your package must be clearly labeled with the RFP number, title, opening date and time, and the name
and address of the Proposer. The CITY is not responsible for submittals via postal or mail courier services, receipt by the
post office or mail courier prior to the deadline does not meet the CITY’s deadline requirements.
Proposals received after October 15, 2025 at 2:00 p.m., will be rejected.
Deadline for questions is October 3, 2025 1:00pm local time
Any Addenda, if required, will be issued by 5:00pm on October 8, 2025 on the Demand Star platform and City Website if
questions are received and require clarification.
If you have any questions regarding this Request for Proposal, please contact Procurement Department, at (407) 327-6557,
or via email at procurement@winterspringsfl.org
PROPOSAL DOCUMENTS CAN BE DOWNLOADED FREE OF CHARGE FROM:
www.demandstar.com
or
https://www.winterspringsfl.org/rfps
EXHIBIT A
EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
Request For Proposal Table of Contents
PART I: SCOPE OF SERVICE/EVALUATION CRITERIA .......................................................................................................... 4
Background ............................................................................................................................................................................... 4
Scope and Term of Service ........................................................................................................................................................ 4
TYPE OF WORK .................................................................................................................................................................................... 4
EVALUATION CRITERIA .................................................................................................................................................................... 6
TIMELINE OF EVENTS ........................................................................................................................................................................ 7
PART II: SPECIFIC BID REQUIREMENTS ............................................................................................................................. 8
FORMAT .................................................................................................................................................................................... 8
Section A – Proposer Information and Acknowledgement Form ............................................................................................. 8
Section B – Table of Contents ................................................................................................................................................... 8
Section C – Executive Summary ................................................................................................................................................ 8
Section D – Qualifications ......................................................................................................................................................... 8
Section E - Other Information ................................................................................................................................................... 9
Section F – Cost and Time ......................................................................................................................................................... 9
Section G – Mandatory Proposal Forms ................................................................................................................................... 9
Section H – Florida State Corporate Filing ................................................................................................................................ 9
PART III: INSTRUCTIONS TO PROPOSERS AND GENERAL PROVISIONS ............................................................................. 10
Definitions ............................................................................................................................................................................... 10
Preparation of Request for Proposal ...................................................................................................................................... 10
Submission and Receipt of Proposals ..................................................................................................................................... 11
Selection of Proposal .............................................................................................................................................................. 11
Acceptance of Offer ................................................................................................................................................................ 11
Discrepancies, Errors, and Omissions ..................................................................................................................................... 12
Right to Reject Proposals ........................................................................................................................................................ 12
Compensation ......................................................................................................................................................................... 12
Fiscal Non-Funding Clause ...................................................................................................................................................... 12
Conflict of Interest .................................................................................................................................................................. 13
Public Entity Crimes ................................................................................................................................................................ 13
Options .................................................................................................................................................................................... 13
Subcontracting ........................................................................................................................................................................ 13
Failure to Submit Proposal ...................................................................................................................................................... 13
Default of Contract ................................................................................................................................................................. 13
Modification for Changes ........................................................................................................................................................ 14
Order of Precedence ............................................................................................................................................................... 14
Examination of Records .......................................................................................................................................................... 14
Proposals Received ................................................................................................................................................................. 14
Lobbying/Cone of Silence ....................................................................................................................................................... 14
Qualifications of Proposer ...................................................................................................................................................... 15
EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
Disqualification of Proposer .................................................................................................................................................... 15
Licenses and Permits ............................................................................................................................................................... 15
Provisions for Other Agencies ................................................................................................................................................. 16
Applicable Law and Venue ...................................................................................................................................................... 16
Proposal Disclosure; Public Records Responsibilities ............................................................................................................. 16
E-Verify .................................................................................................................................................................................... 17
Prohibition on Gifts to City Employees and Officials .............................................................................................................. 18
Discrimination ......................................................................................................................................................................... 18
Additional Information ............................................................................................................................................................ 18
MANDATORY BID FORMS ............................................................................................................................................. 19
PROPOSER INFORMATION AND ACKNOWLEDGEMENT FORM ........................................................................................ 20
REFERENCE PACKAGE ................................................................................................................................................... 21
REFERENCE INFORMATION FORM ................................................................................................................................. 22
INSURANCE REQUIREMENTS FORM .............................................................................................................................. 23
SCRUTINIZED COMPANY CERTIFICATION ....................................................................................................................... 24
NON-COLLUSION AFFIDAVIT of PRIME PROPOSER ......................................................................................................... 26
DRUG FREE WORKPLACE FORM .................................................................................................................................... 27
PUBLIC ENTITY CRIMES STATEMENT .............................................................................................................................. 28
DEBARMENT, SUSPENSION and OTHER RESPONSIBILITY MATTERS ................................................................................... 30
E-VERIFY STATEMENT ................................................................................................................................................... 33
CONFLICT OF INTEREST STATEMENT ............................................................................................................................. 34
AFFIDAVIT OF COMPLIANCE WITH FLORIDA STATUTES § 787.06 .................................................................................... 35
BYRD ANTI-LOBBYING AMENDMENT, 31 U.S.C. §1352 (as amended) ............................................................................. 36
Appendix A: COST PROPOSAL WORKSHEET ................................................................................................................... 37
Appendix B: PROPOSAL BOND FORM ............................................................................................................................ 38
APPENDIX C: PERFORMANCE BOND FORM .................................................................................................................... 39
APPENDIX D: LABOR AND MATERIALS PAYMENT BOND................................................................................................. 43
EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
PART I: SCOPE OF SERVICE/EVALUATION CRITERIA
FOR
RFP # 09-25-01 CS
Cross-Connection Control Program Management Services
Background
The City of Winter Springs is located in Seminole County Florida, which is part of the Orlando-Kissimmee-Sanford
Metropolitan Area. The City covers approximately 15 square miles with a population of approximately 39,000. The City has
three water treatment plants that serve primarily residential consumers. The City’s water system has 441 non-residential
water service connections, 110 non-residential consumers using potable water for irrigation, and 458 residents using
potable water for irrigation.
Scope and Term of Service
The City of Winter Springs is requesting Proposals from qualified companies (Proposer or Proposers) for the purposes of
providing their services for the management of the cross-connection control program. The qualified company selected shall
provide a strong technical support team, demonstrate the ability to improve the management of the program, develop and
implement plans to reduce exposure risks related to the regulatory compliance and safety, and operate in compliance with
state regulations.
Thus, the City is requesting proposals from qualified companies to provide Cross-Connection Management Services to
ensure compliance with Florda Department of Environmental Protection (FDEP) Regulation 62-555.360. The Proposer(s)
awarded will be required to complete an initial survey and inspection within one year of award and maintain program
management services for the following five years. The City anticipates a change in the scope of work as a result of the
improvement project. The City and Contractor will develop a revised scope of work at a mutually agreed upon time.
TYPE OF WORK
1. The primary objectives of this program are to:
a)Preemptively identify and document cross-connection/backflow hazards and notify building owners of any
mandatory corrective action when required and monitor compliance cycle.
b)Manage Backflow Test Tracking/Send Notifications- Monitor, track periodic test documentation, print and
send corrective action notifications related to Backflow Preventer Assemblies connected to the public water
system.
c)Establish a cloud based secure database of cross-connection control and backflow prevention records for
each service connection included in the program. All data collected and managed remains the sole property
of the public water system,
d)Ensure all program data is compatible for import with ESRI ArcGIS/ArcMap for enhanced geographic and
system-wide analysis.
e)Provide onsite training for public water system staff on cross-connection and backflow prevention
fundamentals.
f)Conduct a comprehensive review and optimization of the public water system’s Cross-Connection Control
Program.
2. The project scope includes, but is not limited to:
a.Cross- Connection Surveys/ Inspections: Responsible for the proactive identification and documentation of
cross-connection backflow hazards throughout the City of Winter Springs service area. To include:
i. On-Site Cross-Connection Surveys: Conduct visual inspections at commercial, Industrial, and
institutional properties, as well as select residential properties, to identify all potential cross-
connections.
ii. Hazard Documentation: Maintain accurate records of all surveyed locations, including:
1. Type of facility.EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
2. Potential cross-connections identified.
3. Risk classification is based on degree of hazard.
4. Recommended corrective actions.
iii. Property Owner Notification: Provide written notifications to building owners detailing any
mandatory corrective actions required for compliance.
iv. Follow-Up & Compliance Monitoring: Track compliance cycles and conduct follow-up
inspections to verify corrective actions have been completed.
v. Data Management & Reporting: Maintain a digital tracking system accessible to the City of Winter
Springs staff that includes survey records, compliance statuses, and pending corrective actions
b.Backflow Test Tracking/Notifications: Establish a comprehensive backflow prevention assembly
compliance tracking system to ensure all devices connected to the City of Winter Springs distribution
system are properly tested and maintained. This includes:
i. Backflow Prevention Assembly Inventory with updated device locations and testing schedules.
ii. Monitoring & Compliance Tracking for test due dates and follow-up on overdue tests.
iii. Property Owner Notifications with reminders, compliance deadlines, and enforcement warnings.
iv. Coordination with Certified Backflow Testers to ensure testing is performed by qualified personnel.
v. Enforcement Follow-Up with escalations as necessary, including service shutoffs for non-
compliance.
vi. Secure Data Management to allow staff access to backflow test records and compliance tracking.
c.Cross-Connection Control Program Data Accessibility and GIS Integration:
i. Proposer(s) shall use a cross-connection software package for program management that is
approved by the City of Winter Springs and is able to produce, at a minimum, the following reports
and notices:
1. Standard notices and reports to include inspection, re-inspection, testing, non-compliance
and compliance notices.
2. Produce management reports for notices, inventory of devices, device tests, inspection
schedules, device test schedules, overdue inspections, and device test forms.
3. Schedule inspection and device testing notices from internal records, standard procedures,
and timing as required by FDEP approved, City of Winter Springs CCC Plan.
4. Track testable and non-testable devices and compliance requirements.
5. Automatically access all data relevant to a particular facility or period.
6. Generate the Annual Cross Connection Control Report and support documents.
ii. The Proposer(s) shall provide the entire database for the cross-connection program from program
inception through the end of the calendar year in a mutually agreeable electronic format.
iii. The Proposer(s) shall utilize a proprietary or commercially available cross-connection program
software package. If proprietary software is utilized, the Contractor shall provide the City with a
working copy through the term of the contract and for sufficient period following the termination
of the contract. The city is authorized to view the database, and to export the database to another
cross-connection program software system within six months of contract termination and receipt
of the final database described above.
iv. The Proposer(s) shall provide a written report on specific events or accounts upon request.
v. The Proposer(s) hall provide templated public awareness content and residual notification
templates that align with Rule 62-555.360 that dual check devices shall be refurbished or replaced
at least once every five to ten years.
vi. The Proposer(s) shall provide full-time phone support for customer questions with a trained ASSE
customer service agent. The Contractor’s phone will be staffed during normal business hours, 8am-
8pm EST Monday through Friday. An automatic message service will be provided for after-hour
calls.
vii. The Proposer(s) shall ensure that all cross-connection control program data is accessible to
designated water system staff, and compatible for use with ESRI ArcGIS/ArcMap. This includes:
1. Location Data
2. Owner Information
3. Device/Assembly Information:
a. Manufacturer/Model
b. Size EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
c. Photo location
d. Cost at time of purchase
e. Testing/Inspection frequency
4. Installation date, testing date, and/or replacement date
5. Contact information of testing company
6. Provide location data formatted for easy GIS integration
d. Onsite Cross-Connection & Backflow Basics Training for Public Water System Staff: Proposer(s) shall
provide up to eight (8) hours of onsite training for Winter Springs staff on cross-connection and backflow
prevention. Training topics should include:
i. Overview of Cross-Connection Control Regulations (FDEP 62-555.360)
ii. Identifying Cross-Connections & Backflow Hazards
iii. Types of Backflow Prevention Assemblies & Their Functions
iv. Surveying & Inspection Procedures
v. Understanding Backflow Test Reports
e. Utility Cross-Connection Control Program Review & Optimization: Proposer(s) shall perform a
comprehensive review of the existing Cross-Connection Control Program and provide consulting and
recommendation for improvements. To include:
i. Regulatory Review & Ordinance Compliance
ii. Notification Timeliness & Enforcement Procedures
iii. Inspection Prioritization & High-Hazard Containment
iv. Public Awareness & Customer Education Enhancements
v. Database Management & Business Change Tracking
vi. Facility Inspection Scheduling & Risk Classification
EVALUATION CRITERIA
Proposals will be evaluated by the CITY, and the Proposer will be selected based upon, but not limited to, the following
criteria:
Criteria: Max Points:
Experience: The Proposer’s has demonstrated the necessary methodologies, approach, software, and experience that
attest to the skills, experience, and capability to perform the services of cross-connection control program management.
Experience & Qualifications: Proposer has demonstrated significant experience and references that
attest to their skills and capabilities with cross-connection control program management.
30
Methodology & Approach: Proposers provided detailed methodologies for surveying, tracking,
training, and compliance. Demonstrating the necessary capabilities and skills to undertake this
project.
20
Software & Data Management Capabilities: Proposers provided a detailed explanation of their data
accessibility. Software proposed is compatible with City of Winter Springs ESRI Arc GIS/ArcMap
software, providing an easy GIS Integration atmosphere.
30
Experience Total: 80
Cost: The cost of the Proposal is important to the CITY, however, based on the evaluation of the
other criteria, the CITY will not necessarily select the lowest Proposer.
20
Cost Total: 20
Total Possible Points 100
EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
Pursuant to Florida Statutes § 287.05701, the CITY shall not request documentation regarding, consider, or give preference
based upon, a vendor’s social, political, or ideological interests when determining the vendor’s qualifications.
TIMELINE OF EVENTS
Release of RFP September 22, 2025
Deadline to receive questions (electronically) - 1:00pm local time October 3, 2025
Addendum Released by 5:00pm local time October 8, 2025
RFP Submittals Due by 2:00 pm local time October 15, 2025
RFP Opening – Immediately after Proposal Registration in City Commission Chambers October 15, 2025
Evaluation Committee Vendor Recommendation TBD
CITY Commission Approval of Selection and Consideration of Contract TBD
EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
PART II: SPECIFIC BID REQUIREMENTS
For
RFP 09-25-01 CS
Cross-Connection Control Program Management Services
FORMAT
To assure consistency, Proposals must conform to the following format:
A. Proposer Information and Acknowledgement Form
B. Table of Contents
C. Executive Summary
D. Qualifications
E. Other Information
F. Cost & Time
G. Mandatory Proposal Forms
H. Florida State Corporate Filing
Narrative pages are to be 8 ½ x 11 inches and all materials should be bound into one volume. A clear and concise
presentation of information is encouraged.
Failure of the proposer(s) to organize the information required by this RFP as outlined may result in the City, at its sole
discretion, disqualifying the Proposer from further consideration.
Section A – Proposer Information and Acknowledgement Form
Use the form provided in the Mandatory Proposal Form titled “PROPOSER INFORMATION AND ACKNOWLEDGEMENT
FORM.” (See Proposal Form 1)
Section B – Table of Contents
Identify Proposal material by section and page number.
Section C – Executive Summary
Summarize a short overview of the proposal and value proposition to the City. Limited to 3 pages.
Section D – Qualifications
General – Provide general information about the Proposer, including size, office location(s), and structure of Proposer.
Identify and explain any significant changes in organizational structure, ownership, or management.
Minimum Experience – Proposer must have at minimum 5 years of experience with Cross-Connection Control Program
Management. Proposer(s) must describe the prior experience with similar programs. Proposer(s) must be in good legal
standing.
Desired Experience – Proposer shall demonstrate their ability to undertake the City’s project by providing the technical
qualification of the Proposer, identify key individual team members and principal subcontractors, if applicable. The City
reserves the right to conduct an independent investigation of the Proposer’s technical qualifications by contacting project
references, accessing public information, inspecting facilities or contracting independent parties. Additional information
may be requested during the evaluations of the technical aspects.
Methodology & Approach- Proposers will address their approach to managing the program based on the scope of work EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
provided. These plans submitted in the proposal are preliminary documents that the selected Proposer ill further develop
for implementation following contract award. It is expected that these plans are submitted on company
letterhead/templates with some minor adaptation to this project to indicate how they will apply.
Software & Data Management Capabilities- Proposer(s) will provide a list of software used to complete the scope of work
and manage the project. The proposer should include: (1) how the software will be used and (2) if the software is
compatible with the City’s GIS software.
References – Use the form provided in the Mandatory Proposal Form titled “REFERENCE INFORMATION FORM”
Conclusion – Briefly summarize why Proposer should be selected, including why Proposer is pursuing the City of Winter
Springs’ business. In short, summarize what makes Proposer different and why the CITY should select Proposer above all
others.
Section E - Other Information
This section should address any other information necessary for a full understanding of Proposer’s services. Please provide
relevant information on any additional services offered by Proposer.
Section F – Cost and Time
This section must clearly state a detailed cost breakdown for each item in the scope of work. Provide details on how the
base fee will be adjusted to account for changes in the Proposer’s operating costs. Fee adjustments will take effect on
October 1 each year to align with the City’s fiscal year. Use Appendix A: Cost Proposal Worksheet.
