2084 IFB 18/19-22 LMCC Specialty Contractorsesopi)
FINANCE DEPARTMENT
Thursday, December 20, 2018
TO: City Clerayor
Rm
0
The item(s) noted below is/are attached and forwarded to your office for the following action(s):
❑
Development Order
❑
Mayor's signature
❑
Final Plat (original mylars)
❑ .
Recording
❑
Letter of Credit
Rendering
❑
Maintenance Bond
Safe keeping (Vault)
❑
Ordinance
Deputy City Manager
❑
Performance Bond
❑
Payment Bond
❑
Resolution
❑
City Manager Signature
❑
❑
City Clerk Attest/Signature
❑
City Attorney/Signature
Once completed, please:
❑ Return originals to Purchasing- Department
❑ Return copies
Special Instructions:
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From
SharePoint Finance Purchasing Forms-2018.doc
Date
AGREEMENT BETWEEN THE CITY OF L.M.C.C. SPECIALTY CONTRACTORS,
INC./IFB NUMBER: 18/19-22/CONCRETE AND ASPHALT SERVICES
THIS AGREEMENT (hereinafter the "Agreement") is made and entered into this
qay of June, 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 L.M.C.C. Specialty Contractors, Inc., a
Florida corporation, doing business as Mims Construction Co., whose principal address
is 119 South Pinehills Road; Orlando, Florida 32811 and whose mailing address is Post
Office Box 681554; Orlando, Florida 32868, (hereinafter referred to as "Mims
Construction"). The City and Mims Construction 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
Mims Construction agrees to accomplish the provision of services specified in the
attachments for the compensation set forth in those documents relating to the provision
of concrete and asphalt services.
(b). It is recognized that Mims Construction shall provide services as directed
by the City.
(c). The City's contact/project manager for all purposes under this Agreement
shall be the following:
Ms. Marisol Ordonez
Purchasing Manager
Finance -Purchasing Division
City of Sanford
Post Office Box 1788
1'I'<}y e
Sanford, Florida 32772
Phone: 407.688.5028
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. However, 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. Mims Construction
shall review the quality and status of the concrete and asphalt services delivered to the
City with the City on a semi-annual basis. In any event, this Agreement shall remain in
effect until the services to be provided by Mims Construction 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 Mims Construction. No goods, services or actions have been provided prior
to the execution of this Agreement that would entitle Mims Construction 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,
services or actions provided by Mims Construction 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: (haps://www.sanfordfl.gov/departments/finance/purchasing/contract-
terms-and conditions or www. SanfordFL.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. Mims Construction's 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, Mims Construction must:
(1). Keep and maintain public records that ordinarily and necessarily would be
required by the City in order to perform the service.
21Paoe
(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.
(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 Mims Construction 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 Mims Construction does not comply with a public records request, the
City shall enforce the contract provisions in accordance with this Agreement.
(c). Failure by Mims Construction to grant such public access and comply with
public records requests shall be grounds for immediate unilateral cancellation of this
Agreement by the City. Mims Construction shall promptly provide the City with a copy of
any request to inspect or copy public records in possession of Mims Construction and
shall promptly provide the City with a copy of Mims Construction'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, ECRM, CITY CLERK, CITY OF SANFORD, CITY
HALL, 300 NORTH PARK AVENUE, SANFORD, FLORIDA 32771,
TRACI.HOUCHIN@SAN FORDFL.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 Mims Construction 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
3Page
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 Mims
Construction 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 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.
41Paoe
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 Mims Construction, and all parties have contributed
substantially 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 Mims Construction have executed this
instrument for the purpose herein expressed.
A TTES T. CITY OF SANFORD
By:
Traci Houchin, CMC, FCRM � co Fo)? eff TriplettAL,--,
City Clerk
11 0 or
r s
Approved as to form and j r
legal sufficiency. fill
William L. Colbert, City Attorney
A TTES T. L.M.C.C. SPECIALTY
CONTRACTORS, INC., A FLORIDA
CORPORATION, DOING BUSINESS
AS MIMS CONSTRUCTION CO.
B
L 4ndeMims
Witness # 1 §ignatuo Sole Corp rate Officer
Witness # 1 Name: Dated:
Witness # 23jgKature
Witness # 2 Name: --Z Lz
11
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Attachment "'B"
Midi Price Schedule ,and Acceptance of Bid Terms and Conditions
a)
Note: All concrete and asphalt patches are small in natural and can be located artywhere throughout the City,
b) Non- pt3OT requirements for smaller patches SI -3 Asphalt.
e) Contact local recycling centers for "Free' disposal services.
