2020 IFB 18/19-14 Automotive TransmissionI
FINANCE DEPARTMENT
Thursday, December 20, 2018
:W1
To: City Clerk/Mayor
RE: jSktq-
The item(s) noted below is/are attached and forwarded to your office for the following action(s):
F]
Development Order
F1
Mayor's signature
F]
Final Plat (original mylars)
F] ,
Recording
n
Letter of Credit
Rendering
F]
Maintenance Bond
Safe keeping (Vault)
Ej
Ordinance
Deputy City Manager
F]
Performance Bond
❑
Payment Bond
n
Resolution
F]
City Manager Signature
El
F]
n
City Clerk Attest/Signature
City Attorney/Signature
Once completed, please:
F] Return originals to Purchasing- Department
F] Return copies
EJ
Special Instructions:
U4� r3ojaAzi4e,,,-
From
SharePoint—Finance —Purchasing_Forms - 2018.doc
2-j
Date
AGREEMENT BETWEEN THE CITY OF SANFORD AND SANFORD AUTO AND
TRUCK PARTS, INC.IIFB-18/19-13-AUTOMOTIVE EQUIPMENT PARTS
,'HIS AGREEMENT (hereinafter the "Agreement") is made and entered into this
C>)U day of February, 2019, by and between the City of Sanford, Florida, a Florida
municipality, (hereinafter referred to as the "City"), whose mailing address is 300 North
Park Avenue, Sanford, Florida 32771, and Sanford Auto And Truck Parts, Inc., a
Georgia corporation, whose principal and mailing address is 2913 South Orlando Drive;
Suite 100; Sanford, Florida 32273, (hereinafter referred to as "SA&T"). The City and
SA&T may be collectively referenced herein as the "parties".
WITNESSETH:
IN CONSIDERATION of the mutual covenants, promises, and representations
contained herein and other good and valuable consideration, the receipt and sufficiency
of which is hereby acknowledged, the parties hereto agree as follows:
Section 1. Recitals. The above statements are true and form a material
part of this Agreement upon which the parties have relied.
Section 2. Authority. Each party hereto represents to the other that it has
undertaken all necessary actions to execute this Agreement, and that it has the legal
authority to enter into this Agreement and to undertake all obligations imposed on it.
The persons executing this Agreement for each party certify that they are authorized to
bind the party fully to the terms of this Agreement.
Section 3. Scope of Agreement; Direction of Goods.
(a). This Agreement is for the goods set forth in the attachments hereto and
SA&T agrees to accomplish the provision of goods and actions specified in the
attachments for the compensation set forth in those documents relating to the provision
of automotive equipment parts.
(b). It is recognized that SA&T shall provide goods as directed by the City.
(c). The City's contact/project manager for all purposes under this Agreement
shall be the following:
Ms. Marisol Ordofiez
Purchasing Manager
Finance -Purchasing Division
City of Sanford
Post Office Box 1788
Sanford, Florida 32772
Phone: 407.688.5028
I JPage
tD
Section 4. Effective Date and Term of Agreement. This Agreement
shall take effect on the date that this Agreement is fully executed by the parties hereto.
This Agreement shall be in effect for a term of 3 years with the opportunity for additional
1 year renewal periods when in the best interest of the City. The total Agreement length,
including all renewals, shall not exceed 5 years. The decision to renew or extend this
Agreement shall be at the discretion of the City. SAU shall review the quality and
statute of the automotive equipment parts delivered to the City with the City on a semi-
annual basis. In any event, this Agreement shall remain in effect until the goods to be
provided by SAU to the City under each work order have been fully provided in
accordance with the requirements of the City; provided, however, that, the
indemnification provisions and insurance provisions of the standard contractual terms
and conditions referenced herein shall not terminate and the protections afforded to the
City shall continue in effect subsequent to such goods being provided by SA&T. No
goods or services have been provided prior to the execution of this Agreement that
would entitle SAU for any compensation therefor. Notwithstanding the foregoing, the
City may unilaterally terminate this Agreement in the event that the City is not satisfied
with the goods or services provided by SAU within the 6 calendar months commencing
on the first day of the first month after this Agreement commences.
Section 5. Compensation. The parties agree to compensation as set forth
in the attachments hereto, with the initial purchase of goods being in the amounts set
forth in the attachments hereto and as may be set forth in each purchase/work order
issued by the City.
Section 6. Standard Contractual Terms and Conditions. All "Standard
Contractual Terms and Conditions", as provided on the City's website, apply to this
Agreement. Such Terms and Conditions may be found at the City's website; which can
be reached at: (hftps://www.sanfordfl.-gov/dppartments/fli,nance/i)urchasing/contract-
terms-and conditions or www. Sanford FL. -gov). The parties shall also be bound by the
purchasing policies and procedures of the City as well as the controlling provisions of
Florida law. Work orders shall be used, in accordance therewith, in the implementation
of this Agreement to the extent deemed necessary by the City in its sole and absolute
discretion.
Section 7. SA&T1s Mandatory Compliance with Chapter 119, Florida
Statutes, and Public Records Requests.
(a). In order to comply with Section 119.0701, Florida Statutes, public records
laws, SAU must:
(1). Keep and maintain public records that ordinarily and necessarily would be
required by the City in order to perform the service.
(2). Provide the public with access to public records on the same terms and
conditions that the City would provide the records and at a cost that does not exceed
the cost provided in Chapter 119, Florida Statutes, or as otherwise provided by law.
21 P a a e
C7
(3). Ensure that public records that are exempt or confidential and exempt
from public records disclosure requirements are not disclosed except as authorized by
law.
(4). Meet all requirements for retaining public records and transfer, at no cost,
to the City all public records in possession of SA&T upon termination of the contract and
destroy any duplicate public records that are exempt or confidential and exempt from
public records disclosure requirements. All records stored electronically must be
provided to the City in a format that is compatible with the information technology
systems of the City.