Section G – Mandatory Proposal Forms
Fill out and return the forms provided, Proposer Information and Acknowledgement Form, References Information
Forms, Insurance Requirement Form, Scrutinized Company Certification, Non-Collusion Affidavit of Prime Respondent,
Drug Free Workplace Form, Public Entity Crimes Statement, Debarment, suspension etc. Certification, E-Verify
Statement, Conflict of Interest Statement, Compliance with Florida Statute 787.06 Affidavit, and Appendix A Cost
Proposal Worksheet.
Section H – Florida State Corporate Filing
All Proposals must be signed with the Proposer’s name and by an officer or employee having authority to bind the Proposer
by his/her signature as indicated by the Florida Department of State, Division of Corporations (www.sunbiz.org). Proof of
corporate signer must be included with the submittal with the Proposal. Use Sunbiz website screen shot or include a copy
of Corporate Resolution or a Power of Attorney.
EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
PART III: INSTRUCTIONS TO PROPOSERS AND GENERAL PROVISIONS
FOR
RFP 08-25-01 CS
Cross-Connection Control Program Management Services
Definitions (as used herein)
a. The acronym "RFP" is a "Request For Proposal" and means a solicitation of proposals.
b. The term "Proposal" means the offer of qualitative evaluations by the Proposer.
c. The term " Proposer " means the person, company, or entity making an offer.
d. The term "Change Order" means a written order signed by the Finance Department or authorized representative
directing the Bidder to make changes to a contract or purchase order resulting from the RFP.
e. The term "CITY" means the City of Winter Springs, Florida.
f. The term "CITY Commission" means the governing body of the City of Winter Springs. The CITY Commission is the
only body that can award Bids.
g. The term “Evaluation Committee” means a team of CITY staff that will review and rank all Proposals and may
provide a recommendation regarding selection of a PROPOSER to the CITY Commission.
Preparation of Request for Proposal
a. Proposers are expected to examine the minimum requirements and all special and general conditions. Omission on
the part of the Proposer to make the necessary examinations and investigations, or failure to fulfill every detail the
requirements of the contract document, will not be accepted as a basis for varying the requirements of the CITY or
compensation to the Proposer. Failure to properly and fully complete the Proposal is at the Proposer 's risk. The
Proposer shall sign the Request for Proposal and print or type his/her name, address, and telephone number on the
face page.
b. The apparent silence of any supplemental minimum requirements as to any details, or the omission from it of a
detailed description concerning any point will be regarded as meaning that only the best commercial practices are
to prevail. All workmanship is to be first quality. All interpretations of the minimum requirements shall be made
upon the basis of this statement.
c. Proposers should submit their response to this RFP by:
Providing one (1) original, marked as such, three (3) copies, marked as such and one (1) electronic copy of
Proposer’s response to this office by the date and time indicated in Part I Timeline of Events.
The outside of Proposer’s package must be clearly labeled with the RFP number, title, opening date and time
and the name and address of the Proposer. The CITY is not responsible for submittals via postal or mail courier
services, receipt by the post office or mail courier prior to the deadline does not meet the CITY’s deadline
requirements. Proposal response should include Proposal Bond in the amount of 5% of Proposal value.
d. The Proposer should retain a copy of all documents for future reference.
e. All Proposals must be signed with the Proposer’s name and by an officer or employee having authority to bind the
Proposer by his/her signature as indicated by the Florida Department of State, Division of Corporations
(www.sunbiz.org). Proof of corporate signer must be included with the submittal with the Proposal. You may useEXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
the Sunbiz website screen shot or include a copy of your Corporate Resolution to prove the authority of the
corporate signer.
f. Failure to follow the instructions in the Request for Proposal is cause for rejection of your Proposal.
Submission and Receipt of Proposals
a. Proposals must be received before the specified time as designated in the RFP Timeline of Events. A list of
Proposers who submitted Proposals will be furnished, upon request, following finalization of the RFP process.
b. Proposals shall be submitted in a sealed envelope. The envelope shall show the opening date and time, the RFP
number, and the name and address of the Proposer.
c. The City of Winter Springs is not responsible for the U.S. Mail or private couriers, in regard to mail being delivered
by the specified time so that a Proposal can be considered.
d. Email and Facsimile (FAX) Proposals will not be considered, however, Proposals may be modified by email and FAX
notice, provided such notices are received prior to the time and date specified.
e. Late Proposals will be rejected.
f. Proposals having any erasures or corrections must be initialed by the Proposer, in ink. Proposals shall be signed in
ink. All amounts shall be typewritten or completed in ink.
g. All Mandatory Proposal Forms must be completed and attached to the Proposal response.
h. All costs of Proposal preparation, inspection of the RFP documents, and presentation of the Proposal shall be solely
borne by the Proposer. The CITY shall not be liable for any cost incurred by the Proposer during the preparation
and submission of its Proposal in response to this RFP.
Selection of Proposal
SELECTION OF THE PROPOSER AND PROPOSAL DEEMED THE MOST QUALIFIED, MOST ADVANTAGEOUS, AND IN THE BEST
INTERESTS OF THE CITY, AS DETERMINED BY THE CITY COMMISSION OF THE CITY OF WINTER SPRINGS’S SOLE AND
ABSOLUTE DISCRETION, SHALL NOT RESULT IN THE FORMATION OF A CONTRACT. NO CONTRACT SHALL BE FORMED UNTIL
FINAL APPROVAL OF SUCH CONTRACT BY THE CITY COMMISSION AFTER SUCCESSFUL NEGOTIATION OF SPECIFIC CONTRACT
TERMS DETERMINED TO BE IN THE BEST INTERESTS OF THE CITY BY THE CITY COMMISSION. Negotiations may be
terminated at any time by the CITY Manager or CITY Commission if, in his/her/its sole discretion, the CITY Manager OR CITY
Commission determines that the negotiation of terms acceptable to the CITY will not be successful.
Only the CITY Commission can select Proposals, authorize the CITY Manager to engage in negotiations, and ultimately enter
into a contract.
The project owner provides a recommendation to the CITY Commission for selection. The recommendation may or may not
be adopted by the CITY Commission.
In the event clarification is required, the CITY may require one or more of the top-ranking Proposers to attend a meeting to
make an oral presentation, answer questions. This meeting will be exempt from the requirements of the Sunshine Law in
accordance with section 286.0113, Florida Statutes. Proposer(s) will be notified of any further meeting requirements.
Acceptance of Offer
The signed Proposal shall be considered an offer on the part of the Proposer; however, such offer shall be deemed accepted
only upon issuance by the CITY of a Purchase Order, Blanket Purchase Order, or execution of another contractual document
deemed acceptable to the CITY. The contract will be awarded to the most responsible and responsive, qualified Proposer(s)
whose Proposal is deemed the most advantageous and in the best interests of the CITY in accordance with the criteria set
EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
forth in this RFP.
The CITY reserves the right to accept or reject any and all Proposals or parts of Proposals, waive minor informalities, and to
request clarification of information from any Proposer.
Notice of Award, Performance and Labor and Materials Payment Bond
Within ten (10) calendar days from the date stipulated in the Notice of Award notifying Proposer that its Proposal has been
accepted, the successful Proposer shall execute the Agreement. Simultaneously with the execution of the Agreement,
Proposer shall furnish a Performance Bond and a Labor and Materials Payment Bond each in the amount of 110 percent of
the contract price. The bonds shall be secured from a surety company acceptable to the CITY. The forms of the Bonds the
successful Proposer will be required to execute are included in the RFP Documents. Failure to execute the Agreement
and/or to furnish said bonds within ten (10) calendar days from the date of the Notice of Award entitles the CITY to
consider all rights arising out of the CITY's acceptance of the Proposal as abandoned and the Proposal Bond shall be
forfeited. The CITY shall be entitled to such other rights as may be granted by law.
Discrepancies, Errors, and Omissions
Any discrepancies, errors, or ambiguities in the Request For Proposal or addenda (if any) should be reported in writing to
the CITY's Procurement Manager. Should it be found necessary, a written Addenda will be incorporated in the Request For
Proposal and will become part of the Service Agreement (contract documents). The CITY will not be responsible for any oral
instructions, clarifications, or other communications.
Right to Reject Proposals
The CITY reserves the right to reject any or all Proposals, and to disregard typographical, mathematical, or obvious errors.
The CITY will not pay costs incurred by any Proposer in the preparation of their Proposals.
Compensation
Compensation, which is determined to be fair, competitive, and reasonable, will be considered during the negotiations of a
final contract with the selected Proposer.
Fiscal Non-Funding Clause
In the event sufficient budgeted funds are not available for a new fiscal period, the CITY shall notify the Proposer of such
occurrence and any contracts entered into between the CITY and Proposer shall terminate on the last day of the current
fiscal period without penalty or expense to the CITY.
Rights of the CITY
This RFP constitutes an invitation for submission of Proposals to the CITY. This RFP does not obligate the CITY to procure or
contract for any of the scopes of services set forth in this RFP. The CITY reserves and holds at its sole discretion, various
rights and options under Florida law, including without limitation, the following:
To prepare and issue Addendums to the RFP that may expand, restrict, or cancel any portion or all work described
in the RFP without obligation to commence a new procurement process or issue a modified or amended RFP.
To receive questions from potential Proposers and to provide such answers in writing as it deems appropriate.
To waive any informalities, technicalities or irregularities in the Proposals submitted.
To reject any and all Proposal submissions.
To change the date for receipt of Proposals or any deadlines and dates specified in the RFP.
To change the procurement and/or selection process prior to receipt of Proposals.
To conduct investigations with respect to the information provided by each Proposer and to request additional
information (either in writing or in presentations and interviews) to support such Proposer’s responses and
submittals.
To visit facilities referenced in the Proposer’s submittal at any time or times during the procurement process.EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
To seek clarification of Proposals from the Proposer either in writing or in presentations and interviews
To cancel the RFP; with or without the substitution of another RFP.
Conflict of Interest
Proposer acknowledges and certifies that this Agreement does not violate any ethics provision found in Chapter 112,
Florida Statutes, or Chapter 2 of the Code of Ordinances of the City of Winter Springs.
The Proposer certifies that, to the best of their knowledge or belief, no elected/appointed official or employee of the City of
Winter Springs, a spouse thereof or other person residing in the same household, is financially interested, directly or
indirectly, in providing the goods or services specified in this Proposal. Financial interest includes ownership of more than
five percent (5%) of the total assets or capital stock or being an officer, director, manager, partner, proprietor, or agent of
the business submitting the Proposal or of any subcontractor or supplier thereof providing goods or services in excess of
ten percent (10%) of the total Proposal amount.
Additionally, the Proposer, on company letterhead, must divulge at the time of Proposal submittal, any relative, other than
those already specified, of an elected /appointed official or employee of the City of Winter Springs who has a financial
interest, as defined herein, in providing the goods or services specified in the Proposal. The CITY, at its sole discretion, will
determine whether a conflict exists and whether to accept or reject the Proposal.
Public Entity Crimes
A person or affiliate who has been placed on the convicted vendor list following a conviction for public entity crime may not
submit a Proposal on a contract to provide any goods or services to a public entity, may not submit a Proposal on a contract
with a public entity for the construction or repair of a public building or public work, may not submit Proposals on leases of
real property to a public entity, may not be awarded or perform work as a contractor, supplier, subcontractor, or consultant
under a contract with any public entity, and may not transact business with any public entity in excess of the threshold
amount provided in Section 287.017, for CATEGORY TWO for a period of thirty-six (36) months from the date of being
placed on the convicted vendor list.
Options
When the CITY requests Proposals with options regarding the extent of services to be provided, the CITY requests all
PROPOSERS to provide a cost breakdown for each option proposed. Although all options may be purchased, some options
may not ultimately be purchased. The CITY reserves the right to decide, at its discretion, which options shall be purchased.
The CITY reserves the right to engage more than one (1) PROPOSER if it is believed that different PROPOSERS might best
serve the CITY's interests in performing different segments of the work (e.g., one PROPOSER to provide building estimates,
and another to provide infrastructure estimates).
Subcontracting
Where Proposers do not have the "in-house" capability to perform work desired in the Request For Proposal,
subcontracting may be permitted only with prior knowledge and approval of the CITY. The CITY must be assured of and
agree that any proposed subcontractor(s) can perform work of the desired quality and in a timely manner. The name(s) of
any intended subcontractor(s) should be given in the Proposal.
Failure to Submit Proposal
If PROPOSER does not wish to submit a Proposal, return the RFP and state the reason therefore; otherwise, PROPOSER’s
name may be removed from CITY’s mailing list.
Default of Contract
In case of default by the Proposer, the CITY may procure the requested services from other sources and hold the Proposer
responsible for any excess costs occasioned or incurred thereby. EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
Modification for Changes
No agreement or understanding to modify this RFP and resultant purchase order or contract shall be binding upon the CITY
unless made in writing by the City of Winter Springs.
Order of Precedence
In the event of an inconsistency between provisions of the RFP, the inconsistency shall be resolved by giving precedence in
the following order: (a) Instructions to Proposers and General Provisions; and (b) the minimum requirements.
Examination of Records
The Proposer shall keep adequate records and supporting documentation applicable to the subject matter of this RFP to
include, but not be limited to records of costs, time worked, working paper and/or accumulations of data, and criteria or
standards by which findings or data are measured. Said records and documentation shall be retained by the Proposer for a
minimum of one (1) year from the date the contract is completed and accepted by the CITY. If any litigation is initiated
before the expiration of the one-year period, the records shall be retained until all litigation, claims, or audit findings
involving the records have been resolved, unless otherwise instructed by the CITY. Should any questions arise concerning
this contract, the CITY and its authorized agents shall have the right to review, inspect, and copy all such records and
documentation during the record retention period stated above; provided, however, such activity shall be conducted only
during normal business hours and shall be at CITY expense. Proposers shall be authorized to retain microfilm copies in lieu
of original records if they so desire.
Any subcontractor(s) employed by a Proposer who is subject to these requirements and the Proposer itself are required to
notify any such subcontractor(s).
Proposals Received
All Proposals received in response to this RFP become the property of the CITY.
Lobbying/Cone of Silence
Lobbying is defined as any action taken by an individual, firm, association, joint venture, partnership, syndicate,
corporation, and/or all other groups who seek to influence the governmental decision of a CITY Commission Member, the
CITY Manager, any requesting or evaluating Department/Division/Office personnel and/or any member of the Evaluation
Committee concerning an active solicitation during the black-out period. A lobbying black-out period commences upon the
issuance of this solicitation document.
If an award item is presented to CITY Commission for approval or for a request to provide authorization to negotiate a
Contract(s) and the CITY Commission refers the item back to the CITY Manager, Procurement Division and/or requesting
Department/Division/Office for further review or otherwise does not act on the item, the Cone of Silence/Lobbying Black-
out Period will be reinstated until such time as the CITY Commission meets to consider the item for action.
Bidders, Proposers, Respondents, potential vendors, service providers, lobbyists, consultants, or vendor representatives
shall not contact any CITY Commission member, the CITY Manager, any requesting or evaluating Division, Department,
Office personnel, and/or any member of the Evaluation Committee concerning an active Request For Proposal during the
Lobbying/Cone of Silence Black-out Period.
Byrd Anti-Lobbying Amendment
Contractors who apply for a bid for an award of $100,000 or more shall file the required certification. Each tier certifies to
the tier above that it will not and has not used Federal appropriated funds to pay any person or organization for influencing
or attempting to influence an officer or employee of any agency, a Member of Congress, officer or employee of Congress,
or an employee of a Member of Congress in connection with obtaining any Federal contract, grant, or any other award
covered by 31 U.S.C. § 1352. Each tier shall also disclose any lobbying with non-Federal funds that takes place in connection
with obtaining any Federal award. Such disclosures are forwarded from tier to tier up to the recipient who in turn will
EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
forward the certification(s) to the awarding agency.
Insurance and Hold Harmless Indemnification
To the fullest extent permitted by laws and regulations, Proposer shall indemnify and hold harmless CITY and its consultants,
agents and employees from and against all claims, damages, losses and expenses, direct, indirect or consequential (including
but not limited to fees and charges of engineers, architects, attorneys and other professionals and court and arbitration costs)
arising out of or resulting from the performance of the Work, provided that any such claim, damage, loss or expenses (a) is
attributable to bodily injury, sickness, disease or death, or to injury to or destruction of tangible property other than the Work
itself) including the loss of use resulting therefrom and (b) is caused in whole or in part by any negligent act or omission of
Proposer, any Subcontractor, any person or organization directly or indirectly employed by any of them to perform or furnish
any of the Work or anyone for whose acts any of them may be liable, regardless of whether or not it is caused in part by a
party indemnified hereunder or arises by or is imposed by Law and Regulations regardless of the negligence of any such party.
In any and all claims against CITY or any of their consultants, agents or employees by any employee of Proposer, any
Subcontractor, any person or organization directly or indirectly employed by any of them to perform or furnish any of the
Work or anyone for whose acts any of them may be liable, the indemnification obligation under the previous paragraph
shall not be limited in any way by any limitation on the amount or type of damages, compensation or benefits payable by or
for Proposer or any such Subcontractor or other person or organization under workers’ or workmen’s compensation acts,
disability benefit acts or other employee benefit acts.