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a)
Note: All concrete and asphalt patches are small in natural and can be located artywhere throughout the City,
b) Non- pt3OT requirements for smaller patches SI -3 Asphalt.
e) Contact local recycling centers for "Free' disposal services.
Vwe, the undersigned, as authorized signatory to commit the firm, do hereby accept in total all the terms and conditions stipulated and
referenced in this IFB document and do hereby agree that if a contract is offered or negotiated it will abide by the terms and conditions
presented in the IFB document or as negotiated pursuant thereto. The undersigned, having familiarized him/herself with the terms of
the IFB documents, local conditions, and the cost of the work at the place(s) where the work is to be done, hereby proposes and agrees
to perform within the time stipulated, all work required in accordance with the scope of services and other documents including
Addenda, if any, on file at the City of Sanford Purchasing Division for the price set forth herein in Attachment "B" Bid Price
Schedule and Acceptance of Bid Terms and Conditions. The signature(s) below are an acknowledgment of my/our full
understanding and acceptance of all the terms and conditions set forth in this IFB document or as otherwise agreed to between the
parties in writing,
Bidder/Contractor Name: -619-f-c,4e, ka
C-00ch V'SL&�a) 4A,[ -S
Mailing Address:P
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Telephone Number: 1 a -to 93 IbFax Number: D:7- -3-6 �- ?E-mail Addressl-fry) C Cbr, S-tyudi^
L'4r2 ot t i I �-L-'U's FEIN: S1 -3i,/ 14.2 :9 1
AA Atho
—r&edSignator)i:"' Printed Name
-—'s
Title— + A-& 9 , �Q 1
COUNTY OF OfffiW,
STATE OF FLORIDA U
a +",
On this I day of MM,
Florida, personally appeared 114
within instrument, and he/she/they ackAow'
personally known to me or has produced_
SEAL
to
20 q before me, the undersigned Notary Public of the State of
M1 3 whose name(s) is/are subscribed to the
thats be/they executed it. WITNESS my hand and official seal. He/She is
)k k A �Ctas identification.
(Notary Public in and for the County durState Aforementioned)
My commission expires:
NAKIA KUY
Notary public - State of Florida
_Commission # GG 098361
jy Com. Eypi,,!, Aug 11, 2021
W,*du,mu0t490=WNot4yA1,1
PLEASE COMPLETE AND SUBMIT WITH YOUR IFB RE - -
-Failure to submit this form may be grounds for disqualification of your submittal -
> Note Pursuant to the Terms and Conditions, failure to meet or exceed specifications may result in rejection of
your Bid. Adding your own terms and conditions may cause your Bid to be rejected.
The undersigned, by signing this document hereby certifies that the company named below hereby is or does:
1. States that the entity named below and the individual signing this document has submitted the attached bid or proposal:
2. He is fully informed respecting the preparation and contents of the attached proposal and of all pertinent circumstances
respecting such proposal,
3. Said bid or proposal is genuine and is not a collusive or sham bid or proposal;
4. Neither the said bidder or proposer nor any of its officers, partners, owners, agents, representatives, employees or parties in
interest, including this affiant, has in any way colluded, conspired, connived or agreed, directly or indirectly with any other
bidder, proposer, firm or person to submit a collusive or sham bid or proposal in connection with the Contract for which the
attached bid or proposal has been submitted or to refrain from bidding or proposing in connection with such Contract, or has
in any manner, directly or indirectly, sought by agreement or collusion or communications or conference with any other
bidder, proposer, firm or person to fix the price or prices in the attached bid or proposal or of any other bidder of proposer, or
to fix any overhead, profit or cost element of the bid or proposal price or the bid or proposal price of any other bidder or
proposer, or to secure through any collusion, conspiracy, connivance or unlawful agreement any advantage against the City
of Sanford or any person interested in the proposed Contract.
5. The price or prices quoted in the attached bid or proposal are fair and proper and are not tainted by any collusion, conspiracy,
connivance or unlawful agreement on the part of the bidder or proposer or any of its agents, representatives, owners,
employees, or parties in interest, including the individual signing this document.
Bidder GOS _kVCA-t-.1i
��j
O' 0 nIttiiredfA�'thorized Repr'e'sentative (Affiant) Date
Ly-�,4 -e i ( .............. L 50
Printer Typed Name and Title of Authorized Representative (Affiant)
_X
COUNTY OF AICY
STATE OF FLORIDA
On this "day of t 20 before me, the undersigned Notary Public of the State of
Florida, personally appeared e4kj'303 iwhose name(s) is/are subscribed to the
within instrument, and he/she/they ackn&rIedge that he/she/they executed it. WITNESS my hand and official seal. He/She is
personally known tome or has produced _ �:.�QVICAQ 1, A , as identification.