(b). If SA&T does not comply with a public records request, the City shall
enforce the contract provisions in accordance with this Agreement.
(c). Failure by SA&T to grant such public access and comply with public
records requests shall be grounds for immediate unilateral cancellation of this
Agreement by the City. SA&T shall promptly provide the City with a copy of any request
to inspect or copy public records in possession of SA&T and shall promptly provide the
City with a copy of SA&T's response to each such request.
(d). IF THE CONTRACTOR/VENDOR HAS QUESTIONS
REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA
STATUTES, TO THE CONTRACTOR'S (VENDOR'S) DUTY TO
PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT,
CONTACT THE CUSTODIAN OF PUBLIC RECORDS AT (407) 688-5012,
TRACI HOUCHIN, CMC, FCRM, CITY CLERK, CITY OF SANFORD, CITY
HALL, 300 NORTH PARK AVENUE, SANFORD, FLORIDA 32771,
TRACI.HOUCHIN@SANFORDFL.GOV.
Section 8. Time is of the Essence. Time is hereby declared of the essence
as to the lawful performance of all duties and obligations set forth in this Agreement.
Section 9. Entire Agreement/Modification. This Agreement, together
with all "Standard Contractual Terms and Conditions", as provided on the City's website
and the attachments hereto (the documents relative to the procurement activity of the
City leading to the award of this Agreement) constitute the entire integrated agreement
between the City and SA&T and supersedes and controls over any and all prior
agreements, understandings, representations, correspondence and statements whether
written or oral in connection therewith and all the terms and provisions contained herein
constitute the full and complete agreement between the parties hereto to the date
hereof. This Agreement may only be amended, supplemented or modified by a formal
written amendment of equal dignity herewith. In the event that SA&T issues a purchase
order, memorandum, letter, or any other instrument addressing the goods or services,
work, and materials to be provided and performed pursuant to this Agreement, it is
3Page
hereby specifically agreed and understood that any such purchase order,
memorandum, letter, or other instrument shall have no effect on this Agreement unless
agreed to by the City, specifically and in writing in a document of equal dignity herewith,
and any and all terms, provisions, and conditions contained therein, whether printed or
written or referenced on a Web site or otherwise, shall in no way modify the covenants,
terms, and provisions of this Agreement and shall have no force or effect thereon.
Section 10. Severability. If any term, provision or condition contained in
this Agreement shall, to any extent, be held invalid or unenforceable, the remainder of
this Agreement, or the application of such term, provision or condition to persons or
circumstances other than those in respect of which it is invalid or unenforceable, shall
not be affected thereby, and each term, provision and condition of this Agreement shall
be valid and enforceable to the fullest extent permitted by law when consistent with
equity and the public interest.
Section 11. Waiver. The failure of the City to insist in any instance upon
the strict performance of any provision of this Agreement, or to exercise any right or
privilege granted to the City hereunder shall not constitute or be construed as a waiver
of any such provision or right and the same shall continue in force.
Section 12. Captions. The section headings and captions of this Agreement
are for convenience and reference only and in no way define, limit, describe the scope
or intent of this Agreement or any part thereof, or in any way affect this Agreement or
construe any provision of this Agreement.
Section 13. Counterparts. This Agreement may be executed in any
number of counterparts, each of which shall be deemed an original, but all of which,
taken together, shall constitute one and the same document.
Section 14. Binding Effect. This Agreement shall be binding upon and
inure to the benefit of the successors in interest, transferees and assigns of the parties.
Each party hereto represents to the other that it has undertaken all necessary actions to
execute this Agreement, and that it has the legal authority to enter into this Agreement
and to undertake all obligations imposed on it. The signatories hereof represent that
they have the requisite and legal authority to execute this Agreement and bind the
respective parties herein.
Section 15. Remedies. The rights and remedies of the parties, provided for
under this Agreement, are in addition to any other rights and remedies provided by law
or otherwise necessary in the public interest.
Section 16. Governing law, Venue and Interpretation. This Agreement is
to be governed by the laws of the State of Florida. Venue for any legal proceeding
related to this Agreement shall be in the Eighteenth Judicial Circuit Court in and for
Seminole County, Florida. This Agreement is the result of bona fide arms length
negotiations between the City and SA&T, and all parties have contributed substantially
4 Page
and materially to the preparation of the Agreement. Accordingly, this Agreement shall
not be construed or interpreted more strictly against any one party. than against any
other party and all provisions shall be applied to fulfill the public interest.
IN WITNESS WHEREOF, the City and SA&T have executed this instrument for
the purpose herein expressed.
ATTEST.- CITY OF SANFORD
AI I itjp I:
SANFORD AUTO AND TRUCK
PARTS, IN�
resident/Director re
Michelle L. Blankenship resid ent/D i rector
Vice President/Director Dated: - 5
5 Page
City of Sanford I Finance Department Purchasing
Division
,d Firstar
Avenue 2 Suite 236 Sanford. Florida 12711
300 N. Part,
FORD Phone: 407.688_5028 or 5030 1 Fax. 407.688.5021
INVITATION FOR BID (IFB)
TERAI CONTRACT
i L TITLE: AUTOMOTIVE EQUIPMENT PARTS
Attachment "C'
Public EntikV Crimes Statement
SWORN STATEMENT UNDER SECTION 287,133(3) (a), FLORIDA STATUTES- THIS FORM MUST BE SIGNE I) IN
THE PRESENCE OF A NOTARY PUBLIC OR OTHER OF AUTHORIZED TO ADMINISTER OATHS.
A
This sworn statement is submitted with Bid, of Contract Number IFF 0,19-1j. Automotive Equipment Part,-.
