PROPOSAL AND BID FORM W. REYNOLDS ST. (SR 574) SEWER LINE REPLACEMENT Pursuant to and in compliance with your Invitation to Bid dated February 9, 2010, the Instructions to Bidders, Special Conditions and other documents related hereto, the undersigned does hereby propose to furnish all labor, materials, and equipment necessary for the replacement of existing 10 diameter sewer line between two manholes, approximately 340 linear feet in length along W. Reynolds St. (SR 574), all in accordance with the project construction plans complete and ready to use. BID SCHEDULE Bid No. 10-91345-003 UNIT TOTAL ITEMS DESCRIPTION UNITS QTY. PRICE PRICE 1. Mobilization/Demobilization and Permits LS 1 2. Maintenance of Traffic per FDOT requirements LS 1 3. Erosion and Sediment Control, BMP s LS 1 4. Clearing and Grubbing (Includes Removal of Pavement, Existing Sanitary Sewer Line; and Material disposal to complete the project) LS 1 5. Furnish and Install Stabilization Type B (12 thick) (Minimum LBR 40) LS 1 6. Furnish and Install Limerock LS 1 Base (12 thick) (98% of the max. density compaction) 7a. Furnish and Install Asphaltic Concrete (3 thick) (1/2 FC-12.5 Asphalt) (1/2 SP 12.5) LS 1 7b. Mill and Resurface Asphaltic Concrete work area not excavated (1/2 FC 12.5) LS 1 8. Furnish and Install 10 diameter Sanitary Sewer Main, including bedding and backfill, approx. 11.5 depth. LS 1 9. Furnish and Install 6 SDR 26 1
Lateral Replacement LS 1 10. Furnish and Install Grass Sod (Bahia) LS 1 11. Traffic Markings Temporary Markings LS 1 Thermoplastic LS 1 12. Site Restoration LS 1 TOTAL: $ TOTAL BID TOTAL BID IN WORDS: COMPANY NAME/ADDRESS: THE REMAINDER OF THIS PAGE LEFT BLANK PURPOSELY 2
The undersigned Bidder also declares that he understands a contract may be awarded on the Base Bid or Alternate Bid. The Bidder (Contractor) agrees to start work within ten (10) calendar days after date of written notice to proceed and guarantees to complete all work within thirty (30) CALENDAR DAYS after date of written notice to proceed for work. The Bidder understands that the Owner reserves the right to reject any or all bids and to award part(s) of the contract, if applicable, separately, in combination, or as one contract. The Owner reserves the right to waive technicalities in any bid, reject any or all bids and to accept any bid that in its judgment will be for its best interest. The Bidder agrees that this bid shall be good and may not be withdrawn for a period of sixty (60) calendar days after the scheduled closing time for receiving bids. If written notice of acceptance of this bid is mailed or delivered to the undersigned within thirty (30) days after date of opening of bids, or at any time thereafter before this bid is withdrawn, the undersigned agrees that he will execute and deliver an executed contract in the form attached and that he will give a performance bond as specified, with good and sufficient sureties, all within fifteen (15) days after the prescribed forms are presented to him for signature. The Bidder declares that he understands that the quantities shown on the estimates are approximate only, and are subject to either increases or decreases; and that should the quantities of any of the items or work be increased; the undersigned proposes to do the additional work at the unit prices set out herein; and should the quantities be decreased, he also understands that payment will be made on actual quantities installed at the unit bid prices, and will make no claim for anticipated profits or overhead for any decrease in the quantities. THE REMAINDER OF THIS PAGE LEFT BLANK PURPOSELY 3
Notice of award should be mailed, faxed or delivered to the undersigned at the following address: Firm Name (Typed) SEAL (If a Corporation) Address (Typed) City State Zip Phone Acknowledgment is hereby made by: following addenda, if any: Name (Typed) of receipt of the No. Dated Signature No. Dated Title No. Dated By: Name (Typed) No. Dated Signature Title 4
SWORN STATEMENT PURSUANT TO SECTION 287.133(3)(a), FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICIAL AUTHORIZED TO ADMINISTER OATHS. 1. This sworn statement is submitted with Bid, Proposal, or Contract No. for [print name of the public entity] 2. This sworn statement is submitted by [print individual's name and title] for [print name of entity submitting sworn statement] whose business address is and (if applicable) its Federal Employer Identification Number (FEIN) is (If the entity has no FEIN, include the Social Security Number of the individual signing this sworn statement:.) 3. I understand that a "public entity crime" as defined in Paragraph 287.133 (1)(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 in Florida or with an agency or political subdivision of any other state or of the United States, including, but not limited to, any bid or contract for goods or services to be provided to any public entity or an agency or political subdivision involving antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material misrepresentation. 4. I understand that "convicted" or "conviction" as defined in Paragraph 287.133 (1)(b), Florida Statutes, means a 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 record relating to charges brought by indictment of information after July 1, 1989, as a result of a jury verdict, nonjury trial, or entry of a plea of guilty or nolo contendere. 5. 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 b. 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. c. Those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in the management of an affiliate. The Ownership by one person of shares constituting a controlling interest in another 5
person, or a pooling of equipment or income among persons when not for fair market value under an arm's length agreement, shall be a prima facie case that one person controls another person. A person who knowingly enters into a joint venture with a person who has been convicted of a public entity crime in Florida during the preceding 36 months shall be considered an affiliate. 6. Based on information and belief, the statement which I have marked below is true in relation to the entity submitting this sworn statement. [indicate which statement applies.] Neither the entity submitting this sworn statement, nor any of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in management of the entity, nor any affiliate of the entity has 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 its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the 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. The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the Bidder or Contractor nor any affiliate of the Bidder or Contractor has been charged with and convicted of a public entity crime subsequent to July 1, 1989, AND (Please indicate which additional statement applies). There has been a proceeding before a Hearing Officer of the State of Florida, Division of Administrative Hearings. The Final Order entered by the Hearing Officer did not place the person or affiliate on the convicted vendor list. [Attach a copy of the final order] The person or affiliate was placed on the convicted vendor list. There has been a subsequent proceeding before a hearing officer determined that it was in the public interest to remove the person or affiliate from the convicted vendor list. (Please attach a copy of the final order). The person or affiliate has not been placed on the convicted vendor list. (Please describe any action taken by or pending with the Department of General Services). [signature] [date] STATE OF FLORIDA COUNTY OF PERSONALLY APPEARED BEFORE ME, the undersigned authority, who, after first [name] being sworn by me, affixed his/her signature in the space provided above on this day of, 2010. 6
Notary Public My commission expires 7