(Notary Public in and for the Couneand State Afore1 ti l
i Notary Pubk -State of Florida Commission I GG 098361
SEAL My commission expires
,•R my Comm, Expires Aug 22,2021
:
PLEASE COMPLETE AND SUBMIT WITH YO I B ESPONSE
-Failure to submit this form may be grounds for disqualification of your submittal-
Attachment 'T"
Conflict of Interest Statement
X I am the of P& s, with a local office in Lwu, 5rc,�)b, &,,trac-IDY-S
[Insert Title] ff [Insert Company Name]
and principal office in la, d 1::-- 10 Rt'ct C,
B. The entity hereby submits an offer to IFB; 18/19-22 Concrete and Asphalt Services
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 the appropriate date and
time and that said above stated entity has no financial 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 and due to
any other clients, contracts, or property interests in this solicitation or the resulting project.
H. I hereby also certify that no member of the entity's ownership or management or staff has a vested interest in any City
Division/Department/Office.
1. 1 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 signature(s) below, I/we, the undersigned, as authorized signatory to commit the firm, certify that the information as provided
in Ajophment "D", Conflict of Inte
. gpfist Statement, is truthful and correct at the time of submission,
ArF,IAOT SIGNATr 44.S
r,Y-Ad e I ( 1.
TypeA)Name of AFFIANT
=!�'s
Title_a
COUNTY OF
STATE OF FLORIDA u
(WN
On this Aday of. N\(A4 20 before me, the undersigned Notary Public of the State of
Florida, personally appeared r n-1 ' whose name(s) is/are subscribed to the
within instrument, and he/she/they acknowledge that he/she/they executed it. WITNESS my hand and official seal. He/She is
personally known to me or has produced CA k to I/As-f, ldent' I t"
t t1 iv N N NAKIAKELLY
Notary public -state of Florida
Commission #GGM361
(Notary Public in and for the County and Stat Aforementioned} my, comm. Expires Aug 27- 202i
t Nouty kw
add NO* "Wawl Nr"Ty
SEAL My commission expires:
PLEASE COMPLETE AND SUBMIT WITH YOUR IFB RESPONSE
—Failure to submit this form may be grounds for disqualification of your submittal"w
A#tacbment I
Public Entity Ctimes Statement
1. M
A. This sworn statement is .submitted with; Bid, or Contract Number IFB 1119_22 Concrete and Asphalt Services
, This sworn statement is submitted b 4 ,0 , ; *--a :yrs dho P -Os whose business adobes is
_ and (if applicable) it's Federal
has no FEIN, include the Social Security
Number of the individual signing this swornstatement
My name is j�-P--i and ally relationship to the above is���
Flr-asL- prim VaWt Of in&Vi tunl signing]
D. I understand that a "public entity crime" as defined in section 257, I33(l)(g), :Florida Statutes, means a violation of any stag or
federal lave by a person with respect to and directly related to the transaction of business with any public entity in Florida or
wi(b an agency or political subdivision of any other state or with the united States, including, but not limited to, any bid or
contract for goods or services to be provided to any public entity war an agency or political subdivision and involving antitrust,
fraud, theft, trtbery, collusion, racketeering, conspiracy, or material misrepresentation.
E. t understand that "convicted" or "conviction" as defined in section 257.133{l) (b), Florida Statutes, means a finding of guilt or
a conviction of a public entity crime, with or without an adjudication of wilt, in any Weral or state trial court of record
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 ofguilty or holo contenders.
F, i understandthat "affiliate" as defined in section 287.133(1) too), Florida Statutes, ineans:
1, A predecessor or successor of person convicted of public entity clime; or
I An entity under the control of any natural person who is active in the management of the entity and who has beer
-
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 tiara affiliate. The ownership by
one. person of shares constituting a controlling interest in another person, or a pooling of equipment or income
among persons when not for fair market value under an unn'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 parson who has been
convicted of a public entity crime in Florida during the preceding tturty-six {36) months shall be considered an
affiliate.
G, I understand that a "person" as defined in section 2137,133(1) (e), Florida Statutes. means any natural person or entity
organized under the laws of any state or of the United States with the legal power to enter into a binding contract and which
bids or applies to laid on contracts for the provision of goods or services let by a public entity, or which oathenvvise transacts of
applies to transact business with a public entity. The terata "person" includes Hoose officers, directors, executives, partners,
shareholders, employees, members, and agents who are active in management of an entity.