Proposer's Liability Insurance - The Proposer shall not commence any work under this Contract until he has obtained all
insurance required under the Agreement. Proposer shall purchase and maintain such comprehensive general liability and
other insurance as is appropriate for the Work being performed and furnished and as will provide protection from claims set
forth which may arise out of or result from Proposer's performance and furnishing of the Work and Proposer's other
obligations under the Contract Documents, whether it is to be performed or furnished by Proposer, by any Subcontractor, by
anyone directly or indirectly employed by any of them to perform or furnish any of the Work, or by anyone for whose acts
any of them may be liable. The insurance required shall include the specific coverage's and be written for not less than the
limits of liability and coverage's provided or required by law, whichever is greater. The comprehensive general liability
insurance shall include completed operations insurance. The comprehensive general liability insurance shall also include
Contractual Liability Insurance applicable to Proposer's obligations under the Hold Harmless Indemnification. All of the
policies of insurance so required to be purchased and maintained (or the certificates or their evidence thereof) shall contain
a provision or endorsement that the coverage afforded will not be canceled, materially changed or renewal refused until at
least thirty days’ prior written notice has been given to CITY by certified mail. All such insurance shall remain in effect until
final payment and at all times thereafter when Bidder may be correcting, removing or replacing defective work in accordance
with the Contract Documents. Proposer's General Liability Insurance shall include the CITY, and CITY's consultants as insured
or additional insured which may be accomplished by either an endorsement of Proposer's Comprehensive General Liability
policy or by Proposer's carrier issuing a separate protection liability policy.
Qualifications of Proposer
A Proposer may be required, before the award of any contract, to show to the complete satisfaction of the CITY that they
have the necessary facilities, equipment, ability and financial resources to perform the work in a satisfactory manner within
the time specified.
Disqualification of Proposer
Any or all Proposals will be rejected if there is any reason for believing that collusion exists among the Proposers, and
participants in such collusion will not be considered in future Proposals for the same work.
Licenses and Permits
The Proposer shall secure all licenses and permits and shall comply with all applicable laws, regulations and codes as
EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
required by the United States, the State of Florida, or by the City of Winter Springs. The Proposer must fully comply with all
Federal and State Laws and County and Municipal Ordinances and Regulations in any manner affecting the performance of
the work.
Provisions for Other Agencies
Unless otherwise stipulated by the PROPOSER, the PROPOSER agrees to make available to the Government agencies,
departments, and municipalities the prices submitted in accordance with said terms and conditions therein, should any said
governmental entity desire to buy under the Proposal.
Applicable Law and Venue
This Agreement shall be governed by, construed and interpreted in accordance with the laws of the State of Florida without
regard to the conflicts or choice of law principals thereof. Each of the parties hereto: (a) irrevocably submits itself to the
exclusive jurisdiction of the State of Florida, and agree that venue shall lie exclusively in the Eighteenth Judicial Circuit Court
in and for Seminole County, Florida for any state court action arising out of this Agreement, and exclusively in the United
States District Court for the Middle District of Florida, Orlando Division, for any federal court action arising out of this
Agreement; (b) waives and agrees not to assert against any party hereto, by way of motion, as a defense or otherwise, in
any suit, action or other proceeding, (i) any claim that it is not personally subject to the jurisdiction of the above-named
courts for any reason whatsoever, and (ii) any claim that such suit, action, or proceeding by any party hereto is brought in
an inconvenient form or that venue of such suit, action, or proceeding is improper or that this Agreement or the subject
matter hereof may not be enforced in or by such courts.
Proposal Disclosure; Public Records Responsibilities
Florida law provides that municipal records shall, at all times, be open for personal inspection by any person. Section
119.01, Florida Statutes et. seq. (the Public Records Law). Unless otherwise provided by the Public Records Law,
information and materials received by the CITY in connection with an RFP response and under any awarded contract shall
be deemed to be public records subject to public inspection and/or copying at the end of the statutory exemption time
period pursuant to Section 119.071, Florida Statutes. However, certain exemptions to the Public Records Law are statutorily
provided for under sections 119.07 and 119.071, Florida Statutes, and other applicable laws. If the Proposer believes any of
the information contained in its response is exempt from the Public Records Law, including trade secrets as defined by
Florida law, the Proposer must, in its response, specifically identify the material which is deemed to be exempt and cite the
legal authority for the exemption; otherwise, the CITY will treat all materials received as public records.
Pursuant to section 119.0701, Florida Statutes, for any tasks performed by Proposer on behalf of the CITY, Proposer shall:
(a) keep and maintain all public records, as that term is defined in chapter 119, Florida Statutes (“Public Records”), required
by the CITY to perform the work contemplated by this Agreement; (b) upon request from the CITY’s custodian of public
records, provide the CITY with a copy of the requested Public Records or allow the Public Records to be inspected or copied
within a reasonable time at a cost that does not exceed the costs provided in chapter 119, Florida Statutes, or as otherwise
provided by law; (c) ensure that Public Records that are exempt or confidential and exempt from Public Records disclosure
requirements are not disclosed except as authorized by law for the duration of the term of this Agreement and following
completion or termination of this Agreement, if Proposer does not transfer the records to the CITY in accordance with (d)
below; and (d) upon completion or termination of this Agreement, (i) if the CITY, in its sole and absolute discretion,
requests that all Public Records in possession of Proposer be transferred to the CITY, Proposer shall transfer, at no cost, to
the CITY, all Public Records in possession of Proposer within thirty (30) days of such request or (ii) if no such request is made
by the CITY, Proposer shall keep and maintain the Public Records required by the CITY to perform the work contemplated
by this Agreement. If Proposer transfers all Public Records to the CITY pursuant to (d)(i) above, Proposer shall destroy any
duplicate Public Records that are exempt or confidential and exempt from Public Records disclosure requirements within
thirty (30) days of transferring the Public Records to the CITY and provide the CITY with written confirmation that such
records have been destroyed within thirty (30) days of transferring the Public Records. If Proposer keeps and maintains
Public Records pursuant to (d)(ii) above, Proposer shall meet all applicable requirements for retaining Public Records. All
Public Records stored electronically must be provided to the CITY, upon request from the CITY’s custodian of public records,
in a format that is compatible with the information technology of the CITY. If Proposer does not comply with a Public
Records request, or does not comply with a Public Records request within a reasonable amount of time, the CITY may
EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
pursue any and all remedies available in law or equity including, but not limited to, specific performance. The provisions of
this section only apply to those tasks in which Proposer is acting on behalf of the CITY.
IF THE PROPOSER HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE
PROPOSER’S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC
RECORDS AT:
Telephone number: (407) 327-6560 ext. 7003 E-mail address: cityclerkdepartment@winterspringsfl.org
Attorney Fees
In the event of legal action or other proceeding arising under this RFP, the prevailing party shall be entitled to recover
from the adverse party all its reasonable attorneys’ fees and costs incurred by the prevailing party in the prosecution or
defense of such action, or in any post-judgment or collection proceedings and whether incurred before suit, at the trial
level or at the appellate level. This shall include any bankruptcy proceedings. The prevailing party also shall be entitled to
recover any reasonable attorneys’ fees and costs incurred in litigating the entitlement to attorneys’ fees and costs, as well
as in determining the amount of attorneys’ fees and costs due to the prevailing party. The reasonable costs to which the
prevailing party will be entitled include costs that are taxable under any applicable statute, rule, or guideline, as well as
costs of investigation, copying costs, electronic discovery costs, mailing and delivery charges, costs of conducting legal
research, consultant and expert witness fees, travel expenses, court reporter fees and mediator fees, regardless of
whether such costs are taxable under any applicable statue, rule or guideline.
E-Verify
Pursuant to section 448.095, Florida Statutes, beginning January 1, 2021, any CITY vendors/contractors shall register with
and use the U.S. Department of Homeland Security’s E-Verify system, https://e-verify.uscis.gov/emp, to verify the work
authorization status of all employees hired on and after January 1, 2021. CITY vendors/contractors must provide evidence
of compliance with section 448.095, Florida Statutes. Evidence shall consist of an affidavit from the Proposer stating all
employees hired on and after January 1, 2021 have had their work authorization status verified through the E-Verify system
and a copy of their proof of registration in the E-Verify system. Failure to comply with this provision will be a material
breach of the contract, and shall result in the immediate termination of a contract without penalty to the CITY. Proposer
shall be liable for all costs incurred by the CITY securing a replacement contract, including but not limited to, any increased
costs for the same services, any costs due to delay, and rebidding costs, if applicable. If the Proposer utilizes subcontractors
the following shall apply:
Proposer shall also require all applicable subcontractors performing work under the Agreement to use the E-Verify system
for any employees they may hire during the term of the Agreement.
Proposer shall obtain from all such subcontractors an affidavit stating the subcontractor does not employ, contract with, or
subcontract with an unauthorized alien, as defined in section 448.095, Florida Statutes. Proposer shall provide a copy of all
subcontractor affidavits to the CITY upon request and shall maintain a copy for the duration of the Agreement.
Modification and Withdraw
Proposals may not be modified after submittal.
Proposals may be withdrawn at any time prior to the deadline. Withdrawal requests shall be made in writing and must be
received by the CITY’s Procurement Manager before the time and date stated or, as amended, for the Proposal Opening.
Properly withdrawn Proposals will be returned unopened to the Proposer submitting the Proposal.
A Proposer who timely withdraws its Proposal may submit a new Proposal in the same manner as specified herein under
“Submission of Proposal.” A Proposal submitted in place of a withdrawn Proposal shall be clearly marked as such on the
outside of the envelope and on the Proposal Form.
If a Contract is not awarded within 90 calendar days after opening of Proposals, a Proposer may file a written request with
EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
the CITY’s Procurement Manager for the withdrawal of its Proposal.
Prohibition on Gifts to City Employees and Officials
No organization or individual shall offer or give, either directly or indirectly, any favor, gift, loan, fee, service or other item
of value to any CITY employee, as set forth in Chapter 112, Part III, Florida Statutes, the current CITY Ethics Ordinance, and
CITY Administrative Policy.
Violation of this provision may result in one or more of the following consequences:
a. Prohibition by the individual, firm, and/or any employee of the firm from contact with CITY staff for a
specified period of time;
b. Prohibition by the individual and/or firm from doing business with the CITY for a specified period of time,
including but not limited to: submitting bid/Proposals, RFQ Responses, and/or quotes; and,
c. Immediate termination of any contract held by the individual and/or firm for cause.
Discrimination
An entity or affiliate who has been placed on the discriminatory vendor list may not submit a Bid, Proposal, or reply on a
contract to provide any goods or services to a public entity; may not submit a Bid, Proposal, or reply on a contract with a
public entity for the construction or repair of a public building or public work; may not submit Bids, Proposals, or replies on
leases of real property to a public entity; may not be awarded or perform work as a contractor, supplier, subcontractor, or
consultant under a contract with any public entity; and may not transact business with any public entity.
administrative practices shall apply to any contract negotiated with a selected firm as required by federal law. The most
recent of such requires, including any amendments made such the submission of the Proposal, shall apply, unless federal
government determines otherwise.
Additional Information
Additional information may be obtained from the Finance Director, (407) 327-6557, or from any other individual listed on
the RFP cover letter.
EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
MANDATORY BID FORMS
Proposal Form 1: Proposer Information and Acknowledgement Form
Proposal Form 2: References Information Forms
Proposal Form 3: Insurance Requirements Form
Proposal Form 4: Scrutinized Company Certification
Proposal Form 5: Non-Collusion Affidavit
Proposal Form 6: Drug Free Workplace Form
Proposal Form 7: Public Entity Crimes Statement
Proposal Form 8: Debarment, Suspension etc. Certification
Proposal Form 9: E-Verify Statement
Proposal Form 10: Conflict of Interest Statement
Proposal Form 11: Affidavit of Compliance with Florida Statute 787.06
Proposal Form 12: Byrd Anti-Lobbying Amendment, 31 U.S.C.§1352 (as amended)
Appendix A: Cost Proposal Worksheet
Appendix B: Proposal Bond Agreement
Appendix C: Performance Bond Agreement
Appendix D: Labor and Materials Payment Bond
Mandatory forms must be submitted with the Proposal.
Failure to submit forms may disqualify the Proposer from the RFP
EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
PROPOSER INFORMATION AND ACKNOWLEDGEMENT FORM
For
RFP # 09-25-01 CS
Cross-Connection Control Program Management Services
The undersigned Proposer does hereby agree to furnish the City of Winter Springs, Florida, the items listed in accordance with the
minimum requirements/evaluation criteria shown by the Request For Proposal to be delivered to the specified site for the price
indicated.
IT IS THE PROPOSER’S RESPONSIBILITY TO CHECK www.demandstar.com
FOR FINAL DOCUMENTS AND ADDENDA BEFORE SUBMITTAL
THIS PROPOSAL MUST BE SIGNED BY THE PRINCIPAL OR DIRECTOR AS INDICATED BY THE FLORIDA DEPARTMENT OF STATE, DIVISION
OF CORPORATIONS (www.sunbiz.org). Proof of corporate signer must be submitted with Proposal. If not submitted, Proposer will be
considered non-responsive. Use Sunbiz website screen shot or copy of Corporate Resolution or Power of Attorney.
PROPOSER NAME:
TAX ID# SNN or EIN:
PROPOSER ADDRESS:
PURCHASE ORDER ADDRESS:
PHONE NUMBER:
COMPANY WEBSITE:
COMPANY CONTACT (REP):
CONTACT EMAIL ADDRESS:
SIGNATURE:
THE UNDERSIGNED:
A. Acknowledges receipt of:
1. RFP # 09-25-01 CS Pertaining To: Cross-Connection Control Program Management
2. Addenda:
Number: _________, Dated _________________.
Number: _________, Dated _________________.
B. Has examined the site and all RFP Documents and understands that in submitting its Proposal, they waive all right to plead any
misunderstanding regarding the same.
C. Agrees:
1. To hold this Proposal open for 90 calendar days after the Proposal opening date.
2. To furnish the services specified in this RFP at the prices quoted in the Proposal and in compliance with the RFP
Documents.
3. To accept the provisions of the Instructions to Proposers.
4. To negotiate a contract with the CITY incorporating the Proposal prices, if selected on the basis of this Proposal.
5. To accomplish the work in accordance with the contract documents.
D. Certifies:
1. That all information contained in this Proposal is truthful to the best of my knowledge and belief.
2. That I am duly authorized to submit this Proposal on behalf of the Proposer and that the Proposer is ready, willing, and
able to perform if awarded the Proposal.
Stipulated Amount
A. Submit on Cost Proposal Worksheet, Appendix A.
EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
REFERENCE PACKAGE
MINIMUM QUALIFICATIONS OF PROSPECTIVE BIDDER
CITY CONTRACT NUMBER:
RFP 09-25-01 CS
PROJECT TITLE: Cross-Connection Control Program Management Services
CONTRACTOR FIRM NAME:
___________________________________________________
BUSINESS ADDRESS:
________________________________________________________
CITY, STATE, ZIP CODE:
______________________________________________________
PHONE NUMBER: _________________ FAX NUMBER: ________________
EMAIL ADDRESS:
____________________________________________________________
EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
REFERENCE INFORMATION FORM
RFP # 09-25-01 CS
Cross-Connection Control Program Management Services
Organization:
Contact Person:
Address:
City:
State: Zip:
Phone Number:
( )
Project Cost:
Date Performed:
Organization:
Contact Person:
Address:
City:
State: Zip:
Phone Number:
( )
Project Cost:
Date Performed:
Organization:
Contact Person:
Address:
City:
State: Zip:
Phone Number:
( )
Project Cost:
Date Performed:
PROPOSER Representative
Typed Name/Title:
PROPOSER Representative
Signature:
PROPOSER:
EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
INSURANCE REQUIREMENTS FORM
Insurance Type Required Limits
Worker’s
Compensation
Statutory Limits of Florida Statutes, Chapter 440 and all Federal Government Statutory Limits
Employer’s Liability $1,000,000 each accident, single limit per occurrence
Commercial General
Liability
(Occurrence Form)
patterned after the
current ISO form
$1,000,000 single limit per occurrence
$3,000,000 aggregate for Bodily Injury Liability & Property Damage Liability.
This shall include Premises and Operations; Independent Contractors; Products & Completed
Operations & Contractual Liability.
Indemnification
To the maximum extent permitted by Florida law, the Contractor/Vendor/Consultant shall
indemnify and hold harmless City of Winter Springs, its officers and employees from any and
all liabilities, damages, losses and costs, including, but not limited to, reasonable attorneys’
fees and paralegals’ fees, to the extent caused by the negligence, recklessness, or intentional
wrongful conduct of the Contractor/Vendor/Consultant or anyone employed or utilized by the
Contractor/Vendor/Consultant in the performance of the Agreement. This indemnification
obligation shall not be construed to negate, abridge or reduce any other rights or remedies
which otherwise may be available to an indemnified party or person described in this
paragraph. This section does not pertain to any incident arising from the sole negligence of
the City of Winter Springs.