B. This sworn statement is submitted by_�,_Jt z.Ad &ZV 22tL
,14i 4 ,45J A -i (— %vhosc business address is
[Nim- a enfti% Atli -Hi t, 'orn statmenil
a c�
2- and (if applic, ble i its F dert I
Eniplover identification Nurnbcr`t(tPIN)is
(if the cruityfias no FEINl include the Social Secirrily
Number ofthc individual signing this sworn statement,
(vlv name isAQ11-1 and my relationship to the above is
jl`kaw print name of individtfiil signingi
D, i understand Chat a "public entity crime" as defined in section I -ST 133( ' 1)(g). Florida Stinfutes. means a violation of ane state or
federal law by it person with respect to and directly related to the transaction of'business with any public entity in Flori& of
with ata :agency or political subdivision cif' any other state or with the United States, iticluchn'-.1 but not luniled to, any bid or
contract for eoods or services to be provided it-) any public entity or ail agency or political subdivision and involving antitrust,
fraud, theft, bribery. collusion, racketeering, conspiracy, or rnate'niai nlisrepresentation
E. f understand that "convicted" or "conviction" as defined in section 2877. 030) (b), Florida Statutes. means a finding of guilt or
u
conviction of a public entity crittie, with or without an adjudication of gruilr, in any federal or suite trial court o f record
relating to charges brought by indictment or information after July 1,1 1989, as a result of a jury verdict, non -jury, trial, <Ir
entry of a plea of guilq, or nolo contenders.
F I understand that "'affiliate" as defined in section 287,133f 1) ta). Florida Statutes, means:
I A predecessor or successor of a person convicted of public entity crime; or
Ali Qotitv under the control of any natural person who is active in nig
the anaenictitt of the entity and who has bccil
convicted of a public entity crime. The term ".0filiate" includes those officers. directors. oxeculives, parinct's.
shareholders, employees. members, ail(] agents who are active in the managernent of ail affiliate. The ownership by
utin-iother person. or a pooling, ofequipmnt or wiconic
.me person of shares constituting a controlling interest in ai
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 his been
convicted of public entity crime in Florida during tile preceding thirty-six (36) nionths shall bo considered 311
affiliate,
G. f understand that a "person" as defined in section 287,1330) (c), Florida Statutes. means any niumil person vi- entity
organized Linder the laws of any state or of the United State % with the legal power to enter into a binding contract and which
bids or applies to bid on contracts for tile provision ofactods or services let by a public enlit,,, Or ky,,hich otherwise transacts OW
applies to transact business with a public entity. The term "person" include,s those officers. directors, CYXCLlfiVCS, parlflff'S,
shareholders, employees, members, and agents who are active in management of an colit-,
If- Based on information and belief, the statement, which I have marked belowis true in relation to the entity submilling this
sworn statement. I Please indicate w*itli a check mark (,` 11 xvInch statement applies],
City of Sanford Finance Department Purchasing
Division
300 N. Park Avenue 2111 Floor Suite 236 Sanford. Florida 32771
ANFORD Phone- 407.688.5028 or 5030 Fax: 407.688.5021
S
INVITATION FOR BID (IFB)
TERM CONMACT
TITLE: AUTOMOTIVE EQUIPMENT PARTS
V 1' }eilfrer the entity submitting this �,worti staternent, not, any officers, directors, executives. partners. shareholders. employ cc,,.
unembers, or agents is active in the man agetilent of tile entity. )i(,)r any affiliate of the entity have been convicied of public
entity crime subsequent to July f, 1989.
The entity submitting this sworn stircrocin, or one or niorc of the officers, directors. executives. partners, shareholders,
ornployces, niernbers, or agents who are aclivc in the nianagenient ol'the entity. or an affiliate ofthe craity has been charged kvilh
and convicted of public entity crinic subscelrient ti.)Jull, 1, 1989, AND 1PIcasc indicate Which additional statement appliesi.
There has beco as procceding conecriling the conviction before i judge or hearing officer of the State of Florida. Divisioji of
Administrative flearines, or a court of law having
proper jarisdiction, The final order entered by the hearing officer cit judge did
not place the persoji or affiliate or) tile convicted cont.-icior list, I Please attoch a copy of the final order]
Tile person or id7filiaic %vas placed oil the convicted contractor list. There has been a subsequent procceding, botbna coun
of law having proper itirisdiction or a judge or hearing officer of dila State offlorida, Division of Acirninistrative Ficarings, The
final order entered by the judge or hearing officer deiernpried that is ivas in the public interest to revnovo- the perm)n or all'illate
rr convicted contractor list. tPlease attach a copy (if the final ordcr.j
e person or affifiate has not been placed on any convicted vendor list, I Please describe any action oten by ru pend in -
With the State of Florida. Department tit klanagerilent Service .1
By the signatttre(s) below, Pwc, the undersigned, as aulhori7cd sigilatory to conunil tile Firui, certify (liat the information as provided
in Attachrugq "C", Public Entity
_!�ones-Statetnent. is trullitill and courct -%I ific onic of subolission
t P
Tvped Name ofA)TIAN'T
Tplt�
STATE (--)f
COUNTY (--)I,
Tile foregoing instrument %,&-, -xccuted before nic ifirs day of 20t, by
Sc
'n
personally sworc or 'affintled that liefshe i,-, aufljuriLed (ij execuic this document and thl-reby bind the Corporition, and who is
personalk,, known It-, nie OR has prochice' as idemification,
V
OTARN' PUIVN-, Stale of'
LUIS JOSE SEPULVEOA
Notary Public - State of Florida
4# = Commission # FF 898046
MY Comm. Expires Jul 12, 2019
Pj,E,A,SE COMPLETE AND SUBMIT At IT14 YOUR IFF RESPONSE
ew'Failure to submit Otis form may be gr000ds for disqualification of your submittal
M M 11,1011 - 5 4-,,. 0:4 li, 1,
Attachment "D11
Conflict of Interest Statement
AI am the ba#— of I/
`I'Wal' &A with a local Office in
N
[in ch Title] and principal office Con y I ime
cc in
B. The entity hereby submits an offer to IFB 18/19-13, Automotive Equipment P�rts.
C. The AFFIANT has made diligent inquiry and provided the information in this statement affidavit based upon its full
knowledge.