H, Based on information and belief; the statement, which I have marked below, is true in relation to the entity submitting tlwis
sworn statement. [Please indicate with a check mark (') which statement applies),
City of Sanford I Finance Department I Purchasing
Division
C"OF 300 N. Park Avenue 2nd Floor Suite 236 Sanford, Florida 32771
Phone: 407.688.5028 or 5030 1 Fax: 407.688.5021
INVITATION FOR BID (IFB)
A TERM CONTRACT I I I
TITLE: CONCRETE AND ASPHALT SERVICES
Neither the entity submitting this sworn statement, nor any officers, directors, executives, partners, shareholders, employees,
members, or agents who is active in the management of the entity, nor any affiliate of the entity have been 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 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, AND [Please indicate which additional statement applies].
There has been a proceeding concerning the conviction before a judge or hearing officer of the State of Florida, Division of
Administrative Hearings, or a court of law having proper jurisdiction. The final order entered by the hearing officer or judge did
not place the person or affiliate on the convicted contractor list. [Please attach a copy of the final order.]
— The person or affiliate was placed on the convicted contractor list. There has been a subsequent proceeding before a court
of law having proper jurisdiction or a judge or hearing officer of the State of Florida, Division of Administrative Hearings. The
final order entered by the judge or hearing officer determined that is was in the public interest to remove the person or affiliate
from the convicted contractor list. [Please attach a copy of the final order.]
— The person or affiliate has not been placed on any convicted vendor list. [Please describe any action taken by or pending
with the State of Florida, Department of Management Services.]
By the signaturc(s) below, I/we, the undersigned, as authorized signatory to commit the firm, certify that the information as provided
in Attachment "E", Public Entity Crimes Statement, is truthful and correct at the time of submission.
)r SIGNATOJ�E_ ?_
Tyl@d Name of AFFIANT
--p�u �d �
Title
I #
1.1,114yovelarift-1 �1,
On this day of I N Xk '.N 20 1 -4 . before me, the undersigned Notary Public of the State of Florida,
personally appeared I 1,11MR'Al n"I I im whose name(s) is/are subscribed to the within
instrument, and he/she/they acknowledge�_'that he/she/they executed it. WITNESS my hand and official seal. He/She is personally
I
known to me or has produced GIC
IC( I as identification.
� I
(Notary Public in and for the County anal State Aforementioned NAMAXELLY
t4)taty Nbli, -State Of Flot'da
SEAL My commission expires: C,,mission g GGM361,.E-Ap1re5Au924202'
PLEASE COMPLETE AND SUBMIT WITH YOUR
13�'Failure to submit this form may be grounds for disqualification of your submittal'
City of Sanford I Finance Department I Purchasing
Division
Sc(Mor 300 N. Park Avenue 21111 Floor Suite 236 Sanford, Florida 32771
Phone: 407.688.5028 or 5030 1 fax, 407.688.5021
INVITATION FOR BID (11B)
A TERNI CONTRACT
TITLE: CONCRETE ANWASPHALT SERVICES
I I —
Attachment "F11
If and when the City of Sanford transmits records to the ContractorAtendor which are -exempt from public
re, the Contractor/Vendor shall execute an "Acknowledgement of Receipt of Exempt Public Records and
en 't to Safeguard" which will be provided with the exempt records. A sample forrn is attached f6y tile
roposer's infortnation,
IT, Upon award recommendation or 30 days after opening, it is understood that all submittals shall become "Public
records" and shall be subject to public disclosure consistent with Chapter 119, Florida Stalittes, and Section 24(a),.krticle
I of the Constiftition of the State of Morlda,, and other controlling law (collectively the "Public Records Laws"). If the
City of Sanford (City) rejects all replies submitted in response to a competitive solicitation and provides notice of its
intent to reissue the solicitation, the replies remain exempt from disclosure until the City provides a notice of intent to
award or withdraws the reissued solicitation. If no award is made, responses, are not exempt for longer than 12 months
after the initial notice rejecting, all responses..
Proposers/Bidders must invoke the exemptions to disclosure provided by law as applicable to the response to the
solicitation, must identify the data or other materials to be protected,, and must state the reasons why such exclusion from
public disclosure is necessary. The submission of a proposal authorizes release of your firm's credit data to the City.