Automobile Liability $1,000,000 each person; Bodily Injury & Property Damage, Owned/Non-owned/Hired;
Automobile Included.
Other
Proposer shall ensure that all subcontractors comply with the same insurance requirements that it is required to meet. The
same Proposer shall provide the CITY with certificates of insurance meeting the required insurance provisions.
The City of Winter Springs must be named as “Additional Insured” on the Insurance Certificate for Commercial General Liability
where required.
The Certificate Holder shall be named as City of Winter Springs.
Thirty (30) days cancellation notice required.
The undersigned Proposer agrees to obtain, prior to award, if selected, a minimum level of insurance as stated above.
Proposer
Authorized Signature
Officer Title
Date
EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
SCRUTINIZED COMPANY CERTIFICATION
Florida Statutes, Sections 287.135 and 215.473
Pursuant to Section 287.135, Florida Statutes (2017), a company is ineligible to, and may not, bid on, submit a proposal for,
or enter into or renew a contract with the CITY for goods or services of:
a. Any amount if, at the time of bidding on, submitting a proposal for, or entering into or renewing such contract, the
Proposer 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:
Is on the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran
Terrorism Sectors List, created pursuant to s. 215.473; or
c. 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 Proposer 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:
a. The Proposer is found to have submitted a false certification; been placed on the Scrutinized Companies with
Activities in Sudan List;
b. Been placed on the Scrutinized Companies that Boycott Israel List or
c. Is engaged in a boycott of Israel; or
d. Been engaged in business operations in Cuba or Syria.
e. Has been placed on a list created pursuant to s. 215.473, Florida Statutes, relating to scrutinized active business
operations in Iran.
The CITY shall provide notice, in writing, to the Proposer of any determination concerning a false certification.
a. The Proposer shall have five (5) days from receipt of notice to refute the false certification allegation.
b. If such false certification is discovered during the active contract term, the Proposer 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.
c. If the Proposer 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.
EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
THIS CERTIFICATION FORM MUST BE COMPLETED AND INCLUDED IN YOUR PROPOSAL RESPONSE. FAILURE TO SUBMIT
THIS FORM AS INSTRUCTED SHALL RENDER YOUR PROPOSAL SUBMITTAL NON-RESPONSIVE.
a. The Vendor, owners, or principals are aware of the requirements of Section 287.135, Florida Statutes; and
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 Terrorism Sectors 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 Terrorism Sectors
List; engage in a boycott of Israel; or engage in business operations in Cuba or Syria.
(Authorized Signature)
(Printed Name and Title)
(Name of Proposer)
STATE OF ____________________________________
COUNTY OF __________________________________
The foregoing instrument was acknowledged before me by means of (_____) physical presence or (_____) online
notarization, this ______ day of __________, 2025 by _____________________ the _________________ of
__________________________, a ________________________ (____) who is personally known to me or (_____) who
produced ______________________________________ as identification.
Notary Public __________________________________
Print Name: ___________________________________
My Commission Expires: _________________________
EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
NON-COLLUSION AFFIDAVIT of PRIME PROPOSER
STATE OF
COUNTY OF
____________________________________, being duly sworn, deposes and says that:
(1) He/she is ___________________________ of ___________________________________
Title PROPOSER
The Proposer that has submitted the attached response.
(2) He/she is fully informed respecting the preparation and contents of the attached Proposal and of all pertinent
circumstances respecting such solicitation.
(3) Such Proposal is genuine and is not a collusive or sham solicitation.
(4) Neither the Proposer nor any of its officers, partners, owners, agent representatives, employees or parties in interest
including this affiant, has in any way, colluded, conspired, or agreed, directly or indirectly, with any other Proposer, firm or
person, to submit a collusive or sham response in connection with the RFP for which the attached Proposal has been
submitted or to refrain from proposing in connection with such RFP, 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 Proposal or of any other Proposer, or to fix any overhead, profit or cost element of the proposed price or
the proposed price of any other Proposer, or to secure through any collusion, conspiracy, connivance or unlawful
Agreement any advantage against the City of Winter Springs, Florida, or any person interested in the proposed Agreement.
(5) The price or prices quoted in the attached Proposal are fair and proper and are not tainted by any collusion, conspiracy,
or unlawful Agreement on the part of the Proposer or any of its agents, representatives, owners, employees, or parties of
interest, including affiant.
(Signed) (Title)
STATE OF _______________________________________
COUNTY OF _____________________________________
The foregoing instrument was acknowledged before me by means of (_____) physical presence or (_____) online
notarization, this ______ day of __________, 2025 by _____________________ the _________________ of
__________________________, a ________________________ (____) who is personally known to me or (_____) who
produced ______________________________________ as identification.
Notary Public __________________________________
Print Name: ___________________________________
My Commission Expires: _________________________
EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
DRUG FREE WORKPLACE FORM
The undersigned Proposer, in accordance with Florida Statute 287.087 hereby certifies that
_____________________________________________________ does:
(Name of Proposer)
1. Publish a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or
use of a controlled substance is prohibited in the workplace and specifying the actions that will be taken against
employees for violations of such prohibition.
2. Inform employees about the dangers of drug abuse in the workplace, the business’s policy of 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.
3. Give each employee engaged in providing the commodities or contractual services that are under contract a copy
of the Drug-Free statement.
4. Notify the employees that as a condition of working on the commodities or contractual services that are under
contract, employee will abide by the terms of the statement and will notify the employer of any conviction of, or
plea of guilty or nolo contendere to, any violation of Chapter 893 or of any controlled substance law of the United
States or any state, for a violation occurring in the workplace no later than five (5) days after such conviction.
5. Impose a sanction on, or require the satisfactory participation in a drug abuse assistance or rehabilitation program
if such is available in the employee’s community, by any employee who is so convicted.
6. Make a good faith effort to continue to maintain a drug-free workplace through implementation of this section.
7. As the person authorized to sign the statement, I certify that this business complies fully with the above
requirements.
(Authorized Signature) (Date)
(Print/Type Name as Signed Above)
EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
PUBLIC ENTITY CRIMES STATEMENT
SWORN STATEMENT UNDER F.S. SECTION 287.133(3) (A), ON PUBLIC ENTITY CRIMES
THIS FORM MUST BE SIGNED IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICER AUTHORIZED TO
ADMINISTER OATHS.
1. This sworn statement is submitted with Proposal for RFP 09-25-01 CS Cross-Connection Control Program
Management Services.
2. This sworn statement is submitted by (Proposer) ___________________________ whose business address is
_____________________________________ and (if applicable) Federal Employer Identification Number (FEIN)
is _____________________ (If a Sole Proprietor and you have no FEIN, include the last four (4) digits of your
Social Security Number: ___________.
3. My name is ____________________ and my relationship to the Proposer named above is _____________________.
4. I understand that a "public entity crime" as defined in Paragraph 287.133(a) (g). Florida Statutes, means a violation of any state
or federal law by a person with respect to and directly related to the transaction of business with any public entity or with an agency or
political subdivision of any other state or with the United States, including, but not limited to, any proposal or contract for goods or
services to be provided to any public entity or any agency or political subdivision of any other state or of the United States and involving
antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material misrepresentation.
5. I understand that "convicted" or "conviction" as defined in paragraph 287.133(a) (b), Florida Statutes, means finding of guilt or
a conviction of a public entity crime with or without an adjudication of guilt, in any federal or state trial court of records relating to
charges brought by indictment or information after July 1, 1989, as a result of a jury verdict, non-jury trial, or entry of a plea of guilty or
nolo contendere.
6. I understand that an "affiliate" as defined in Paragraph 287.133(1) (a), Florida Statutes, means:
A predecessor or successor of a person convicted of a public entity crime; or
An entity under the control of any natural person who is active in the management of the entity and who has been convicted of
a public entity crime. The term "affiliate" includes those officers, directors, executives, partners, shareholders, employees,
members, and agents who are active in the management of an affiliate. The City of Fernandina Beach, Florida ownership by
one of shares constituting a controlling income among persons when not for fair interest in another person, or a pooling of
equipment or income among persons when not for fair market value under a length agreement, shall be a prima facie case that
one person controls another person. A person who was knowingly convicted of a public entity crime, in Florida during the
preceding 36 months shall be considered an affiliate.
7. I understand that a "person" as defined in Paragraph 287.133(1) (e), Florida Statutes, means any natural person or entity
organized under the laws of the state or of the United States with the legal power to enter into a binding contract for provision of goods
or services let by a public entity, or which otherwise transacts or applies to transact business with a public entity. The term "person"
includes those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in management
of an entity.
directors, executives, partners, shareholders, employees, members, and agents who are active in management of an entity.
8. Based on information and belief, the statement which I have marked below is true in relation to the entity submitting this sworn
statement. (Please indicate which statement applies)
____Neither the entity submitting this sworn statement, nor any officers, directors, executives, partners, shareholders, employees,
members, or agents who are active in management of the entity, nor affiliate of the entity have been charged with and convicted of a
public entity crime subsequent to July 1, 1989.
____The entity submitting this sworn statement, or one or more of the officers, directors, executives, partners, shareholders,
employees, members, or agents who are active in management of the entity, or an affiliate of the entity has been charged with and
convicted of a public entity crime subsequent to July 1, 1989. (Please attach a copy of the final order.)
____The person or affiliate was placed on the convicted FIRM list. There has been a subsequent proceeding before a hearing officer of
the State of Florida, Division of Administrative Hearings. The final order entered by the hearing officer determined that it was in public
interest to remove the person or affiliate from the convicted FIRM list. (Please attach a copy of the final order.)
____The person or affiliate has not been placed on the convicted FIRM list. (Please describe any action taken by, or pending with, the
Department of General Services.)
___________________________________________________________
Signature Date:
EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
PUBLIC ENTITY CRIMES STATEMENT cont.
STATE OF __________________________________
COUNTY OF ________________________________
PERSONALLY, APPEARED BEFORE ME, the undersigned authority, who, after first being sworn by me, affixed his/her
signature at the space provided above on this ___ day of ________________, 2025, and is personally known to me, or
has provided ______________________ as identification.
____________________________________________ My Commission expires: ________________
Notary Public
EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
DEBARMENT, SUSPENSION and OTHER RESPONSIBILITY MATTERS
Certification A - Primary Covered Transactions
The prospective primary participant certifies to the best of its knowledge and belief that its principals:
a. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from covered transactions by any Federal debarment or agency;
b. Have not within a three-year period preceding this proposal, been convicted of or had a civil
judgment rendered against them for commission of fraud or a criminal offense in connection with
obtaining, attempting to obtain, or performing a public (Federal, State, or local) transaction or contract
under a public transaction; violation of Federal or State antitrust statutes or commission of
embezzlement, theft, forgery, bribery, falsification, or destruction of records, making false statements,
or receiving stolen property;
c. Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity
(Federal, State, or local) with commission of any of the offenses enumerated in paragraph (1) (b) of this
certification; and
d. Have not within a three-year period preceding this application/proposal had one or more
public transactions (Federal, State, or local) terminated for cause or default.
Where the prospective primary participant is unable to certify to any of the statements in this
certification, such prospective participant shall attach an explanation of this proposal.
Instructions for Certification (A)
By signing and submitting this Bid, 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
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
EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
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 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 - 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
EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
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.
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.
Proposer: Date:
Signature of Authorized Certifying Official: Title:
EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
E-VERIFY STATEMENT
Bid Number: RFP # 09-25-01 CS
Project Description: Cross-Connection Control Program Management Services
Proposer acknowledges and agrees to the following:
Proposer shall utilize the U.S. Department of Homeland Security’s E-Verify system, in accordance
with the terms governing use of the system, to confirm the employment eligibility of:
1. All persons employed by the Proposer during the term of the Contract to perform
employment duties within Florida; and
1. All persons assigned by the Proposer to perform work pursuant to the contract with
the CITY.
Proposer: __________________________________________________________________
Authorized Signature: __________________________________________________________
Title: ________________________________________________________________________
Date: _______________________________________________________________________
EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
CONFLICT OF INTEREST STATEMENT
This sworn statement is submitted with Proposal for RFP # 09-25-01 CS Cross-Connection Control Program Management
Services
This sworn statement is submitted by (Proposer) ___________________________________ whose business address is
__________________________________________ and (if applicable) Federal Employer Identification Number (FEIN) is
___________________________( If a Sole Proprietor and you have no FEIN, include the last four (4) digits of your Social
Security Number: ____________.)
My name is ________________________ and my relationship to the Proposer named above
is________________________.
1. The above-named Proposer is submitting a Proposal for the City of Winter Springs.
2. The Affiant has made diligent inquiry and provides the information contained in the Affidavit based upon his/her
own knowledge.
3. The Affiant states that only one submittal for the above Proposal is being submitted and that the above-named
Proposer has no financial interest in other entities submitting Proposals for the same project.
4. Neither the Affiant nor the above- named Proposer 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 Proposer’s submittal for the above Proposal. This statement restricts the discussion of pricing
data until the completion of negotiations if necessary and execution of the Contract for this project.
5. Neither the Proposer 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.
6. Neither the Proposer 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.
7. I certify that no member of the Proposer’s ownership or management is presently applying for an employee
position or actively seeking an elected position with the City of Winter Springs.
8. I certify that, should the Proposer be awarded a contract after successful negotiation, the execution and approval of
such contract by the City of Winter Springs City Commission shall not create a conflict of interest under Chapter
112, Florida Statutes, Code of Ethics for Public Officers. I further certify that no member of the Proposer’s
ownership or management is a spouse, child or “relative” as defined in Section 112.3142, Florida Statutes, of a
current City Commission member.
9. In the event that a conflict of interest is identified in the provision of services, I, on behalf of the above-named
Proposer, will immediately notify the City of Winter Springs.
________________________________________________________
Signature Date:
STATE OF ____________________________
COUNTY OF __________________________
PERSONALLY, APPEARED BEFORE ME, the undersigned authority, who, after first being sworn by me, affixed his/her
signature at the space provided above on this ______ day of ________________, 2025, and is personally known to me, or
has provided ______________________ as identification.
________________________________________ My Commission expires: ____________________
Notary Signature
EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
AFFIDAVIT OF COMPLIANCE WITH FLORIDA STATUTES § 787.06
Florida Statutes § 787.06(13) provides that:
When a contract is executed, renewed, or extended between a nongovernmental entity and a
governmental entity, the nongovernmental entity must provide the governmental entity with an affidavit
signed by an officer or a representative of the nongovernmental entity under penalty of perjury attesting
that the nongovernmental entity does not use coercion for labor or services as defined in this section. For
purposes of this subsection, the term "governmental entity" has the same meaning as in s. 287.138(1).
THIS AFFIDAVIT MUST BE COMPLETED AND INCLUDED IN YOUR PROPOSAL RESPONSE. FAILURE TO SUBMIT THIS FORM
AS INSTRUCTED SHALL RENDER YOUR PROPOSAL SUBMITTAL NON-RESPONSIVE.
a. The Vendor, owners, or principals are aware of the requirements of Section § 787.06, Florida Statutes; and
b. The Vendor, owners, or principals are eligible to participate in this solicitation and do not use coercion for the labor
or services contemplated in their Proposal response.
(Authorized Signature)
(Printed Name and Title)
(Name of Proposer)
STATE OF ____________________________________
COUNTY OF __________________________________
The foregoing instrument was acknowledged before me by means of (_____) physical presence or (_____) online
notarization, this ______ day of __________, 2025 by _____________________ the _________________ of
__________________________, a ________________________ (____) who is personally known to me or (_____) who
produced ______________________________________ as identification.
Notary Public: _________________________________
Print Name: ___________________________________
My Commission Expires: _________________________
EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
BYRD ANTI-LOBBYING AMENDMENT, 31 U.S.C. §1352 (as amended)
Contractors who apply or bid for an award of $100,000 or more shall file the required certification. Each tier certifies to the
tier above that it will not and has not used Federal appropriated funds to pay any person or organization for influencing or
attempting to influence an officer or employee of any agency, a member of Congress, officer or employee of Congress, or
an employee of a member of Congress in connection with obtaining any Federal contract, grant, or any other award
covered by 31 U.S.C. §1352 (as amended). Each tier shall also disclose any lobbying with non-Federal funds that takes place
in connection with obtaining any Federal award. Such disclosures are forwarded from tier to tier up to the recipient. See
below – Certification Regarding Lobbying.
Byrd Anti-Lobbying Certification
Appendix A, 44 C.F.R. Part 18 – Certification Regarding Lobbying
Certification for Contracts, Grants, Loans, and Cooperative Agreements
The undersigned certifies, to the best of his or her knowledge and belief, that:
1. No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for
influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee
of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making
of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension,
continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.
2. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or
attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress,
or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement,
the undersigned shall complete and submit Standard Form-LL, “Disclosure Form to Report Lobbying,” in accordance with its
instructions.
3. The undersigned shall require that the language of this certification be included in the award documents for all
subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements)
and that all subrecipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was made or
entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by
section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of
not less than $10,000 and not more than $100,000 for each such failure.