D. The AFFIANT states that only one submittal for this solicitation has been submitted and tendered by tile appropriate date and
time and that said above stated entity has no financill interest in other entities submitting a proposal for the work
contemplated hereby.
E. Neither the AFFIANT nor the above named entity has directly or indirectly entered into any agreement, participated in any
collusion or collusive activity, or otherwise taken any action which in any way restricts or restraints the competitive nature of
this solicitation, including but not limited to the prior discussion of terms, conditions, pricing, or other offer parameters
required by this solicitation.
F Neither the entity nor its affiliates, nor anyone associated with them, is presently suspended or otherwise prohibited from
participation in this solicitation or any contract to follow thereafter by any government entity.
G. Neither the entity nor its affiliates, nor anyone associated with them, have any potential conflict of interest because anti due to
any other clients, contracts, or property interests in this solicitation or the resulting prqject.
K I hereby also certify that no member of the entity's ownership or management or staff has a vested interest in any City
Division/DepartmentiOfficc.
I. I certify that no member of the entity's ownership or management is presently applying.. actively seeking, or has been
selected for an elected position within City of Sanford government.
J. In the event that a conflict of interest is identified in the provision of services.. 1, the undersigned will immediately notify the
City in writing.
By the Signa refs) below, LINve, the signed, as authorized signatory to commit the firm, certify that the information as provided
in At! $ , Conflictjaflfi-ierest Statement, is truthful and correct at the time of submission.
ANT6,31QXAATURJ�
/)7
Typpd Name Zof AFFIANT
- - j P
limp
STATE OF
COUNTY OF
TheC0 foregoing, "Instrument was CXCCLqcd before me this T day of j,-vwo-,, '1 0 -L9-. by ll f), , -L-1 NA "'A5Kp- as -i4P-51Lt'r)-A- or �r�
personally swore or aiFlnlhe/she is authorized to execute this document and thereby bind the Corporation, and who is
personally known to tile OR has produced as identification.
n.' Y. 10, =�
LUIS JOSE SEPULVEDA
LUIS
State5980
0, FloridaNotary P
`�y
Notary Public - State of FlNOTARY PU91-1C, State of
Commission # FF 8980&
pir's SE COMPLETE AND SUBMIT WITH YOUR IFB RESPONSE
L Jul 1
Expires Jul 12,
My Ex 2
t ..... �
to sul it this form may be grounds for disqualification of your submittal -
to
L:11 '9 Comm.com�m
City of Sanford Finance Department Purchasing
Division
tUi
, 300 N. Park Avenue 2"d Floor Suite 236 Sanford. Florida 32771
SNFORDI Phone: 407.688.5028 or 5030 1 Fax: 407.688.5021
fff
INVITATION FOR BID (IFB) ...... ......
TERM CONTRACT
TITLE: AUTOMOTIVE EQUIPMENT PARTS
Attachment "D11
Conflict of Interest Statement
AI am the ba#— of I/
`I'Wal' &A with a local Office in
N
[in ch Title] and principal office Con y I ime
cc in
B. The entity hereby submits an offer to IFB 18/19-13, Automotive Equipment P�rts.
C. The AFFIANT has made diligent inquiry and provided the information in this statement affidavit based upon its full
knowledge.
D. The AFFIANT states that only one submittal for this solicitation has been submitted and tendered by tile appropriate date and
time and that said above stated entity has no financill interest in other entities submitting a proposal for the work
contemplated hereby.
E. Neither the AFFIANT nor the above named entity has directly or indirectly entered into any agreement, participated in any
collusion or collusive activity, or otherwise taken any action which in any way restricts or restraints the competitive nature of
this solicitation, including but not limited to the prior discussion of terms, conditions, pricing, or other offer parameters
required by this solicitation.
F Neither the entity nor its affiliates, nor anyone associated with them, is presently suspended or otherwise prohibited from
participation in this solicitation or any contract to follow thereafter by any government entity.
G. Neither the entity nor its affiliates, nor anyone associated with them, have any potential conflict of interest because anti due to
any other clients, contracts, or property interests in this solicitation or the resulting prqject.
K I hereby also certify that no member of the entity's ownership or management or staff has a vested interest in any City
Division/DepartmentiOfficc.
I. I certify that no member of the entity's ownership or management is presently applying.. actively seeking, or has been
selected for an elected position within City of Sanford government.
J. In the event that a conflict of interest is identified in the provision of services.. 1, the undersigned will immediately notify the
City in writing.
By the Signa refs) below, LINve, the signed, as authorized signatory to commit the firm, certify that the information as provided
in At! $ , Conflictjaflfi-ierest Statement, is truthful and correct at the time of submission.