If a Proposer/Bidder submits information exempt from public disclosure, the Proposer/Bidder must specifically and in
detail identify with specificity which pages/paragraphs of their bid/proposal pack -age are exempt from the Public Records
Laws, identifying the spmific exemption under the Public Records Laws that applies to each. The protected information
must be submitted to the City in a separate envelope marked accordingly,
By submitting a response to this solicitation, the Proposer/Bidder agrees to defend, indemnify and hold the City harmless
in the event the City litigates the public records status of the Proposer's/Bidder's documents this provision including the
obligation to pay the full legal costs of the City including, but not limited to., attorney's fees, court costs, and any and all
other charges, regardless of what level of trial or appeal.
or
4zjy,s ��b ) PLU'l lid C-0-hs-rn't-� io, atr),
4 t,, '.4-,ts —
and Title of Authorized Representative (Affiant)
COUNTY OF E) f N-)Gt,,
STATE OF F LO-kIDA
On this r day of 20 before me, the undersigned Notary Public of the State of
Florida, personally appeared Nxtyy) whose name(s) is/are subscribed to the
within instrument, and he/she/they acknowlede that he/shclthey executed it. WITNESS my hand and official seal. He/She is
personally known to me or has producedEv-.t 6 c4,, t . as identification.
W'.
(Notary Public in and for the County pfd State Aforementione mAWA KELLY
ffls b -stateofflofida
�b ljotarypu tic
SEAL My commission expires:
Commission # GG 09B361
My Comm. Exoms Aug 22. 2021
awdd � cqh t4alloW Wuy Asul-
PLEASE COMPLETE AND SUBMIT WITH YOUR E,[POMNSE
a'Failure to submit this form may be grounds for disqualification of your submittal -w
AttadbwotOG"
10E"&LCA= •LFfgaGjJ3:E L) =�j
The Bidder certifies that no segregated facilities are maintained and will not be maintained during the execution
of this contract at any of its establishinents.
The Bidder further certifies that none of its employees are, permitted to perform their services at any location
under the Bidder,- control during the life of this contract where segregated facilities are maintained.
The Bidder certifies further that it will not maintain or provide for its employees any segregated facilities at any
of its establishments,, and that he will not permi't his employees to perform their services at any location', under
his control, where segregated facilities are maintained.
As used in this certification, the term "segregated facilities" means any waiting rooms, work area, rest rooms
and wash rooms, restaurants and other eating areas, time clocks, looker rooms and other storage or dressing
areas, parking lots, drinking fountains, recreation or entertainment areas, transportation. and housing facilities
provided for employees which are segregated by explicit directive or are in fact segregated on the basis of race,
creed, color or national origin, because of habit, local custom, or otherwise.
The Bidder agrees that (except where it has obtained identical certification from proposed subcontractors for
specific time periods) it will obtain identical certifications from proposed subcontractors prior to the award of
subcontract exceeding $ 10,000 and that it will retain such certifications in its files.
�- p ,da,,+
or Typed, Name and Title of Authorized
PLEASE COMPLETE AND SUBMIT88,qTH YOUR IF8 RESPONSE
Failure to subtult this forth way be grounds for disqoalification of your submittal'w
Attachment 1114"
DISPUTE S DISCLOSURE FORM
Answer the following questions by answering "YES" or "NO". If you answer "YES", please explain in the
space provided, please add a page(s) if additional space is needed.
1. Has your firm, or any of its officers, received a reprimand of any nature or been suspended by the
Department of Professional Re dation or any other regulatory agency or professional association within
the last five (5) years? (YO
Has your firm, or any member of your firm, been declared in default, terminated or removed from a
contract or job related to the servicesyour irm provides in the regular come of business within the last
five (5) years?
3. Has your firm had filed against it or filed any requests for equitable adjustment, contract claims or
litigation in tine past five (5) years at is related to the services your firm provides in the regular course
of business? VQ years at
— (Y& Note- If yes, the explanation must state the nature of the request
for equitable adjustment, contract claim or litigation, a brief description of the case, the outcome or
status of suit a -ad the monetary amounts or extended contract time involved.
I hereby certify that all statements made are true and agree and understand that any misstatement of
misrepresentation or falsification of facts shall be cause for forfeiture of -rights for farther consideration of the
project identified.
L&�C&
Firm A
dW Lz�41 I4
or Typed Name and Title of Authorized Representative
LEASE COMPLETE AND SUBMIT WITH YOUR IFB RESPONSE
`O'Fallure to submit this form may be grounds for disqualification of your submittsl"W
When applicable, the drug-free certification form below must be signed and returned with the IFB response.
In order to have a drug-free workplace program, a business shall:
A. Publish a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a
controlled substance is prohibited in the workplace and specifying the actions that will be taken against employees for
violations of such prohibition.
B. Inform employees about the dangers of drug abuse in the workplace, the business' 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.
C. Give each employee engaged in providing the commodities or contractual services that are under 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 Statutes, or of any controlled
substance law of the United States or any state, for a violation occurring in the workplace no later than five (5) days after
such conviction.
E. Impose a sanction on, or require the satisfactory participation in, a drug abuse assistance or rehabilitation program if such is
available in the employee's community, by any employee who is so convicted.