Byrd Anti-Lobbying Amendment, 31 U.S.C. §1352 (as amended)
The PROPOSER, _____________________________, certifies or affirms the truthfulness and accuracy of each statement of
its certification and disclosure, if any. In addition, the Contractor understands and agrees that the provisions of 31 U.S.C.
Chapter 38, Administrative Remedies for False Claims and Statements, apply to this certification and disclosure, if any.
Signature of PROPOSER’s Authorized Official
Name and Title of PROPOSER’s Authorized Official
Date
EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
Appendix A: COST PROPOSAL WORKSHEET
RFP 09-25-01 CS
Cross-Connection Control Program Management Services
Bid Form – See notes below for specifics of each Cost Element of the Bid
Cross Connection Control Program Management Bid Worksheet
Project Items Unit Cost Qty Lump Sum Cost
Initial Software and Set up fee 1
Annual Fee for Device Test Management 1
Onsite Cross-Connection Survey and Inspection for Residential 568 Onsite Cross-Connection Survey and Inspection for Non-
Residential 441
Cross-Connection Control Basics Staff Training (8-hr day) 1
On-going Cross Connection Control Program Administrative
support, Review and Optimization 1
Total Annual Program Fee
Alternative Items for Back Flow Prevention Assembly Testing and Replacement Bid Worksheet
Project Items Unit Cost
Fire System Backflow Prevention Assembly Testing Fee
Backflow Prevention Assembly Testing Fee (Residential, 2-inch or
smaller)
Backflow Prevention Assembly Testing Fee (Non-Residential,
greater than 2-inch)
Backflow Prevention Assembly Repair/Replacement fee
(Residential, 2-inch or smaller)
Backflow Prevention Assembly Repair/ Replacement fee (Non-
Residential, greater than 2-inch)
Total Proposed Cost: _____________________________________________($ )
Estimated Completion Time: ___________Days from Notice to Proceed to Final Completion
Bid is inclusive of all costs necessary to accomplish all tasks required to complete RFP Project.
Alternative bid items are at the discretion of the City to include during negotiations.
EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
Appendix B: PROPOSAL BOND FORM
KNOW ALL MEN BY THESE PRESENTS, that we, the undersigned,
as Principal, and as
Surety, are hereby and firmly bound unto the CITY OF WINTER SPRINGS as OWNER, in the penal
sum of Dollars ($ ) 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 Proposal, attached hereto and hereby made a part hereof to enter into a
contract in writing, for the Work described as: Cross-Connection Control Program Management
Services
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 ______day of _____, 2025, 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.
(Principal) (Seal)
(Title)
(Address)
(Surety) (Seal)
(Title)
(Address)
(Witness)
EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
APPENDIX 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
SR434 At Winding Hollow Blvd. 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 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.
2. 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
EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
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 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.
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
EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
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: Kevin Sweet, 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
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 law’s provisions.
11. VENUE. In the event any legal action shall be filed upon this performance bond, the venue shall lie exclusively in the
Circuit Court for Seminole County, Florida.
EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
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.
Principal Surety
_______________________________ ____________________________________
(Typed Firm Name) (Typed Firm Name)
_______________________________ ____________________________________
(Seal) (Seal)
By: By:
_______________________________ ____________________________________
(Signature) (Signature)
_______________________________ ____________________________________
(Printed Name) (Printed Name)
________________________________ ____________________________________
(Title) (Title)
________________________________ ____________________________________
________________________________ ____________________________________
(Address) (Address)
________________________________ ____________________________________
EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
APPENDIX D: 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 SR434 At Winding Hollow Blvd. 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 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
EXHIBIT A
RFP 09-25-01 CS Cross-Connection Control Program Management Services
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.
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)
EXHIBIT A
RFP 09-25-01 CS
Cross-Connection Control Program Management Services
PROPOSAL OFFERED BY:
AARON'S BACKFLOW SERVICES, INC.
EXHIBIT B
RFP 09-25-01 CS
Cross-Connection Control Program Management Services
SECTION A -PROPOSER INFORMATION AND ACKNOWLEDGEMENT FORM
EXHIBIT B
PROPOSER INFORMATION AND ACKNOWLEDGEMENT FORM
For
RFP #09-25-01 CS
Cross-Connection Control Program Management Services
The undersigned Proposer does hereby agree to furnish the City of Winter Springs,Florida,the items listed in accordance with the
minimum requirements/evaluation criteria shown by the Request For Proposal to be delivered to the specified site for the price
indicated.
IT IS THE PROPOSER'S RESPONSIBILITY TO CHECK www.demandstar.com
FOR FINAL DOCUMENTS AND ADDENDA BEFORE SUBMITTAL
THIS PROPOSAL MUST BE SIGNED BY THE PRINCIPAL OR DIRECTOR AS INDICATED BY THE FLORIDA DEPARTMENT OF STATE,DIVISION
www.sunbiz.org).Proof of corporate signer must be submitted with Proposal.If not submitted,Proposer will beOFCORPORATIONS(
considered non-responsive.Use Sunbiz website screen shot or copy of Corporate Resolution or Power of Attorney.
PROPOSER NAME:
TAX SNN or EIN:
PROPOSER ADDRESS:
PURCHASE ORDER ADDRESS:
PHONE NUMBER:
COMPANY WEBSITE:
COMPANY CONTACT (REP):
CONTACT EMAIL ADDRESS:
SIGNATURE:
THE UNDERSIGNED:
Acknowledges receipt of:
Panos Inc.
1.
2.
RFP #09-25-01 CS
Addenda:
Number:
Number:
-7
ED FL 351/11
4b 7 -9433
aar0KlSbackC/ocU,
A-anonVacg)nan
aaro @ a msh CUL
Pertaining To:Cross-Connection Control Program Management
Dated
Dated
B.
c.
D.
Has examined the site and all RFP Documents and understands that in submitting its Proposal,they waive all right to plead any
misunderstanding regarding the same.
Agrees:
1.
2.
3.
4.
5.
To hold this Proposal open for 90 calendar days after the Proposal opening date.
To furnish the services specified in this RFP at the prices quoted in the Proposal and in compliance with the RFP
Documents.
To accept the provisions of the Instructions to Proposers.
To negotiate a contract with the CITY incorporating the Proposal prices,if selected on the basis of this Proposal.
To accomplish the work in accordance with the contract documents.
Certifies:
1.
2.
That all information contained in this Proposal is truthful to the best of my knowledge and belief.
That I am duly authorized to submit this Proposal on behalf of the Proposer and that the Proposer is ready,willing,and
able to perform if awarded the Proposal.
Stipulated Amount
Submit on Cost Proposal Worksheet,Appendix A.A.
RFP 09-25-01 CS Cross-Connection Control Program Management Services
EXHIBIT B
RFP 09-25-01 CS
Cross-Connection Control Program Management Services
SECTION B -TABLE OF CONTENTS
EXHIBIT B
Table of Contents
Section A —Proposer Information and Acknowledgement Form
Section B —Table of Contents
Section C —Executive Summary
Section D—Qualifications
Section E —Other Information
Section F —Cost and Time
Section G —Mandatory Proposal Forms
Section H —Florida State Corporate Filing
Proposal Cover Page
18-26
27-29
30-54
55-57
1
2-3
4-5
6-8
9-17
EXHIBIT B
RFP 09-25-01 CS
Cross-Connection Control Program Management Services
SECTION C-EXECUTIVE SUMMARY
EXHIBIT B
Office:407-829-7933 |Fax:800-283-3168jAARON'S Address:130 Middle Street,Lake Mary FL 32746
Web:aaronsbackflow.com I Email:office@aaronsbackflow.com
LIC#:CFC1427186 1 FIRE LIC #FPC14-000029
Section C —Executive Summary
Aaron's Backflow Services,Inc.hereby submits this proposal to the City of Winter Springs for
Cross Connection Control Program Management Services.The proposal is designed to ensure
compliance with Florida Department of Environmental Protection Regulation 62-555.360.The
services proposed include an initial survey and inspection of 558 customers using potable water
for irrigation,as well as 441 customers with non-residential potable water service connections.
The services proposed also include program management services for the City for the next five
years.Additional services will be discussed at a later time as needed.
The services in this proposal will be performed by our local staff at Aaron's Backflow Services,
Inc. in Lake Mary,Florida.Our offices are located at 130 Middle Street,Lake Mary,Florida 32746.
At that location,we have a dedicated office staff of 6 full time clerical employees and 2 part time
clerical employees.Additionally,we employ 19 full time certified backflow testers,trained and
licensed to conduct any surveys,inspections,testing, repairs,and replacements of backflows as
neded.
We have extensive experience all things backflow.We have been in business for 22 years,and
during that time,we have focused exclusively on backflow services as our scope of work.Our
qualifications and experience are outlined elsewhere in this Proposal,but our experience
provides the expertise to ensure that compliance with local and State requirements are met,
safety standards are upheld,and management of the program is concise and effective.
As part of this proposal,Aaron's Backflow Services will:
Identify and document cross connections and/or hazards
Notify customers of corrective action needed
Monitor and establish a compliance cycle
Review the City's current cross connection program to determine needed improvements
Provide 8 hours of onsite training for City staff members,with additional training as
needed
Provide a cloud based software system for tracking,scheduling,and maintaining records
related to the cross connection program.We intend to use a system called Syncta.This
EXHIBIT B
system has been used by our company for many years and is compatible for import with
ERSI ArcGIS/ArcMap.
Manage the City's backflow tracking program,including organizing and compiling backflow
device information and testing schedules,sending notices to customers,coordinating with
outside backflow testing companies when needed,providing in house testing when needed,and
enforcement follow ups for non-compliant customers
Review the City's current program to provide consulting and suggestions for the future
Provide full time customer service phone support form Monday-Friday 8am-5pm
Provide monthly invoices for all services to the City
Ensure that City staff has direct access to all staff at Aaron's Backflow Services,including
President Aaron Vaughan,our office staff,and our field technicians
Provide QAQC for all operations.A dedicated field supervisor will be tasked with overseeing
backflow field technicians to ensure quality work,and periodic follow ups/quality control will be
provided by review of no less than 5%of all field work.
All backflow technicians employed by Aaron's Backflow Services are TREEO Certified backflow
testers in the State of Florida.All office staff are familiar with water purveyor backflow
compliance.
All field staff with Aaron's Backflow Services are equipped with a clearly marked company vehicle,
backflow testing gauge,company uniform with clearly marked company information,training in
customer service as well as backflow testing services,iPad and iPhone,and all necessary parts,
materials,and tools.
Our value to the City is measured in a few ways.We are a local company with ties to the
community,and we are readily accessible via phone,email,and in person.We have over 22 years
of experience in backflow services,including many contracts with local municipalities throughout
Central Florida.We are licensed to test all backflows of all sizes and types,as a licensed Stat of
Florida Plumbing Contractor AND a State of Florida Fire Protection Contractor.We have used
Syncta,a cloud based software system,for over 10 years and have invaluable experience and
knowledge of that system and its ease of use for both testers and water purveyors.We pride
ourselves on our backflow knowledge,integrity,and customer service and believe we can provide
great guidance and benefit to the City of Winter Springs.
EXHIBIT B
RFP 09-25-01 CS
Cross-Connection Control Program Management Services
SECTION D -QUALIFICATIONS
EXHIBIT B
j AARON'S Office:407-829-7933 |Fax:800-283-3168
Address:130 Middle Street,Lake Mary FL 32746
Web:aaronsbackflow.com I Email:office@aaronsbackflow.com
LIC#:CFC1427186 1 FIRE LIC #FPC14-000029
Section D -Qualifications
General:
Aaron's Backflow Services,Inc.is a local business out of Lake Mary,Florida.The President and
100%owner is Aaron Vaughan.Aaron is a licensed State of Florida Plumbing Contractor,licensed
backflow tester,licensed backflow repair technician,and licensed State of Florida Fire Protection
contractor.Our company has been in business in Central Florida since 2003.We currently
employ 6 full time and 2 part time clerical staff in our Lake Mary office.We also currently employ
19 full time backflow technicians,some of whom hold other licenses as repair technicians and
water based system technicians.Many of our staff have been with our company for many years.
We have a full time field supervisor,tasked with ensuring quality work of all field technicians.
Our office is located at 130 Middle Street,Lake Mary FL 32746.That space includes dedicated
office space and a dedicated warehouse space.Our office hours are Monday —Friday 7am-5pm.
We have had no ownership or management changes since opening in 2003.We own and insure
a fleet of 19 company vehicles for use by our technicians in the field.We provide our technicians
with training,software,tools,technology,and support they need to test and survey backflows of
all sizes and models.
Our staff:
Owner/President —Aaron Vaughan
Clerical Staff -Heather Lee,Cindy Li-Ravinder,Terri Cater,Michelle Remele,Terrisue Deem,
Makayla Remaley,Melissa Scott,and Jessica Williams
Field Supervisor —Armando Sierra
Backflow Technicians —Luis Lugo,Daniel Frenier,Joshua Marchany,Jonathan White,Patrick
Derival,Josh Cruz,Juan Patricio,Taylor Lally, Julian Caraballo,Julian Uliaszek,Mario Effio,Luis
Martinez,Imanol Alemany,Xavier Alvarez, Edward Rojas,Austin Johnson
Experience:
Aaron's Backflow Services,Inc.opened in 2003.Since that time,we have focused primarily onbackflowservicesandfirehydrantflowtesting.During our 22 years in business,we have
provided private services directly to commercial and residential customers.We have also held
EXHIBIT B
multiple long term contracts with water purveyors throughout Central Florida. Some of our
contracts include those with the following water purveyors:Toho Water Authority,Volusia
County,Orange County,OUC,JEA, City of Casselberry,City of Port Orange,City of Deland,
City of Maitland,and Polk County.
Recent and current contracts:
TohoWater Authority
June 2018 -May 2022 and August 2022 -present
We provide backflow services for Toho Water Authority customers,including residential and
commercial surveys.Surveys include identification of hazards on property and
recommendations for needed backflow devices or other protections.We conduct cross
connection surveys for reclaimed water customers.We test and certify residential backflow
devices, and perform repairs as needed.We install and replace PVB,RP, Dual check and
DC backflow devices. For this contract,we install approximately 200-300 new devices
monthly,and test/survey approximately 2000 devices monthly.We use Syncta to track and
manage all testing,survey,and installation data.We track the device information,hazard
information,location,testing schedule,last tested date and next test due date, and all
testing and survey information in our system.We use Syncta to manage all data and we
share that data with Toho Water Authority as they request.All data is available immediately
to Toho and is sent daily as a practice.
City of Deland
May 2020 —May 2025 and June 2025 —present
We provide testing and repair of residential backflow devices for the City of Deland water
customers (approximately 9000 per year).We also provide testing of commercial non-
compliance backflow devices, and testing,repair and replacement of City owned backflow
devices as needed. For this contract,we also use Syncta to track and store data for testing
and repairs,as well as to maintain records of all device information,location information,
and customer information.We manage all scheduling of the entire contract within our
system.We track previous test dates and next test due dates for all customers, enter new
customers as they arise, and handle the non-compliance testing for commercial customers.
City of Port Orange
February 2020 -January 2024 and February 2024 —present
We provide testing and repair of residential backflows for the City of Port Orange utility
customers for approximately 9000 customers per year.For this contract,we also use
Syncta to enter testing and repair data, update and store device information,and location
EXHIBIT B
information.We also use Syncta to schedule and route all tests as they are due.We
manage all scheduling for the contract within our system,and share all testing data with
the City upon completion.
Orlando Utilities Commission
January 2021 -January 2026
We provide testing, repair,and replacement of residential and commercial backflow
customers in OUC.We perform approximately 14,000 residential tests per year,and several
thousand commercial tests per year.We test and repair commercial devices ranging in size
from %"—12",includingfireline devices.We are a preferred contractor for OUC.
Orange County Utilities
February 2018 —September 2022 and February 2024 —present
We provide testing and repair of residential backflow devices for Orange County water
customers.We perform approximately 9000 tests per year and we use Syncta to track and
store all backflow device information,testing information,and scheduling data.We use
Syncta to create routes and schedules for testing due annually.
Software and Data Management:
We will use Syncta,our cloud based software program,for this project.We have used
Syncta internally for over 10 years for many contracts and for our own management of our
robust private commercial operations.Syncta is an ideal system for tracking and managing
a cross connection program,as it is specifically a backflow software program.Syncta is
designed for use as a tester and as a water purveyor.
Syncta provides a Data Sync Feature that updates customer information from a water
purveyor's billing or CIS system into Syncta directly.This allows the customer information
to always remain current in Syncta. Data is posted at a specific interval to a secure FTP site
to keep data updated.
Full access and login credentials will be provided by Syncta to the City and any designated
staff members.Syncta can be accessed by the web or by the Syncta app.Syncta can be
used on a desktop,phone,or other tablet/device.
Syncta ensures that all data is compatible with the City's ESRI ArcGIS/ArcMap.
EXHIBIT B
Syncta provides a built in mapping feature which allows all users to view each location on a
map,with a pin showing the location.From that pin,you can click to view all data in one
place for that customer including testing history, upcoming test due dates,communication
with the customer,device information,hazard information,and all related information.