ANT6,31QXAATURJ�
/)7
Typpd Name Zof AFFIANT
- - j P
limp
STATE OF
COUNTY OF
TheC0 foregoing, "Instrument was CXCCLqcd before me this T day of j,-vwo-,, '1 0 -L9-. by ll f), , -L-1 NA "'A5Kp- as -i4P-51Lt'r)-A- or �r�
personally swore or aiFlnlhe/she is authorized to execute this document and thereby bind the Corporation, and who is
personally known to tile OR has produced as identification.
n.' Y. 10, =�
LUIS JOSE SEPULVEDA
LUIS
State5980
0, FloridaNotary P
`�y
Notary Public - State of FlNOTARY PU91-1C, State of
Commission # FF 8980&
pir's SE COMPLETE AND SUBMIT WITH YOUR IFB RESPONSE
L Jul 1
Expires Jul 12,
My Ex 2
t ..... �
to sul it this form may be grounds for disqualification of your submittal -
to
L:11 '9 Comm.com�m
City of Sanford J Finance Department Purchasing
Division
,�AMN �,-V
300 N. Park A,enue 2"1 Floor Suite 236 Sanford, Florida 32771
Phone. 407.688.5028 or 5030 1 Fax- 407.688.5021
���
0D'
INVITATION FOR BID (IFF)
TERM CONTRACT
TITLE: AUTOMOTIVE EQUIPMENT PARTS
k. Any changes to the coverage requirements indicated above shall be approved by the City of
Sanford, Risk Manager.
1. Address of "Certificate Holder" is City of Sanford; P 0 Box 1788 (300 N. Park Avenue)-.
Sanford, Florida 32771; Attention Purchasing Manager; Phone 407,688.5028115030 Fax
407.688.5021.
m. All certificates of insurance, notices etc. must be provided to the above address.
n. In the description of the certificate of insurance please also add the solicitation number and
prqicct name.
ft AfURE
Typed Name of pAF IANT
( j I eqwu tv 7
Title
STATE OF 1,
COUNTY OF -5nb k,
The foregoing instrument was executed before me this �7 day of 0 by
who
(-,A V -P -A of ��;;-rA eLk—
W; as I PC- r- tn ct
personally swore or affirmed that he/she is authorized to execute this document and thereby bind the Corporation. and who is
personally known to me OR has produced —as identification.
CIL
LUIS JOSE SEPULVEDA
Notary Public - State of Florida
NO-CNRY PUbLIC, State of
Commission # FF 898046
(Stan My Comm. Expires Jul 12, 2019
lip)
The Q1, reserves the unilateral right to niodif
j� the insurance requirententv set forth at ai�jl time during the process of solicitation
or subsequent thereto.
PLEASE COMPLETE AND SUBMIT WIT R YOUR IFB RESPONSE
`2"Failure to submit this form may be grounds for disqualification of your submittal"O
13T ID171111 11 n
Attachment "E"
Drug -Free Workplace Certification
When applicable. the drug-free certification form below must be signed and returned with the IFB response.
In order to have a drums free workplace prograrn, a business steal I:
Al Publish a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession. or use of a
controlled substance is prohibited in file workplace and specifying the actions that will be taken against employees for
violations of such prohibition.
B. Inform employees about the dangers of drug abuse in the workplace, the business' policy of maintaining .1 drug-firce
workplace. any available drug counseling, rehabilitation, and employee assistance programs, and the penalties that may be
imposed upon employees for drug abuse violations.
C Give each employee engaged in providing the commodities oi- contractual services that are Linder bid a copy of the statement
specified in the first paragraph,
D_ In the statement specified in the first paragraph, notify the employees that, as a condition of working on the commodities or
contractual services that are under bid, the employee will abide by the terms of the statement and will notify the employer of
any conviction of, or plea of guilty or nolo contendere to. any violation of chapter 893. Florida Statutcs, or of any controlled
substance law of tile United States or any state, for a violation occurring in the workplace no later than five (5) days after
such conviction.
1--,. 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.
1
F. Make a good faith effort to continue to maintain a drug-free workplace through implementation of the foreg0ing provisions.
By the signature(s) below, fAvc, tfi,.�-ersigried, as authorized signatory to commit the fine. certify that the information as provided
in Attar i 41 Drug-Frpe-Wo`rkpince Certification. is truthful and correct at the time of submission,
a
Type N11m f FFI NT
'e.) �49o t
T it] ti
STA'm OF 'F' s f .,(4 v,
COUNTY OF
The foregoing instrument was exec/ ted before me this r? day of -)o by
P 10
k:iA SLS: as _Of 5J1144)
personally swore or affirmed that helshe is authorized to execute this document and jlicrcby bind tile Corporation, and who is
personally known to me OR has produced as identification.
LUIS JOSE SEPULVEDA
State of
I.WS: Notary Public - State of Florida
NO - ARY 11 BLIC
WMy Commission # FF 898046
ComrL%C(4Wc0V1AIqV1P, TE AND SUBMI'r WITH YOUR [FB RESPONSE — (it* applicable)
'0
pylvj7.;Al 11) 0 - 11 , 11 t I ,
City of Sanford Finance Department Purchasing
Division
300 N. Park Avenue 2`1 Floor Suite 236 Sanford, Florida 32771
bANFRD Phone: 407.688.5028 or 5030 Fax: 407.688.5021
"`
INVITATION FOR BID (IFB)
TERM CONTRACT
"4
Ge t
�z
TITLE: AUTOMOTIVE EQUIPMENT PARTS
Attachment "E"
Drug -Free Workplace Certification
When applicable. the drug-free certification form below must be signed and returned with the IFB response.
In order to have a drums free workplace prograrn, a business steal I:
Al Publish a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession. or use of a
controlled substance is prohibited in file workplace and specifying the actions that will be taken against employees for
violations of such prohibition.
B. Inform employees about the dangers of drug abuse in the workplace, the business' policy of maintaining .1 drug-firce
workplace. any available drug counseling, rehabilitation, and employee assistance programs, and the penalties that may be
imposed upon employees for drug abuse violations.
C Give each employee engaged in providing the commodities oi- contractual services that are Linder bid a copy of the statement
specified in the first paragraph,
D_ In the statement specified in the first paragraph, notify the employees that, as a condition of working on the commodities or
contractual services that are under bid, the employee will abide by the terms of the statement and will notify the employer of
any conviction of, or plea of guilty or nolo contendere to. any violation of chapter 893. Florida Statutcs, or of any controlled
substance law of tile United States or any state, for a violation occurring in the workplace no later than five (5) days after
such conviction.