F. Make a good faith effort to continue to maintain a drug-free workplace through implementation of the foregoing provisions.
By the signature(s) below, I/we, the undersigned, as authorized signatory to commit the firm, certify that the information as provided
in AVachment 1, Drug-FreeWgr1kplace Certification, is truthful and correct at the time of submission.
ME
Name
COUNTY OF Of CkY)Ckt,
STATE OF FLORIDA "j
11C\
I I Q�l
On this day of 20 before me, the undersigned Notary Public of the State of
Florida, personally appeared whose name(s) is/are subscribed to the
within instrument, and he/she/they acknowledge thate/sbe/ hey executed it. WITNESS my hand and official seal. He/She is
personally known to me or has produced - floc - �(, rX W —, as identification.
A NAKIA KELLY
Aforementioned) Public stateof Florida
(Notary Public in and for the County and I Notary
commission 0 GG 098361
My Comm. Expires Aug 22,2021
ma,
SEAL My commission expires: ur&d througli t4aloral Notaty Assn.
PLEASE COMPLETE AND SUBMIT WITH YOUR IFB;
—Failure to submit this form may be grounds for disqualification of your submittal-
Attachment "J"
Unauthorized (Illegal) Alien Workers 435-8
The CITY will not intentionally award publicly -funded contracts to any contractor who knowingly employs unauthorized
alien workers, constituting a violation of the employment provisions contained in 8 U.S.C. Section 1324a(e) Section
274A(e) of the Immigration and National1j, Act (INA). The CITY shall consider the employment by the CONTRACTOR
of unauthorized aliens, a violation of Section 274A(e) of the INA. Such violation by the CONTRACTOR of the
employment provisions contained in Section 274A(e) of the INA shall be grounds for immediate termination of this
Agreement by the CITY.
I By qeptiting this certification, the CONTRACTOR certifies that 4U10, et, a Ik e_a�ttc*)Or
dbA- name of company) does not and will not during the performance of any
contract resulting from the solicitation identified below employ illegal alien workers or otherwise violate the provisions of
the federal Immigration Reform and Control Act of 1986.
2. The Undersigned agrees to, upon request of the City, provide copies of Immigration Form 1-9 for each person
associated with the above named company who has been or is present at the designated jobsite associated with any work
or project resulting from this solicitation.
CONTRACTOR: 'aa &ryCko ch,,,L e, A'b( s& -m s iii c,h
V
Signatur PrintedName:
Title: Date:
Affix Corporate Seal
COUNTY OF Uf L�Mt,
STATE OF FLOR
O+X,N day ofd
On this I ay
Florida, personally appeared_ -.1 . 1
within instrument, and he/she/they ackho w_
personally known to me or has produced
that
20 19 , before me, the undersigned Notary Public of the State of
(Notary Public in and for the County and State
SEAL My commission expires:
whose name(s) is/are subscribed to the
it. WITNESS my hand and official seal. He/She is
t— . as identification.
NAKIA KELLY
Notary Public - Stateof Florida
Commission I GG 098361
my Comm. Expires Aug 22.2021
AWL
PLEASE COMPLETE AND SUBMIT WITH YOUR IMM-SPOMSE - - - - -
<rFailure to submit this form may be grounds for disqualification of your submittal -w
Project Ngivc Concrete and 6.sPhalt Services
Bid 1'B 18/19-22
The Affiant identified below attests to the following
That the Contractor is currently in compliance with and throughout the term sof the above identified project and will retrain in
compliance with Executive Order 11-02, rued by the Office of the Governor, Mate of Florida, requiring the use of the
Department of Homeland Security's Status Verification (T -Verify") System to ensure that all employees of the Contract and
the Contractor's subcontractors performing, work under the above -fisted Contract are legally permitted to work in the United
States.
29. Each Contractor that performs work finder the project referenced alcove shall provide the City of Sanford, Florida, a copy of
the "Edit CompanyProfile" screen indicating enrollment in the E -Verify Program.,
3. The Contractor will register and participate in the work status verification for all newly hired employees of the contractor and
for all subcontractors performing work on the above -listed Contract.
4. The Contractor agrees to maintain records of its compliance with the verification, requirements as outlined in this Affidavit
and, upon request of the any :Authority having jurisdiction over the Project, including; but not limited to, the State of Florida,
agrees to provide a copy of each such verification to that Authority'.
a, That all persons assigned by the Contractor or its subcontractors to perform work under the above identified project will meet
the employment eligibility requirements as established by the Federal Government and the government of the State of
Florida:
That the Contractor understands and agrees that its Failure to comply with the verification requirements as set forth herein or
its failure to ensure that: all employees and subcontracts performing work tinder the above identified project are legally
authorized to work in the United States and the State of Florida constitute a breach of contract for which the City ofSanford
may immediately terminate the Contract without notice and without penalty. Contractor further understands arta agrees that
in the event of such termination, the Contractor shill be liable to the City for any casts incurred by the City as a result of the
Contractor's breach.