Methodology and Approach:
As a local company in business for over 22 years, we have the experience to understand all
aspects of backflow testing and cross connection programs.We do not subcontract work,
as it is our goal to be hands on with everything we do.We prioritize relationships with our
customers and with water purveyors.Integrity is paramount in everything we do.We have
extensive experience managing large scale contracts with water purveyors,and with testing,
surveying,repairing and replacing backflows.It is our goal to forge a great working
relationship with the City and impart our experience and knowledge to help you build a
successful program.
As such,we will use what we've learned to import data into Syncta. Data can be easily
uploaded from an Excel or csvfile.Once uploaded, the data can be scheduled,tracked, and
routed based on any formula the City would like to use.Monthly scheduling and
notifications work best.Our office is open for customer calls Monday-Friday from 9am-5pm
and will be serviced by local employees here in our office. Our local technicians will be
dispatched as needed, and will input results directly into Syncta.We are able to route and
schedule based on any data desired:location,job type,urgency,and last tested date,to
name a few. Results from Syncta can be easily sent to the City's internal system with ease.
References —See attached form
Conclusion
Aaron's Backflow Services,Inc. is a unique blend of a company that has the comfortable
feel of a local,family owned,accessible business,yet,has over 20 years of vast experience
to help with your needs.We have carved out a niche in the backflow industry and are able
to provide you with all the services you need under one roof. Our Plumbing license and Fire
Protection license allow us to take care of all jobs internally,without the need to subcontract
work out.We are accessible and look forward to helping you build your program.Thank you
for your consideration.
EXHIBIT B
syncta SM
Water Purveyor Solution
For purveyors,it's not easy keeping up with manual data entry,site survey
data,and tracking who's submitted their test.Easily enter,track,and store
backflow test data with Syncta, the modern way to track and store all of
your backflow test information.
If you thought you knew what customer service was,you'll have to
think again.Brock Sheehan at Syncta is the essence of customer
service!With a very 'hands-onl approach,a supreme knowledge of the
backflow business and a genuine concern for helping you and your
business flourish...thatls what is offered by Syncta.
Mike &Virginia
FDI Backflow Specialists
Nevada, USA
Not sure what plan is right for you?
Take Syncta for a test drive with our free 30-day trial.
EXHIBIT B
syncta
End The Paperchase With Syncta.
You've got better things to do than chase paper.Syncta stops the paperchase
and frees you from the tedious and time-consuming task of manually entering
backflow test results.Syncta is the comprehensive solution designed for water
purveyors to easily manage cross connection control programs.
EXHIBIT B
can do for you:
syncta SM
Send Unlimited Notifications
Easily send notifications and reminders of when tests are due via email,
or print and mail them.
View Test Results 24/7
Our cloud-based portal enables testers to enter test data from any
device at any time —eliminating the need for you to manually enter test
results.
Simplify Surveys &Tests
Schedule surveys and tests,record survey results,upload photos,track
deficiencies and resolve test failures.
Synchronize &Report
Set up a recurring synchronization of data with a system of record,pull
real-time reports 24/7 and prepare annual state compliance reports.
EXHIBIT B
re Data Transmissionsynctarvices(AWS)to securely host your data
zoo Oil er -no software downloads or service
interruptions.
Responsive Customer Service
Stay connected with the Syncta Customer Success team via phone,
email,and live chat support.
Eliminate Paper
Save time and money by switching from paper to electronic test
submissions and test reports.
Visual Mapping
Use Google Map's geolocation feature to see customer addresses and
assemblies on a map.
EXHIBIT B
RFP 09-25-01 CS
Cross-Connection Control Program Management Services
SECTION E -OTHER INFORMATION
EXHIBIT B
ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (MM,'DDMYYY)
10/15/2025
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER
Brown &Brown Insurance Services,Inc.
2290 Lucien vvay,Suite 400
Maitland
INSURED
Aaron's Backflow Services,lnc
130 Middle Street
Lake Mary
COVERAGES
AXAJC NO :(407)660-2012
NAIC #
10847
42376
FL
FL
32751
32746
CL2591719478
NAME:
PHONE
E-MAILADDRESS:
INSURER A :
INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
Amy Manor CRIS
(407)660-8282
Amy.Manor@bbrown.com
INSURER(S AFFORDING COVERAGE
CUMIS Insurance Society,Inc.
Technology Insurance Company,Inc.
CERTIFICATE NUMBER:REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED.NOTWTHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO Wr*lCHTHIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR TYPE OF INSURANCE
X COMMERCIAL GENERAL LIABILITY
X OCCURCLAIMS-MADE
GEN'LAGGREGATELIMIT APPLIES PER;
OTHER:
AUTOMOBILE LIABILITY
x ANY AUTO
OWNED
AUTOS ONLYHIRED
AUTOS ONLY
UMBRELLA LIAB
EXCESS LIAB
SCHEDULED
AUTOSNON.on,NED
AUTOS ONLY
OCCUR
CLAIMS-MADE
X RETENTION S 10,000DED
WORKERS COMPENSATION
AND EMPLOYERS LIABILITY YINANYPROPRIETOR/PARTNER/EXECUTIVE NOFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
If yes,describe under
DESCRIPTION OF OPERATIONS betow
IN D VND
N/A
POLICY NUMBER
323345
323346
323347
TWC4667217
POLIMMIDDNYYY
09/18/2025
09/18/2025
09/18/2025
09/18/2025
p LI
MM/DD
09/18/2026
09/18/2026
09/18/2026
09/18/2026
LIMITS
EACH OCCURRENCE
PREMISES Ea occurrence
MED EXP(An one
PERSONAL &ADV INJURY
GENERAL AGGREGATE
PRODUCTS -COMP/OP AGG
MBINED SINGLE LIMIT
Ea accident
BODILY INJURY (Per person)
BODILY INJURY (Per accident)
PROPERTY DAMAGEPeraccident
PIP -Basic
EACH OCCURRENCE
AGGREGATE
X PER
TATUTE OTH-
E.L.EACH ACCIDENT
E.L.DISEASE -EA EMPLOYEE
E.L.DISEASE -POLICY LIMIT
5,000
s 1,000,000
s 10,000
1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
RE:RFP #09-25-01 CS
City of Winter Springs is granted additional insured status by the General Liability policy with regard to the operations of the named insured when required by
written contract or agreement.
CERTIFICATE HOLDER
City of Winter Springs
1126 East S.R.434
Winter Springs
ACORD 25 (2016/03)
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
FL 32708
ACCORDANCEWITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
01988-2015 ACORD CORPORATION.All rights reserved.
The ACORD name and logo are registered marks of ACORD
EXHIBIT B
AARON'S Office:407-829-7933 |Fax:800-283-3168
Address:130 Middle Street,Lake Mary FL 32746
Web:aaronsbackflow.com I Email:office@aaronsbackflow.com
LIC#:CFC1427186 1 FIRE LIC #FPC14-000029
Aaron's Backflow Services,Inc.was incorporated in the State of Florida in 2003.Aaron
Vaughan is the President and founder.Prior to starting Aaron's Backflow Services,Inc.,Aaron
worked for the City of Winter Park in the water department.Over the past 22 years,our company
has grown from one employee to over 20 full-time employees.We currently employ 17 full-time
backflow technicians,all of whom are certified by the University of Florida TREEO Center.We
also employ 5 full-time administrative team members.Many of our field staff and office staff
have been with the company for several years.Aaron Vaughan holds the following licenses:
State of Florida Certified Plumbing Contractor since 10/6/2006 (Lic#CFC1427186)
Certified Backflow Prevention Device Tester since 2001
Certified Backflow Prevention Repair Technician since 2001
State of Florida Class II Fire Protection Contractor since 9/17/14 (Lic#FPC14-000029)
Aaron's Backflow Services,Inc.focuses primarily on backflow services.We provide
backflow testing, repair,replacement,and installation of residential and commercial backflow
devices throughout Central Florida.We service devices ranging in size from %"—12", and we are
licensed to provide those services on fireline devices.We have a robust private service
department,where we provide service directly to our private customers.Our customers include
homeowners,HOAs,property management companies,business owners,facility maintenance
companies,and much more.
In addition,we house a substantial department dedicated to providing contract services
to water purveyors for residential and commercial backflow services.Over the years,we have
engaged in successful contracts with municipalities including Orange County,Volusia County,
Toho Water Authority,Florida Department of Transportation,JEA,City of Deland,City of Port
Orange,City of Maitland,City of Casselberry,OUC,and others.Below are detailed descriptions
of some of our more recent and current contracts:
TOHO Water Authority
102 N Alaska Avenue,Kissimmee FL 34741
Steven Hollingsed
(407)483-3830
shollingsed@tohowater.com
June 2018 —May 2022 (ISt contract)and August 2022 —current (2nd contract)
We provide backflow services for Toho Water customers,including all of the following:
Residential and commercial surveys for Toho water customers.Surveys include
identifying locations where backflows are needed,identification of existing hazards,and
meters (domestic,irrigation and reclaimed)
Cross-connection surveys for reclaimed water customers,for individual and community
reclaimed water meter users.
II Page
EXHIBIT B
AARON'S Office:407-829-7933 |Fax:800-283-3168
Address:130 Middle Street,Lake Mary FL 32746
Web:aaronsbackflow.com I Email:office@aaronsbackflow.com
LIC#:CFC1427186 1 FIRE LIC #FPC14-000029
•
Testing/Certification of existing residential backflow devices.We test RP,PVB,and DC
backflow devices ranging in size from %"—2"
Backflow repairs as needed for devices that fail initial testing.
Install new backflow devices for residential customers
Replace existing backflow devices that fail testing and can not be repaired.We remove
the failed device and replace with RP,PVB,DC,or Dual check backflows.
We provide approximately 2000-3000 tests/surveys per month and 200-300
installations/replacements per month
Orlando Utilities Commission (OUC)
100 W Anderson St,Orlando FL 32801
Leonel Dominguez
(407)466-4533/(407)434-2523
LDominguez@ouc.com
January 2021 —January 2026
We provide testing and repair of existing residential backflow devices for OUC water customers.
We perform approximately 18,000 residential tests per year,and several thousand commercial
tests per year.We also provide replacement of residential backflow devices that fail testing and
need replacement (approximately 80 replacements per month).We provide testing of
commercial non-compliance backflow devices,including fireline backflows,ranging in size from
%"—12".We are also a Preferred Contractor for OUC,and in that capacity,we provide
installations and replacement of failed commercial backflow devices,ranging in size from %"—
12".Commercial backflow replacements include fireline and non-fireline devices.
Orange County Utilities
8100 Presidents Drive,Suite D
Orlando FL 32809
Hiram Forestier
(407)836-6858
Hiram.Forestier@ocfl.net
February 2018 —September 2022 (ISt contract)and February 2024 -current (2nd contract)
We provide testing and repair of residential backflow devices for Orange County water
customers.We service approximately 9,000 customers per year.
21 Page
EXHIBIT B
j AARON'S
City of Port Orange
1000 City Center Circle
Port Orange,FL 32129
Graeme Gardiner
(386)506-5953
GGardiner@port-orange.org
Office:407-829-7933 |Fax:800-283-3168
Address:130 Middle Street,Lake Mary FL 32746
Web:aaronsbackflow.com I Email:offce@aaronsbackflow.com
LIC#:CFC1427186 1 FIRE LIC #FPC14-000029
February 2020 —January 2024 (ISt contract)and February 2024 —current (2nd contract)
We provide testing and repair of residential backflows for City of Port Orange utility customers.
We provide this service for approximately 9,000 customers per year.
City of Deland
120 S Florida Ave
Deland,FL 32720
Becki Gattie
(386)626-7214
gattieb@deland.org
May 2020 -May 2025
We provide testing and repair of residential backflow devices for the City of Deland water
customers (approximately 9,000 per year).We also provide testing of commercial non-
compliance backflow devices,and testing,repair,and replacement of City owned backflow
devices as needed.We submit reports to the City of Deland through Swift Comply.
City of Maitland
1827 Fennell Street,Maitland FL 32751
Karen McCullen
(407)875-2829
KMccullen@itsmymaitland.com
August 2015 —August 2019
We replaced and installed backflow preventers and meters for the City of Maitland's water
customers.We replaced approximately 1000 meters and approximately 550 backflow devices
per year.
31 Page
EXHIBIT B
Ron DeSantis,Governor Melanie S.Griffin,Secretary Zlorida
STATE OF FLORIDA
GOB DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD
THE PLUMBING CONTRACTOR HEREIN IS CERTIFIED UNDER THE
PROVISIONS OF CHAPTER 489,FLORIDA STATUTES
VAUGHAN,AARON ALAN
AARON'S BACKFLOW SERVICES INC
130 MIDDLE STREET
FL 32746LAKEMARY
LICENSE NUMBER:CFC1427186
EXPIRATION DATE:AUGUST 31,2026
Always verify licenses online at MyFloridaLicense.com
ISSUED:09/01/2024
Do not alter this document in any form.
This is your license.It is unlawful for anyone other than the licensee to use this document.
EXHIBIT B
Jimmy Patronis
CHIEF FINANCIALOFFICER
JoAnne Rice
DIVISION DIRECTOR
8/19/24,9:07 AM
Bruce Gillingham
BUREAU CHIEF
Ronald Dilworth
SAFETY PROGRAM MANAGER
FLORIDA DEPARTMENT OF FINANCIAL SERVICES
THIS CERTIFIES THAT:
DIVISION OF STATE FIRE MARSHAL
200 EAST GAINES STREET -Tallahassee,Florida 32399-0342
Tel.850-413-3644
CERTIFICATE OF COMPETENCY
OFFICIAL COPY
Aaron A Vaughan
130 Middle Street
Lake Mary FL 32746
BUSINESS ORGANIZATION:Aaron's Backflow Services, inc.
Contractor II is limited to the execution of contracts requiring the ability to layout,fabricate,install,inspect,
alter,repair,and service water sprinkler systems, water spray systems,foam-water sprinkler systems,foam-
water spray systems,standpipes,combination standpipes and sprinkler risers,all piping that is an integral part
of the system beginning at the point of service,sprinkler tank heaters,air lines,thermal systems used in
connection with sprinklers, and tanks and pumps connected thereto,excluding pre-engineered systems.
Issue Date:
Type:
Class:
County:
License/Permit #:
Expiration Date:
07/01/2024
07
12
Seminole
FPC14-000029
06/30/2026
Chief Financial Officer
Page -j
EXHIBIT B
FLdRIDA1853
TREEO CENTER
Center for Training,Research and Education for Environmental Occupations
Aaron Vaughan
has •successfully met certification requirements as
BackflowPrevention Assembly
Repair and Maintenance Technician
Dale issued:
Cert(/icate No.:
CEU's:
March 1042,2003
03/12/2003
0814
107 William T. Engcl,.1r.,
Dircclor
Ph.D
University of Florida TREEO Center 0 3900 SW 63rd Boulevard o Gainesvil FL 326083800
EXHIBIT B
UFi TREEO Center
CN)VERSITY FLORIDA
-['llter for TÜfiiT1ing,Research auci Education Oc -
certifies that
Aaron Vaughan
has successfully completed
the examinations for
Backflow Prevention Tester Recertification
OF TREEO
CERTIFIED
Date Issued:3/15/2025
CertificateNo:PR_5000
Expiration:3/31/2027
Operator Certification Program
Course#: 04251051
CEUs:1.2
university of Florida TREEO Center
March IS,2025
Certificateof Completion
FBPR Construction Licensing Board
SponsorNo.:0000995
Classroom Hours:7
Course #0000710
FPBE Provider #0004021 30.0 CHE
•3900 SW 63 Gainesville FL 32608-2900
Andrew Direc•.a:•
352.392.0570
EXHIBIT B
RFP 09-25-01 CS
Cross-connection Control Program Management Services
SECTION F -COST AND TIME
EXHIBIT B
Office:407-829-7933 |Fax:800-283-3168AARON'S Address:130 Middle Street,Lake Mary FL 32746
Web:aaronsbackflow.com I Email:office@aaronsbackflow.com
LIC#:CFC1427186 1 FIRE LIC #FPC14-000029
Section F —Cost and Time
Initial Software and Set up Fee —This is a one time cost as charged to us by Syncta for the import
of data provided to us by the City.The cost is based set up of the system accordingly after
conversations between Aaron's Backflow Services,the City of Winter Springs,and Syncta.This is
an initial fee only and will not recur if additional data is added later.
Annual Fee for Device Test Management —This fee is based on management of 1009 locations,
as provided in the RFP.Additional locations,if added,will result in an adjustment of this fee to
account for the management of additional services.Note that a higher volume of locations will
result in a lower per-customer fee,so the cost per test may be reduced as we make future
adjustments.
Survey costs —These will be billed as each individual survey is conducted,and include the cost of
a technician to perform the survey and make any and all recommendations for future actions.
Records of each survey will be stored and shared with the City.Each survey will include
information about the property,any devices on property,hazards,and needed future action.
Staff training —One time fee for an 8 hour training.We anticipate providing ongoing
training/assistance throughout the contract at no additional charge,as needed.