1--,. 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.
1
F. Make a good faith effort to continue to maintain a drug-free workplace through implementation of the foreg0ing provisions.
By the signature(s) below, fAvc, tfi,.�-ersigried, as authorized signatory to commit the fine. certify that the information as provided
in Attar i 41 Drug-Frpe-Wo`rkpince Certification. is truthful and correct at the time of submission,
a
Type N11m f FFI NT
'e.) �49o t
T it] ti
STA'm OF 'F' s f .,(4 v,
COUNTY OF
The foregoing instrument was exec/ ted before me this r? day of -)o by
P 10
k:iA SLS: as _Of 5J1144)
personally swore or affirmed that helshe is authorized to execute this document and jlicrcby bind tile Corporation, and who is
personally known to me OR has produced as identification.
LUIS JOSE SEPULVEDA
State of
I.WS: Notary Public - State of Florida
NO - ARY 11 BLIC
WMy Commission # FF 898046
ComrL%C(4Wc0V1AIqV1P, TE AND SUBMI'r WITH YOUR [FB RESPONSE — (it* applicable)
'0
pylvj7.;Al 11) 0 - 11 , 11 t I ,
TITLE: AUTOMOTIVE EQUIPMENT
ktilacbment IT"
Bid Price Scliedule and Acceptance of Bid Terms and Conditions
liwe, the orich,,rsig..'ried. as authorized sig lil the finn, do hereby at cept In total all the tenth and conditions s:.tall
wl
'llatol`y to corrill I
referenced in this fFB docutriont and do hereby agree that if a continct is offewd or rig::~ ilated it will abide by the terms and conditrow,
presented in the IFF docurnent oras negotiated porstlant thercro, The undersignea, having, tianniinrized hinvilerselt kvith the leinis, of
the JFB documents;, local conditions, and the cost, of the work at tile placets) where the work is to be done, hereby fitoposes, "Inj ag
to perforni within the tinge ilipialated. all work, required In accordaneQ with the scope of, services .lnd other docutrtents, nleludnlf�
Addenda. if any, oil file at tile to orSinford Purchasing Division for the price sit Forth herein in Settitio 11 of the Bid docaawrit and
Attachment "F" Bid Pri" Schedule and Acceptance of Bid Tertils and Conditions. -File sionwutvtst bciow art: all
icknowledginew ofnipour titill tolderstanding and acceptance ofali file terms and conditions set tbrth in this IFF docuinclal or as
otherwisc au'reed to betweerl the Parties ill writing,
Flidderic,ontractor Narne
klailing, Addrcss; &41
ud
%Vr*321 11-n-laul Address.
1Fr_1 Tit C, d- �.j A 1w
'TATE CIF
S
COI-XTY OF
The 111 _Xclluted 6 --fort Ine
brego w. instruniew da1v
o LA
Personally swore of affirloid that he/she is anihorir,cd to cxecote fill,, docuoicrit and thereby hind the Corporabow and Who IS
personally known to tile OR has produced
-;"r, A0 LUISS JOSE SEPULVEDA
NOTARY POBI.W. Stale of
Rotary otary Public - State of Florida
No
s I Commission # FF 898046
MAY Comm. Expires Jul 12, 2019
rL AND SU81811T WITH VOUR IFB RE SPONSE,
19 PIKE,
PLC
4"Failure to submit this Form may be grounds Cot, disqualification of your subrrlitlal"�l
City of Sanford Finance Department Purchasing
Division
jO0 N. Park Avenu e 211 Floor Suite 23auford. Floridia 327771
ANS E�
OR
Phone: 407.688.5028 oi- 5030l Fax: 407.688.5021
INVITATION FOR -BID (IFB)
'rut Rim CONTRACT
TITLE: AUTOMOTIVE EQUIPMENT
ktilacbment IT"
Bid Price Scliedule and Acceptance of Bid Terms and Conditions
liwe, the orich,,rsig..'ried. as authorized sig lil the finn, do hereby at cept In total all the tenth and conditions s:.tall
wl
'llatol`y to corrill I
referenced in this fFB docutriont and do hereby agree that if a continct is offewd or rig::~ ilated it will abide by the terms and conditrow,
presented in the IFF docurnent oras negotiated porstlant thercro, The undersignea, having, tianniinrized hinvilerselt kvith the leinis, of
the JFB documents;, local conditions, and the cost, of the work at tile placets) where the work is to be done, hereby fitoposes, "Inj ag
to perforni within the tinge ilipialated. all work, required In accordaneQ with the scope of, services .lnd other docutrtents, nleludnlf�
Addenda. if any, oil file at tile to orSinford Purchasing Division for the price sit Forth herein in Settitio 11 of the Bid docaawrit and
Attachment "F" Bid Pri" Schedule and Acceptance of Bid Tertils and Conditions. -File sionwutvtst bciow art: all
icknowledginew ofnipour titill tolderstanding and acceptance ofali file terms and conditions set tbrth in this IFF docuinclal or as
otherwisc au'reed to betweerl the Parties ill writing,
Flidderic,ontractor Narne
klailing, Addrcss; &41
ud
%Vr*321 11-n-laul Address.