', That for the purposes of this Affidavit, the following definitions apply:
"Employee" - Any person who is hired to perform work in the State of Florida.
"Status Verification System:" - the procedures developed under the .Illegal Immigration Reform and Immigration
Responsibility Act of 1996, operated by the Department of Homeland Security and known as the "E -Verify Program", or any
successor electronic verification system that may replace the E -Verify Program.
TITLE: CONCRETE AND ASPHALT SERVICES
')67
Authorized represatative (Affiant)
Printed $r' Typed Name and Title of Authorized Representative (Affiant)
COUNTY OF
STATE OF FLORIDA J
(). -JAI
On this :1 day of [VIN 20
Florida, personally appeared I "I vid-6k M ,
within instrument, and he/she/they acknowledge that h
personally known to me or has produced— TlcmAci 1
before me, the undersigned Notary Public of the State of
whose name(s) islare subscribed to the
executed it. WITNESS my hand and official seal. He/She is
3— . as identification.
(Notary Public in and for the Couriiiand Yate Aforem
NAXIA KELLY
Notary Public - state of Florida
SEAL My commission expires: %
mmission # GG 098361
My Comm, Expires Aug 22, 2021
PLEASE COMPLETE AND SUBMIT WITH IV IFB RESPONSE
cy*Failure to submit this form may be grounds for disqualification of your submittal-
By executing this Certification, the undersigned CONTRACTOR certifies that the information herein contained is true
and correct and that none of the information supplied was for the purpose of defrauding the City of Sanford (CITY).
The CONTRACTOR will not discriminate against any employee or applicant for employment because of physical or
mental handicap in regard to any position for which the employee or applicant for employment is qualified. The
CONTRACTOR agrees to comply with the rules, regulations and relevant orders issued pursuant to the Americans with
Disabilities Act (AFA), 42 USC s. 12101 et seq. It is understood that in no event shall the CITY be held liable for the
actions or omissions of the CONTRACTOR or any other party or parties to the Agreement for failure to comply with the
ADA. The CONTRACTOR agrees to hold harmless and indemnify the CITY, its agents, officers or employees from any
and all claims, demands, debts, liabilities or causes of action of every kind or character, whether in law or equity, resulting
from the CONTRACTOR's acts or omissions in connection with the ADA.
,� i� �. �-� ��� �� �� roc �� � �� ��s ��� �,�
Con 'tor," /
S i'gn e of Autho-Az/ed R4presentative (Affiant) Drte
h j, lyid-tV
Printed or Typed Name and Title of Authorized Representative (Affiant)
1—
COUNTY OF I )f QkMt'
STATE OF FLORIDA "
()_en 1
On this n day of MW 2 1 cl
before me, the undersigned Notary Public of the State of Florida,
personally appeared iUVIdeAl M imi whose names) is/are subscribed to the within instrument, and
he/she/they acknowledge that he/she/they executed it. WITNESS my hand and official seal. He/She is personally known
tome or has produced 043iwl(-A Uu-nw' as identification,
NAKIA KELLY
00
CommiWon # GG 098361
My Comm. Expires Aug 22,2021
0wtkdjhwaqbNaroWKW0tafyAWL
State adf Florida
W.1
ary Public -State of Florida
` - "_ - =_40'
SEAL
(Notary Public in and for the C84ty and State Aforementioned)
My commission expires:
PLEASE COMPLETE AND SUBMIT WITH YOUR IFB RESPONSE
O'Faffure to submit this form may be grounds for disqualification of your submittal"W
Division.