Ongoing Cross connection review and optimization —One time fee.
All testing, repair,and replacement fees as listed for devices 2"and smaller are listed as a set fee
that includes labor,parts,materials,and a 1 year warranty.Fees for repair or replacement
should be adjusted annually if there is an increase in materials charges.Any requested increases
will be accompanied by proof of price increases on parts.
Repair and replacement fees for devices greater than 2"will need to be quoted on an individual
basis.The cost of repair and replacement of larger devices varies greatly depending on the size
of the device as well as the needed parts and labor involved.
EXHIBIT B
Cross Connection Control Program Management Bid Worksheet
Project Items
Initial Software and Set up fee
Annual Fee for Device Test Management
Survey and Inspection for Residential
Survey and Inspection for Non-Residential
Staff Training (8-hr day)
On-going Cross Connection control Program Review and Optimization
Unit Cost
$13,000.00
$18,153.00
$29.00
$34.00
$1,öoo.oo
$1,500.00
1
1
568
441
1
1
Lump Sum Cost
$13,000.00
$18,153.00
$16,472.00
$14,994.00
$1,000.00
$1,500.00
$65,119.00TotalAnnualProgramFee
Alternative Items for Back Flow PreventionAssemby Testingand Replacement Bid Worksheet
Project Items
Fire System Backflow PreventionAssembly Testing Fee
Backflow PreventionAssembly Testing Fee (Residential,2-inch or smaller)
Backflow Prevention Assembly Testing Fee (Non-Residential,2-inch or smaller)
Backflow Prevention Assembly Testing Fee (Non-Residential,greater than 2-inch)
Backflow Prevention Assembly Repair fee (Residential,2-inch or smaller)
Backflow Prevention Assembly Replacement fee (Residential,2-inch or smaller)
Backflow Prevention Assembly Repair fee (Non-Residential,2-inch or smaller)
Backflow PreventionAssembly Replacement fee (Non-Residential,2-inch or
smaller)
Backflow PreventionAssembly Repair fee (Non-ResidentiaI,greater than 2-inch)
Backflow Prevention Assembly Replacement fee (Non-ResidentiaI,greater than 2
inch)
***$2000 is the minimum cost to repair a device greater than 2". The range can
be anywhere from $2000-$6000 depending on the parts needed for repair and
the device size.The cost to repair a 12"device is much different than the cost to
repair a 3" device.***
*****$3500 is the minimum cost to replace a device greater than 2".The range
can be anywhere from $3500-$28,000 depending on the device size.The cost to
replace a 12"device is much different than the cost to replace a 3" device.***
Unit Cost
$55.00
$30.00
$35.00
$55.00
$195.00
$780.00
$395.00
$1,670.00
$2,000.00 ***
$3,500.00
EXHIBIT B
RFP 09-25-01 CS
Cross-Connection Control Program Management Services
SECTION G -MANDATORY PROPOSAL FORMS
EXHIBIT B
RFP 09-25-01 CS
REFERENCE PACKAGE
MINIMUM QUALIFICATIONS OF PROSPECTIVE BIDDER
CITY CONTRACT NUMBER:
RFP 09-25-01 CS
PROJECT TITLE:Cross-Connection Control Program Management Services
CONTRACTOR FIRM NAME:
BUSINESS ADDRESS:
ED
CITY,STATE,ZIP CODE:
Laue FL
L/D9-nq-ü433PHONENUMBER:FAX NUMBER:
EMAIL ADDRESS:
aaaon O
Cross-Connection Control Program Management Services
EXHIBIT B
Organization:
Contact Person:
Address:
City:
Phone Number:
Project Cost:
Organization:
Contact Person:
Address:
City:
Phone Number:
Project Cost:
Organization:
Contact Person:
Address:
City:
Phone Number:
Project Cost:
REFERENCE INFORMATION FORM
RFP #09-25-01 CS
Cross-Connection Control Program Management Services
S-hLvcnkb/)/MscJ
IDA N.Pr(aßIcaAvc
(483-3?3D
81.6M(LnnlA-Ll)q
Duc
CLOMI
11)0 ID.
FLState:
D/bUlLnJ
6z44-iu
3147 VIZip:
Date Performed:
a
Zip:
Date Performed:
32/01
goo-I
)9-o g.Aycnu-c
State:
(38b)
Zip:3099-0
PROPOSER Representative
Typed Name/Title:
PROPOSER Representative
Signature:
PROPOSER:
RFP 09-25-01 CS
Date Performed:
Cross-Connection Control Program Management Services
EXHIBIT B
Insurance Type
Worker's
Compensation
Employer's Liability
Commercial General
Liability
(Occurrence Form)
patterned after the
current ISO form
Indemnification
Automobile Liability
Other
INSURANCE REQUIREMENTS FORM
Required Limits
Statutory Limits of Florida Statutes,Chapter 440 and all Federal Government Statutory Limits
$1,000,000 each accident,single limit per occurrence
$1,000,000 single limit per occurrence
$3,000,000 aggregate for Bodily Injury Liability &Property Damage Liability.
This shall include Premises and Operations;Independent Contractors;Products &Completed
Operations &Contractual Liability.
To the maximum extent permitted by Florida law,the Contractor/Vendor/Consultant shall
indemnify and hold harmless City of Winter Springs,its officers and employees from any and
all liabilities,damages,losses and costs,including,but not limited to,reasonable attorneys'
fees and paralegals'fees,to the extent caused by the negligence, recklessness,or intentional
wrongful conduct of the Contractor/Vendor/Consultant or anyone employed or utilized by the
Contractor/Vendor/Consultant in the performance of the Agreement.This indemnification
obligation shall not be construed to negate,abridge or reduce any other rights or remedies
which otherwise may be available to an indemnified party or person described in this
paragraph.This section does not pertain to any incident arising from the sole negligence of
the City of Winter Springs.
$1,000,000 each person;Bodily Injury &Property Damage,Owned/Non-owned/Hired;
Automobile Included.
Proposer shall ensure that all subcontractors comply with the same insurance requirements that it is required to meet.The
same Proposer shall provide the CITY with certificates of insurance meeting the required insurance provisions.
The City of Winter Springs must be named as "Additional Insured"on the Insurance Certificate for Commercial General Liability
where required.
The Certificate Holder shall be named as City of Winter Springs.
Thirty (30)days cancellation notice required.
The undersigned Proposer agrees to obtaina prior to awarde if selected,a minimum level of insurance as stated above.
Proposer
Authorize ig ature
Officer Title
Date
RFP 09-25-01 CS Cross-Connection Control Program Management Services
EXHIBIT B
SCRUTINIZED COMPANY CERTIFICATION
Florida Statutes,Sections 287.135 and 215.473
Pursuant to Section 287.135,Florida Statutes (2017),a company is ineligible to,and may not,bid on,submit a proposal for,
or enter into or renew a contract with the CITY for goods or services of:
a.
b.
c.
Any amount if,at the time of bidding on,submitting a proposal for,or entering into or renewing such contract,the
Proposer is on the Scrutinized Companies that Boycott Israel List,created pursuant to s.215.4725,or is engaged in
a boycott of Israel;or
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:
Is on the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran
Terrorism Sectors List,created pursuant to s.215.473;or
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 Proposer 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:
a,
b.
c.
d.
e.
The Proposer is found to have submitted a false certification;been placed on the Scrutinized Companies with
Activities in Sudan 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.
Has been placed on a list created pursuant to s.215.473,Florida Statutes,relating to scrutinized active business
operations in Iran.
The CITY shall provide notice,in writing,to the Proposer of any determination concerning a false certification.
a.
b.
c.
The Proposer 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 Proposer 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 Proposer 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.
RFP 09-25-01 CS Cross-Connection Control Program Management Services
EXHIBIT B
THIS CERTIFICATION FORM MUST BE COMPLETED AND INCLUDED IN YOUR PROPOSAL RESPONSE.FAILURE TO SUBMIT
THIS FORM AS INSTRUCTED SHALL RENDER YOUR PROPOSAL SUBMITTAL NON-RESPONSIVE.
a.
b.
c.
d.
The Vendor,owners,or principals are aware of the requirements of Section 287.135,Florida Statutes;and
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
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 Terrorism Sectors List and,further,are not engaged in business operations in Cuba or
Syria;and
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 Terrorism Sectors
(Authoriz S nature)
Vuy)un
(Printed Name and Title)
fhTrDnsgact-V(dnJ
(Name of Proposer)
STATE OF
COUNTY OF
The foregoing instrument was acknowledged before me by means of ( )physical presence or (
notarization,this
)online
of
produced
RFP 09-25-01 CS
Y)who is personally known to me or ()who
as identification.
Notary Public
Print Name:
My Commission Expires:
Notary Public State of Florida
Michelle RemeleMyCommissionHH436394Expires11/24/2027
Cross-Connection Control Program Management Services
EXHIBIT B
STATE OF
COUNTY OF
NON-COLLUSION AFFIDAVIT of PRIME PROPOSER
Sambtcl&
C/au$)uca
PotSl(LLvu-(1)He/she is
Title
,being duly sworn,deposes and says that:
PztMsof
PROPOSER
The Proposer that has submitted the attached response.
(2)He/she is fully informed respecting the preparation and contents of the attached Proposal and of all pertinent
circumstances respecting such solicitation,
(3)Such Proposal is genuine and is not a collusive or sham solicitation.
(4)Neither the Proposer nor any of its officers,partners,owners,agent representatives,employees or parties in interest
including this affiant,has in any way,colluded,conspired,or agreed,directly or indirectly,with any other Proposer,firm or
person,to submit a collusive or sham response in connection with the RFP for which the attached Proposal has been
submitted or to refrain from proposing in connection with such RFP,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 Proposal or of any other Proposer,or to fix any overhead,profit or cost element of the proposed price or
the proposed price of any other Proposer,or to secure through any collusion,conspiracy, connivance or unlawful
Agreement any advantage against the City of Winter Springs,Florida,or any person interested in the proposed Agreement.
(5)The price or prices quoted in the attached Proposal are fair and proper and are not tainted by any collusion,conspiracy,
e p rt ft Proposer or any of its agents,representatives,owners,employees,or parties oforunlawfulAgreemento
interest,including affia
(Signed)
PctJ
(Title)
STATE OF
COUNTY OF
(L)Physical presence or ( )onlineTheforegoinginstrumentwasacknowledgedbeforemebymeansof
j 5 0 byAiLIN1—U$ULLhePceGdL/Uf-notarization,this of
)who is personally known to me or who
produced
Notary Public State of Florida
Michelle Remele
My Commission HH 436394
Expires 11/24/2027
as identification.
Notary Public
Print Name:
My Commission Expires:
RFP 09-25-01 CS Cross-Connection Control Program Management Services
EXHIBIT B
DRUG FREE WORKPLACE FORM
The undersigned Proposer,in accordance with Florida Statute 287.087 hereby certifies that
does:
(Name of Proposer)
1.
2.
3.
4.
5.
6.
7.
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.
Inform employees about the dangers of drug abuse in the workplace,the business's policy of 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.
Give each employee engaged in providing the commodities or contractual services that are under contract a copy
of the Drug-Free statement.
Notify the employees that as a condition of working on the commodities or contractual services that are under
contract,employee will abide by the terms of the statement and will notify the employer of any conviction of,or
plea of guilty or nolo contendere to,any violation of Chapter 893 or of any controlled substance law of the United
States or any state,for a violation occurring in the workplace no later than five (5)days after such conviction.
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.
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 business complies fully with the above
requirements.
(uthorize Signature)
VctLYbwV\(Print/Type Name as Signe Above)
5)DS
(Date)
RFP 09-25-01 CS Cross-Connection Control Program Management Services
EXHIBIT B
PUBLIC ENTITY CRIMES STATEMENT
SWORN STATEMENT UNDER F.S. SECTION 287.133(3)(A),ON PUBLIC ENTITY CRIMES
THIS FORM MUST BE SIGNED IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICER AUTHORIZED TO
ADMINISTER OATHS.
1.
2.
This sworn statement is submitted with Proposal for RFP 09-25-01 CS Cross-Connection Control Program
Management Services.
This sworn statement is submitted by (Proposer)w ose business address is
(Middle LLLefv(a1Y FC 39-91/11
and (if applicable)Federal Employer Identification Number (FEIN)
is (If a Sole Proprietor and you have no FEIN,include the last four (4)digits of your
Social Security Number:
Vaug3.My name is and my relationship to the Proposer named above is
4.I understand that a "public entity crime"as defined in Paragraph 287.133(a)(g).Florida Statutes,means a violation of any state
or federal law by a person with respect to and directly related to the transaction of business with any public entity or with an agency or
political subdivision of any other state or with the United States,including,but not limited to,any proposal or contract for goods or
services to be provided to any public entity or any agency or political subdivision of any other state or of the United States and involving
antitrust,fraud,theft,bribery,collusion,racketeering,conspiracy,or material misrepresentation.
I understand that "convicted"or "conviction"as defined in paragraph 287.133(a)(b),Florida Statutes,means finding of guilt or5.
a conviction of a public entity crime with or without an adjudication of guilt,in any federal or state trial court of records relating to
charges brought by indictment or information after July 1,1989,as a result of a jury verdict,non-jury trial,or entry of a plea of guilty or
nolo contendere.
I understand that an "affiliate"as defined in Paragraph 287.133(1)(a),Florida Statutes,means:6.
•A predecessor or successor of a person convicted of a public entity crime;or
•An entity under the control of any natural person who is active in the management of the entity and who has been convicted of
a public entity crime.The term "affiliate"includes those officers, directors,executives,partners,shareholders,employees,
members,and agents who are active in the management of an affiliate.The City of Fernandina Beach,Florida ownership by
one of shares constituting a controlling income among persons when not for fair interest in another person,or a pooling of
equipment or income among persons when not for fair market value under a length agreement,shall be a prima facie case that
one person controls another person.A person who was knowingly convicted of a public entity crime,in Florida during the
preceding 36 months shall be considered an affiliate.
I understand that a "person"as defined in Paragraph 287.133(1)(e),Florida Statutes,means any natural person or entity7.
organized under the laws of the state or of the United States with the legal power to enter into a binding contract for provision of goods
or services let by a public entity,or which otherwise transacts or applies to transact business with a public entity.The term "person"
includes those officers,directors,executives,partners,shareholders,employees,members,and agents who are active in management
of an entity.
directors,executives,partners,shareholders,employees,members,and agents who are active in management of an entity.
8.Based on information and belief,the statement which I have marked below is true in relation to the entity submitting this swornstatement.(Please indicate which statement applies)
either the entity submitting this sworn statement,nor any officers, directors,executives,partners,shareholders,employees,
members,or agents who are active in management of the entity,nor affiliate of the entity have been charged with and convicted of a
public entity crime subsequent to July 1,1989.
The entity submitting this sworn statement,or one or more of the officers, directors,executives,partners,shareholders,
employees,members,or agents who are active in management of the entity,or an affiliate of the entity has been charged with and
convicted of a public entity crime subsequent to July 1,1989.(Please attach a copy of the final order.)
The person or affiliate was placed on the convicted FIRM list.There has been a subsequent proceeding before a hearing officer of
the State of Florida,Division of Administrative Hearings.The final order entered by the hearing officer determined that it was in public
interest to remove the person or affiliate from the convicted FIR list.(Pl se ach a copy of the final order.)
The person or affiliate has not been placed on the convict IRM is (P ase describe any action taken by,or pending with,the
Department of General Services.)
RFP 09-25-01 CS
/0)15bs
Date:Sig at re
Cross-Connection Control Program Management Services
EXHIBIT B
PUBLIC ENTITY CRIMES STATEMENT cont.
Vlohc(LSTATEOF
COUNTY OF
PERSONALLY,APPEARED BEFORE ME,the undersigned authority,who,after first being sworn by me,affixed his/her
Edayo l)cbbcfsignatureatthespaceprovidedaboveonthis ,2025,and is rsonally known to ,or
has provided
Notary Public
RFP 09-25-01 CS
as identification.
II acyl27MyCommissionexpires:
Notary Public State of Florida
Michelle Remele
My Commission HH 436394
Expires 11124/2027
Cross-Connection Control Program Management Services
EXHIBIT B
DEBARMENT,SUSPENSION and OTHER RESPONSIBILITY MATTERS
Certification A-Primary Covered Transactions
The prospective primary participant certifies to the best of its knowledge and belief that its principals:
a.Are not presently debarred,suspended,proposed for debarment,declared ineligible,or
voluntarily excluded from covered transactions by any Federal debarment or agency;
b.Have not within a three-year period preceding this proposal,been convicted of or had a civil
judgment rendered against them for commission of fraud or a criminal offense in connection with
obtaining,attempting to obtain,or performing a public (Federal,State,or local)transaction or contract
under a public transaction;violation of Federal or State antitrust statutes or commission of
embezzlement,theft, forgery,bribery,falsification,or destruction of records,making false statements,
or receiving stolen property;
c.Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity
(Federal,State,or local)with commission of any of the offenses enumerated in paragraph (1) (b)of this
certification;and
d.Have not within a three-year period preceding this application/proposal had one or more
public transactions (Federal,State,or local)terminated for cause or default.