1Fr_1 Tit C, d- �.j A 1w
'TATE CIF
S
COI-XTY OF
The 111 _Xclluted 6 --fort Ine
brego w. instruniew da1v
o LA
Personally swore of affirloid that he/she is anihorir,cd to cxecote fill,, docuoicrit and thereby hind the Corporabow and Who IS
personally known to tile OR has produced
-;"r, A0 LUISS JOSE SEPULVEDA
NOTARY POBI.W. Stale of
Rotary otary Public - State of Florida
No
s I Commission # FF 898046
MAY Comm. Expires Jul 12, 2019
rL AND SU81811T WITH VOUR IFB RE SPONSE,
19 PIKE,
PLC
4"Failure to submit this Form may be grounds Cot, disqualification of your subrrlitlal"�l
City of Sanford I Finance Department I Purchasing
Division
. . . . . . . .....
lift) N. Park Avenue2"d Floor Suite 236 Sanford, Floridi 31771
SkNFPhone: 407.688.5028 or 5030 1 Fax: 407�68&5021
ORD
1''ta
IFB)
TERM CONTR-ACT
TITLE: AUTOMOTIVE EQUIPMENT PARTS
Attachment `(G"
Addendum Receipt Acknowledgement Certification
Hie 1111dersianed acknowledges rcccif)t, (iff t1w fi)II(IN01111-1 addelida to the soficilation documelms! t(live number and dwe 140ACIO
Addendum No, 4�$ �/g
Addendum No
AddendLon No
Addendum No
,,kddendum No
Date, -L
k
Date&
madjag
Date&
I
1'eicphoije umber:
Dated:
lei
By Tile signature(s) bcjow� 11we, the ullde(sigmcdas jothwized Signatory to commit tile firm. �xrtify that the information as provided
in Attachment "C". Addendum Receipt Acknowledgement Certification, is mithful and correcial the time of submission,
Bidder"Comraclot- Nome,
ov 6"
madjag
1'eicphoije umber:
1aIN11mix, E -mad Address.
lei
i=1,tTMv 7-760 LC
-i
rV
Printed Name
TWO;
Date
PLEASE, CONNIPLETE ANS SITMITWITH YOUR IFF RESPONSE
`V'Faiture to subinit this form may bt- grounds for disqualification of your submitbl"F�'
City of Sanford I Finance Department I Purchasing
Division
300 Nk Parh Avenue 2"' Floor Suite 236 Sanford. Florida 32771
Phone: 407.688.5028 or,5030 I Fax: 407.688.5021
'A
S NFORD.
INVITATION FOR BID (IFB-)
TERM CONTRACT
TITLE: AUTOMOTIVE EQUIPMENT PARTS
Attachment "11"
Organizational Information
The Bidder most include a copy of their State Certificate of Good Standing, Articles of Incorporation, which lists tire corporatc
officers. In addition to the aforementioned documents. the BidILICT"Bidder must include nccessary intbrination to verdv the rridividmil
signing this propo.sal/bid and or any contract document has been authorized to bind the corvoration. Examples loctudc:
A- A copy of the Articles of Incorporation listing tire approved signatories of the C0Q)0ratiODL
(3 A copy of a resolution listing the members of" staff ass authori/_cd signatories for tire c.otopany
C A letter from a corporate officer, listing the niernbers of staff that areauthorix.cd siollialorics 1,01 file colnpanv
I
By the sitinaturc(s) Wow. Itwe, the undersigned, as authorized, sigmatory try corortrit the firm, certify that the information as providCd
tit Attachment "H", Organizational Information. is truthful and correct at the little ol'stibmission.
/*
Biddev('oniractor Name:
–
- Address: v4 ell
,\4aihn
„il
Te ber Y0, 3 Z,7 5is
_J�a\ NLM'nbcr� V67-371-3Vj) F-roai!Addrcss� ew,
141,
mlw
FEIN: 063�
gnarory Printed JNttrre
Title Date
131 -EASE COMPLETFAND SURMITWITH YOUR lFB RESPONSE
'w'Failure to submit this form nuo, be !!rounds for disqualification of your submittal—
TYPE OF ORGANIZATION
{Please ace a check mark- IV) next to a licable type)
V
Corporation
Partnership
Non -Profit
Joint verittite
i
Solc Proprieti-L)rship
Other (Please 5pecif V)
State of Incorporatioll
Priocipal Place of'Busincs%
t Err ter Address)
ZWZ
Federal LD. or Social Security
Number
6 b,- s
I
By the sitinaturc(s) Wow. Itwe, the undersigned, as authorized, sigmatory try corortrit the firm, certify that the information as providCd
tit Attachment "H", Organizational Information. is truthful and correct at the little ol'stibmission.
/*
Biddev('oniractor Name:
–
- Address: v4 ell
,\4aihn
„il
Te ber Y0, 3 Z,7 5is
_J�a\ NLM'nbcr� V67-371-3Vj) F-roai!Addrcss� ew,
141,
mlw
FEIN: 063�
gnarory Printed JNttrre
Title Date
131 -EASE COMPLETFAND SURMITWITH YOUR lFB RESPONSE
'w'Failure to submit this form nuo, be !!rounds for disqualification of your submittal—
City of Sanford I Finance Department Purchasing
Division
1 300 N. ParkAvemile 2"1 Floor Suite 236 Sanford, Florida 32771
Phone4
: 076
,88.5028 or
bANTORD, 1- 30 F x: '07.688.5021
INVITATION FOR BID (IFB)
TERNI CONTRACT
5,
TITLE:.AUTOMOTIVE EQUIPMENT PARTS
Attachment "J",
References
Bidder shall :submit �is a part of their bid response, a ininitnurn of'five (5) Of tbletnosi st-g-nificant pi-qjccts similar in size and scope
which were performed within the last ifitce (3) scars, The corttact person shall be sorneone who has personal kao"Iedge ofilli.-
Biddor's performance for the specific requirements listed and is aivarc the City may be comacting thern,
'l -Failure to suibinit this form may be grounds for disqualification of your submittal-
0) loj"_it_� ty ... ill, lkl 1 1,
Form W-9 Request for Taxpayer
(Rev. October 2007) Identification Number and Certification
Department of the Treasury
Internal Revenue service I
rn
as
CL
C
0
M
CLO
25
0
-
s V)
E r -
IL
Q
CL
0
C.,
W
W
Name (as shown an your income tax return)
Alfred M Blankenship
Business name, if different from above
Sanford Auto & Truck Parts Inc
Give form to the
requester. Do not
send to the IRS.