Where the prospective primary participant is unable to certify to any of the statements in this
certification,such prospective participant shall attach an explanation of this proposal.
Instructions for Certification (A)
By signing and submitting this Bid,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
certification,in addition to other remedies available to the Federal Government,the department or
agency may terminate this transaction for cause or default.
The prospective primary participant shall provide immediate written notice to the departmentc.
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
RFP 09-25-01 CS Cross-Connection Control Program Management Services
EXHIBIT B
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.
The prospective primary participant agrees by submitting this proposal that,should thee.
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.
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.
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 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 -Lower Tier Covered Transactions
The prospective lower tier participant certifies,by submission of this proposal,that neithera.
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.
The certification in this clause is a material representation of fact upon which reliance wasa.
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
RFP 09-25-01 CS Cross-connection Control Program Management Services
EXHIBIT B
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.
The terms covered transaction,debarred,suspended,ineligible,lower tier covered transaction,c.
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.
The prospective lower tier participant further agrees by submitting this proposal that it wille.
include this clause title UCertification 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.
Nothing contained in the foregoing shall be construed to require establishment of a systemg.
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.
Proposer:flams
Signature of Author •edC rt'
Date:acte(-tnA
i Official:Title:
RFP 09-25-01 CS Cross-connection Control Program Management Services
EXHIBIT B
E-VERIFY STATEMENT
Bid Number:RFP #09-25-01 CS
Project Description:Cross-Connection Control Program Management Services
Proposer acknowledges and agrees to the following:
Proposer shall utilize the U.S.Department of Homeland Security's E-Verify system,in accordance
with the terms governing use of the system,to confirm the employment eligibility of:
1.
1.
All persons employed by the Proposer during the term of the Contract to perform
employment duties within Florida;and
All persons assigned by the Proposer to perform work pursuant to the contract with
the CITY.
Proposer:Aaronsbact+/LUI)«,
Authorized Signature:
Title:
Date:Io )15 bs
RFP 09-25-01 CS Cross-Connection Control Program Management Services
EXHIBIT B
CONFLICT OF INTEREST STATEMENT
This sworn statement is submitted with Proposal for RFP #09-25-01 CS Cross-Connection Control Program Management
Services
This sworn statement is submitted by (Proposer)whose business address is
and (if applicable)Federal Employer Identification Number (FEIN)is
00-03'0-0-00
Security Number:
My name is
PCUis
(If a Sole Proprietor and you have no FEIN,include the last four (4)digits of your Social
and my relationship to the Proposer named above
1.
2.
3.
4.
5.
6.
7.
8.
9.
The above-named Proposer is submitting a Proposal for the City of Winter Springs.
The Affiant has made diligent inquiry and provides the information contained in the Affidavit based upon his/her
own knowledge.
The Affiant states that only one submittal for the above Proposal is being submitted and that the above-named
Proposer has no financial interest in other entities submitting Proposals for the same project.
Neither the Affiant nor the above-named Proposer 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 Proposer's submittal for the above Proposal.This statement restricts the discussion of pricing
data until the completion of negotiations if necessary and execution of the Contract for this project.
Neither the Proposer 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.
Neither the Proposer 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.
I certify that no member of the Proposer's ownership or management is presently applying for an employee
position or actively seeking an elected position with the City of Winter Springs.
I certify that,should the Proposer be awarded a contract after successful negotiation,the execution and approval of
such contract by the City of Winter Springs City Commission shall not create a conflict of interest under Chapter
112,Florida Statutes,Code of Ethics for Public Officers.I further certify that no member of the Proposer's
ownership or management is a spouse,child or "relative"as defined in Section 112.3142,Florida Statutes,of a
current City Commission member.
In the event that a conflict of interest is identified in the provisio fs rvi es,,on behalf of the above-named
Proposer,will immediately notify the City of Winter Springs.
Signature
STATE OF
CeminpLLCOUNTYOF
Date:
PERSONALLY,APPEARED BEFORE ME,the undersigned authority,who,after first being sworn by me,affixed his/her
signature at the space provided above on this 2025,an IS personally known to m ,or
has provided
Notary Signature
RFP 09-25-01 CS
as identification.
My Commission expires:
Cross-Connection Control Program Management Services
Notary Public State of Florida
Michelle RemeleMYCommissionHH436394Expires11/24/2027
EXHIBIT B
AFFIDAVIT OF COMPLIANCE WITH FLORIDA STATUTES 5 787.06
Florida Statutes 5 787.06(13)provides that:
When a contract is executed,renewed,or extended between a nongovernmental entity and a
governmental entity,the nongovernmental entity must provide the governmental entity with an affidavit
signed by an officer or a representative of the nongovernmental entity under penalty of perjury attesting
that the nongovernmental entity does not use coercion for labor or services as defined in this section.For
purposes of this subsection, the term "governmental entity"has the same meaning as in s.287.138(1).
THIS AFFIDAVIT MUST BE COMPLETED AND INCLUDED IN YOUR PROPOSAL RESPONSE. FAILURE TO SUBMIT THIS FORM
AS INSTRUCTED SHALL RENDER YOUR PROPOSAL SUBMITTAL NON-RESPONSIVE.
a.The Vendor,owners,or principals are aware of the requirements of Section 5 787.06,Florida Statutes;and
b.The Vendor,owners,or principals are eligible to participate in this solicitation and do not use coercion for the labor
or services contemp ated in heir roposal response.
(Authoriz Si nature)
(Printed Name and Title)
jL)amts
(Name of Proposer)
STATE OF
SemindcCOUNTYOF
The foregoing instrument was acknowledged before me by means of (physical presence or (
15 da 0 040bQT2025b thenotarization,this
)online
of
corpuvæK&'Ä )who is personally known to me or (
as identification.
)who
produced
Notary Public:
Print Name:
ll/a*laqMyCommissionExpires:
Notary Public State of Florida
Michelle RemeleMyCommissionHH436394
RFP 09-25-01 CS
Expires 11124/2027
Cross-Connection Control Program Management Services
EXHIBIT B
BYRD ANTI-LOBBYING AMENDMENT,31 U.S.C.51352 (as amended)
Contractors who apply or bid for an award of $100,000 or more shall file the required certification.Each tier certifies to the
tier above that it will not and has not used Federal appropriated funds to pay any person or organization for influencing or
attempting to influence an officer or employee of any agency,a member of Congress,officer or employee of Congress,or
an employee of a member of Congress in connection with obtaining any Federal contract,grant,or any other award
covered by 31 U.S.C.51352 (as amended).Each tier shall also disclose any lobbying with non-Federal funds that takes place
in connection with obtaining any Federal award.Such disclosures are forwarded from tier to tier up to the recipient.See
below —Certification Regarding Lobbying.
Byrd Anti-Lobbying Certification
Appendix A,44 C.F.R.Part 18 —Certification Regarding Lobbying
Certification for Contracts,Grants, Loans,and Cooperative Agreements
The undersigned certifies,to the best of his or her knowledge and belief, that:
No Federal appropriated funds have been paid or will be paid,by or on behalf of the undersigned,to any person for1.
influencing or attempting to influence an officer or employee of an agency,a Member of Congress,an officer or employee
of Congress,or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making
of any Federal grant,the making of any Federal loan,the entering into of any cooperative agreement,and the extension,
continuation,renewal,amendment,or modification of any Federal contract,grant,loan,or cooperative agreement.
If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or2.
attempting to influence an officer or employee of any agency,a Member of Congress,an officer or employee of Congress,
or an employee of a Member of Congress in connection with this Federal contract,grant,loan,or cooperative agreement,
the undersigned shall complete and submit Standard Form-LL,"Disclosure Form to Report Lobbying,"in accordance with its
instructions.
3.The undersigned shall require that the language of this certification be included in the award documents for all
subawards at all tiers (including subcontracts,subgrants,and contracts under grants,loans,and cooperative agreements)
and that all subrecipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was made or
entered into.Submission of this certification is a prerequisite for making or entering into this transaction imposed by
section 1352,title 31,U.S.Code.Any person who fails to file the required certification shall be subject to a civil penalty of
not less than $10,000 and not more than $100,000 for each such failure.
Byrd Anti-Lobbying Amendment,31 U.S.C.51352 (as amended)
The PROPOSER,,certifies or affirms the truthfulness and accuracy of each statement of
its certification and clo ur ,if y.In addition,the Contractor understands and agrees that the provisions of 31 U.S.C.
Chapter 38,Admin•rativ dies for False Claims and Statements,apply to this certification and disclosure,if any.
Signature of ÖROPOSER'sAuthorized Official
Vaughan,
Name and Title of PROPOSER's Authorized Official
Date
RFP 09-25-01 CS Cross-Connection Control Program Management Services
EXHIBIT B
Cross Connection Control Program Management Bid Worksheet
Project Items
Initial Software and Set up fee
Annual Fee for Device Test Management
Survey and Inspection for Residential
Survey and Inspection for Non-Residential
Staff Training (8-hr day)
On-going Cross Connection control Program Review and Optimization
Unit Cost
$13,000.00
$18,153.00
$29.00
$34.00
$1,000.00
$1,500.00
Qty
1
1
568
441
1
1
Lump Sum Cost
$13,000.00
$18,153.00
$16,472.00
$14,994.00
$1,000.00
$1,500.00
$65,119.00TotalAnnualProgramFee
Alternative Items for Back Flow Prevention Assemby Testing and Replacement Bid Worksheet
Project Items
Fire System Backflow Prevention Assembly Testing Fee
Backflow Prevention Assembly Testing Fee (Residential,2-inch or smaller)
Backflow Prevention Assembly Testing Fee (Non-Residential,2-inch or smaller)
Backflow Prevention Assembly Testing Fee (Non-ResidentiaI,greater than 2-inch)
Backflow Prevention Assembly Repair fee (Residential,2-inch or smaller)
Backflow Prevention Assembly Replacement fee (Residential,2-inch or smaller)
Backflow Prevention Assembly Repair fee (Non-ResidentiaI,2-inch or smaller)
Backflow Prevention Assembly Replacement fee (Non-Residential,2-inch or
smaller)
Backflow Prevention Assembly Repair fee (Non-Residential,greater than 2-inch)
Backflow PreventionAssembly Replacement fee (Non-ResidentiaI,greater than 2-
inch)
***$2000 is the minimum cost to repair a device greater than 2".The range can
be anywhere from $2000-$6000 depending on the parts needed for repair and
the device size.The cost to repair a 12"device is much different than the cost to
repair a 3"device.***
*****$3500 is the minimum cost to replace a device greater than 2".The range
can be anywhere from $3500-$28,000 depending on the device size.The cost to
replace a 12"device is much different than the cost to replace a 3"device.***
Unit Cost
$55.00
$30.00
$35.00
$55.00
$195.00
$780.00
$395.00
$1,670.00
$2,000.00
$3,500.00
EXHIBIT B
Appendix B:PROPOSAL BOND FORM
KNOW ALL MEN BY THESE PRESENTS,that we,the undersigned,
as Principal,and
Surety,are hereby and firmly bound unto the CITY OF WINTER SPRINGS as OWNER,in the penal
as
sum of Dollars ($)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 Proposal,attached hereto and hereby made a part hereof to enter into a
contract in writing,for the Work described as:Cross-Connection Control Program Management
Services
NOW,THEREFORE,if the Principal shall not withdraw said Bid within 90 days after the opening ofthe
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 day of 2025,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.
(Witness)
RFP 09-25-01 CS
(Principal)
(Address)
(Surety)
(Address)
Tit e
Tit e
(seal)
(seal)
Cross-Connection Control Program Management Services
EXHIBIT B
CUiVhia)Ddaqs DC tv 74vQtncI
APPENDIX C:PERFORMANCE BOND FORM
Bond No.
BY THIS PERFORMANCE BOND,We
Surety,whose address is
as Principal,whose address is
and telephone number is and
and telephone number is
as
are bound
to the City of Winter Springs,a Florida municipal corporation,as OWNER,whose address is 1126 E.State Road 434,Winter
in the initial sum of $32708 and telephone numberFlorida is 407-327-1800,Springs,
(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
SR434 At Winding Hollow Blvd._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.
2.
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.
B.
C.
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
Pay OWNER all losses,damages, delay damages (liquidated or actual),expenses,costs 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
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.
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.
2.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 OVVNER's discretion in approving the Surety's CONTRACTOR Will not be
RFP 09-25-01 CS Cross-connection Control Program Management Services
EXHIBIT B
B.
C.
D.
E.
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
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 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
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
Other Acts.Take any other acts mutually agreed upon in writing by the OWNER and the Surety.
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 DEFAULTWAS 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.
5.
6.
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.
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.
NO THIRD-PARTY BENEFICIARIES.The Surety provides this performance bond for the sole and exclusive benefit of
RFP 09-25-01 CS Cross-Connection Control Program Management Services
EXHIBIT B
7.
8.
9.
the OWNER and OWNER's heirs,administrators,executors,successors and assigns.No other party,person or entity
has any rights against the Surety.
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:Kevin Sweet,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
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.
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 law's provisions.
11.VENUE.In the event any legal action shall be filed upon this performance bond,the venue shall lie exclusively in the
Circuit Court for Seminole County,Florida.
RFP 09-25-01 CS Cross-connection Control Program Management Services
EXHIBIT B
12.MISCELLANEOUS.
A.
B.
C.
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.
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.
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.
Principal
(Typed Firm Name)
(Seal)
By:
(Signature)
(Printed Name)
(Title)
(Address)
RFP 09-25-01 CS
Surety
(Typed Firm Name)
(Seal)
By:
(Signature)
(Printed Name)
(Title)
(Address)
Cross-Connection Control Program Management Services
EXHIBIT B
wjvh(h 10 (iZL(S o/no-Acc ftwarJ
APPENDIX D:LABOR AND MATERIALS PAYMENT BOND
Bond No.
BY THIS LABOR AND MATERIALS PAYMENT BOND,We
and telephone
as Surety,whose address is
as Principal,whose address is
number is and
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
1.
2.
3.
4.
5.
of the SR434 At Winding Hollow Blvd.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:
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.
CLAIMS.Claims made under this bond shall be made pursuant to provisions of Section 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.
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.
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.
RECITALS.The recitals contained in this labor and materials payment bond are incorporated by reference herein
RFP 09-25-01 CS Cross-Connection Control Program Management Services
EXHIBIT B
6.
7.
8.
and are expressly made a part of this bond.
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.
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.
MISCELLANEOUS.
A.
B.
C.
D.
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.
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.
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.
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
(Typed Firm Name)
(Seal)
By:
(Signature)
(Printed Name)
(Title)
(Address)
(Date of Execution)
RFP 09-25-01 CS
Surety
(Typed Firm Name)
(Seal)
By:
(Signature)
(Printed Name)
(Title)
(Address)
(Date of Execution)
Cross-Connection Control Program Management Services
EXHIBIT B
RFP 09-25-01 CS
Cross-Connection Control Program Management Services
SECTION H -FLORIDA STATE CORPORATE FILING
EXHIBIT B
DIVISION OF CORPORATIONS
9nJz.org
Department of State /Division of Corporations I Search Records I Search-hy Entity-Name /
Detail by Entity Name
Florida Profit Corporation
AARON'S BACKFLOW SERVICES,INC.
EiLngJnfgr-ma-tion
Document Number
FEI/EIN Number
Date Filed
State
Status
principaLAddress
130 MIDDLE STREET
LAKE MARY,FL 32746
Changed:01/27/2022
MajLingAddr-ess
130 MIDDLE STREET
LAKE MARY,FL 32746
Changed:01/27/2022
P03000121646
20-0312266
10/22/2003
FL
ACTIVE
Registered Agent Name &Address
VAUGHAN,AARON A
130 MIDDLE STREET
LAKE MARY,FL 32746
Address Changed:01/27/2022
Officer/Director Detail
Name &Address
Title PD
VAUGHAN,AARON A
130 MIDDLE STREET
LAKE MARY,FL 32746
Annual-Repons
Report Year
2023
Filed Date
01/31/2023
EXHIBIT B
2024
2025
Pocu—gn-Umages
02/08/2024
01/27/2025
01127/2025 ANNUAL REPORT
02/08/2024 ANNUAL REPORT
01131/2023 ANNUAL REPORT
QI/27/2022 ANNUAL REPORT
02/07/2021 ANNUAL REPORT
02/04/2020 ANNUAL REPORT
02/02/2019 ANNVAk REPORT
02/01/2018 -ANNUAL REPORT
01/06/2017 -ANNUAL REPORT
03/17/2016 -ANNUAL REPORT
02/12/2015 ANNUAL REPORT
03/13/2014 ANNUAL REPORT
04/29/2013 ANNUAL REPQ&I
04125/2012 ANNUAL REPORT
04/29/2011 ANNUAL REPORT
04/24/2010 ANNUAL REPORT
04/1912009 ANNUAL REPORT
04/29/2008 ANNUAL REPQRT
04/28/2007 REPQRT
04/12/2006 —ANNUAL REPORT
03/26/2005 ANNUAL REPORT
Q4(30/2QQ4 -ANNUAL REPORT
10/22/2003 Domestic Profit
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EXHIBIT B