Check appropriate box: 0 Individual/Sole proprietor 0 Corporation R Partnership n Exempt
R limited liability company. Enter the tax classification P=disregarded entity, C=corporation, P=partnership) ❑10 . ....... payee
E] Other (see instructions) 0 -
Address (number, street, and apt. or suite no.) Requester's name and address (optional)
2913 South Orlando Drive, Suite 100
City, state, and 71P code
;anford, FL 32773
List account number(s) here (optional
Taxpayer Identification Number,
Enter your TIN in the appropriate box. The TIN provided must match the name given on Line 1 to avoid Social security number
backup withholding. For individuals, this is your social security number (SSN). However, for a resident
alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is
your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. or
Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose Employer identification number
number to enter. 1 59 :1 3606633
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and
2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal
Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has
notified me that I am no longer subject to backup withholding, and
3, 1 am a U.S. citizen or other U.S. person (defined below).
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup
withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply.
For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement
arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the Certification, but you must
provide your correctTIN. See the instructions on page 4.
SignSignature of 01-01-2019
Here I U.S. person P Date ►
General Instructions
De int person. For federal tax purposes, you are
considered a U.S. person if you are:
Section references are to the Internal Revenue Code unless
otherwise noted.
* An individual who is a U.S. citizen or U.S. resident alien,
* A partnership, corporation, company, or association created or
Purpose of Form
organized in the United States or under the laws of the United
A person who is required to file an information return with the
States,
IRS must obtain your correct taxpayer identification number (TIN)
* An estate (other than a foreign estate), or
to report, for example, income paid to you, real estate
* A domestic trust (as defined in Regulations section
transactions, mortgage interest you paid, acquisition or
301.7701-7),
abandonment of secured property, cancellation of debt, or
Special rules for partnerships. Partnerships that conduct a
contributions you made to an IRA.
trade or business in the United States are generally required to
Use Form W-9 only if you are a U.S. person (including a
pay a withholding tax on any foreign partners' share of income
resident alien), to provide your correct TIN to the person
from such business. Further, in certain cases where a Form W-9
requesting it (the requester) and, when applicable, to:
has not been received, a partnership is required to presume that
1. Certify that the TIN you are giving is correct (or you are
a partner is a foreign person, and pay the withholding tax.
waiting for a number to be issued),
Therefore, if you are a U.S. person that is a partner in a
2. Certify that you are not subject to backup withholding, or
partnership conducting a trade or business in the United States,
provide Form W-9 to the partnership to establish your U.S.
3. Claim exemption from backup withholding if you are a U.S.
status and avoid withholding on your share of partnership
exempt payee. If applicable, you are also certifying that as a
income.
U.S. person, your allocable share of any partnership income from
The person who gives Form W-9 to the partnership for
a U.S. trade or business is not subject to the withholding tax on
purposes of establishing its U.S. status and avoiding withholding
foreign partners' share of effectively connected income.
on its allocable share of net income from the partnership
Note. If a requester gives you a form other than Form W-9 to
conducting a trade or business in the United States is in the
request your TIN, you must use the requester's form if it is
following cases:
substantially similar to this Form W-9.
* The U.S. owner of a disregarded entity and not the entity,
Cat. No. 10231X Form W-9 (Rev. 10-2007)
ITEM DESCRIPTION
A. LIGHTING PRODUCTS
1. 1157 BULB
2. 1156 BULB
4. 3IS7 BUI-,B
N
4, 3156 BULB
6. 9006 14EADLIGHT
7 9007 HEADLIGHT
& H6054
B. CHEMICA.LS & rLUIDS
I . REARVIEW MIRROR GLUE KIT
2, RADIATOR COOLANT (GALLON)
3. WAS14ER SOLVENT (GALLON)
4. RADIATOR FLUSH (12 oz BOTTLE)
5. RADIATOR BARS LEAK (10 OZ)
6. BLACK RVT SILICONE (TUBE)
T 3M WEATHER-STRIP ADHESIVE
C. WIPER BLADES
1, ANCO 31 -18
I a P..o 011liltl;
2. .NCO 31-22
ANCO 31-17
4. XNCO 31-20
1. 30 LB. CAN 1 -134A $ ,o
E. SPARK PLUGS
1, AC DELCO $
2. MOTORCRAFT s
3. BOSCH 5%
4. N $ �
1. 16 LB VENTED $
2. 13 LB VENTED $
3. 7 LB VENTED $
1, 2016 CHEVROLET IMPALA 3.6 $ / ci 16, q
2. 2016 FORD EXPLORER INTERCEPTOR
3. 2016 FORD TAURUS INTERCEPTOR
4. 2014 FORD -F- 150
H- WATER PUAIP (LIEW)
1, 2014 FORD TAUTRUS
TITLE: AUTONIOTI'VE EQUIPMENT PARTS
1 2014 CHEVROLET IMPALA 33.51, 015 CIJEVR.OLET 1500 P/Tj /*
4. 2015 FORD F- 150
1. 2015 CHEVROLET 1500
2. 2014 FO -FIS 5.0 L
4 2014 CHEVROLET I-MPALA-31.61,
J. E LEI CTRICAL
1, ATO 30 FUSE
2. A(3C30 FUSE
3. 2 POSITION TOGGLE SWITCff
4. BLACK ELECTRICAL TAFE- ROLL
$ 'v
$
THE REMMNDER OF THIS PAGE LEFT INTENTIONALLY BLANK
WHO V.1111 x A P-1 Aimnli