`< crnr 300 e Park avenue tau Floor Shite �' Sanford, Florida 32771
`= Phone: 407.688.5028 or 030 Fax: 407. 8,5021
INVITATIONFOR
BID FB
A ti a` RM ONT"CT
I TITLE: CONCRETE AND ASPHALT S' A 'E I
Attacbment iiM"
insurance Requirements
0 rtes' ta<M01
Contract xceed$
Contract does not, Lxceed
Contract dim not Exceed
COVERAGE REQUI131 tt
500'000, 180 slays and
SWAN,180 stays and
P-5,400,30 days and no
unusual haiards exist
no unusual bazarsts exist
unusuat hazards exist
Workers' Compensation
Employers Liability
Employers Liability
Employers Liability
$1,000,000.00
$50000.00
'1x500.000.00
'Cerfiftco'es of eceniption are not
Each Accident
Each Accident
Each Accident
acceptable it, liet, of'"'Orkem,
$1,000,010.00
$500,000.00
$500;000.00
compenTation irastownce
Disease
Disease
Disease
$1,000,000.00
5300,000.00
$500,000.00
Commercial General Unbility
x+3,000.000.00 Per
$1,000,000.00 Per
$500,000,00 Per
shall include- Bodfdy trtlaared Liability
Occurrence
Occurrence
Occurrence
and Ad rdsing InjuritV Liability
Covervgwv shall inchtde: Premises/
:1,000,000.00 General
$1,000,000.09 Genal
$500,000.00 General
Operations, Prodi tsu'Completerl
Aggrepte
Aggregate
Aggregate
Operations,' Contractual Liability
independent Contractors,Explosion;
Collapse: Undmground, When required
by the City, coverage in ust be provided
fir Harassment, A bine and
Molestation,
Comprehensive Amar Liability,
1,00+0,000 Combined
S 1,000,000 Combined
S 5004000 Per t urrence
CSL, ,shall include `'arta+ auto" or
Single Limit
Single Limit
shall include all of the ollowing.
$ 1,000,000 General
S 500,000 General Aggregate
owaac4 leases hirer), non -owned
r 1,000,000 General
Aggregate
autos, and scheduled tawas..
re s2e
Professional Liability (when required)
1,000,00-0.00
$1,000,000.00
$1,000,0t)0.00
minimum
minimum
Mitairnton
Builder's Risk (jvheu requir ) shall
i 00010 of completed
1011% of completed
100%0 completed
include then, sinkholes, off site
ohne of additions
value of additions
valise of additions'
storage, transit, installation and
and structure
and structure
and structure
equipment breakdown. Permission
to occupy shall be included and the
policy shall be endorsed to cover the
interest of all parties, including the;
City of Sanford, all contractors .and
subcontractors.
3,000,000 Aggregate:
$1,M0,000 Agate:
$500,000 As+ reg te.
Garage Beepers (when requ red)
No per vehicle
No per vehicle maximum
No per vehicle maximum
maximum preferred
aferred
gLeferred
$3,000,000 Combined
$1,000,000 Combined
$500,000 Combined Single
Garage Liability (n hoi required)
Single Limit
Single Limit
Limit
$3,000,000 General
$1,000,000 General
$500,000 GeneralAggregate
Aggregate
A to
0 rtes' ta<M01
ORD
truce Department
Division
300 N. Park AVenot 2'd Floor -Suite 236 Sanford, Florida 32771
11hone: 407.688.5028 or 5030 117ax: 4f17. 88 5421
VMTATION FOR BID (WB)
A TERM CONTRACT
I TITLE: CONCRETE AND ASPHALT SERVICES I
It is noted that Professional Liability, builder's risk, garage keepers and garage liability is not required unless
applicable conditions exist. If clarification is needed the CONTRACTOR must request, clarification ftorti the City
of Sanford Purchasing Office.
Il,Vendor, Contractor, bidder shall provide, to the City of Sanford "City," prior to comme"cinany
g work, a
Certificate of Insurance which verifies coverage in compliance with the requirements outlined below, Any work
initiated without completion of this requirement shall be uostaltorized and the City will not be rtsponsiblc,
The City reserves the Fight, as conditions warrant, to modify or increase insurance requirements outlined below as
may be determined by the project, conditions and, exposure
� Certification Terms and Conditions
It is noted that the City has a contractual relationship with the reamed vendor, contractor or provider (collectively
referred hereinafter as Contractor) applicable to a purchase order, work order, contract or other form of
commitment by the City of Sanford, whether in writing or not and has no such contractual relationship with the
Contractor's insurance carrier. Therefore, the onus is on the Contractor to insure. that they have the insurance
coverage specified by the City to meet all contractual obligations and expectations of the City, Further, as the
Contractoes instance coverage, is a maner between the vendor and its insurance carrier., the City will turn to the
Contractor for relief as a mutt of any damages or alleged damages for which the Contractor is responsible to
indemnify and hold the City harmless. It is understood that the Contractor way satisfy relief to the City for such
damages either directly or through its insurance coverage; exclusions by the insurance carrier notwithstanding, the
City will expect relief from the Contractor.
a. The insurance limits indicated above and otherwise referenced are minimum limits acceptable to the
City, Also, all contractor policies shall to be considered primary to City coverage and shall
not contain co-insurance provisions,
bAll policies, except for professional liability policies and workers compensation policies, shall name
the City of Sanford as Additional Insured.
c. Professional Liability Coverage, when applicable, will be defined on a case by case basis,
d- In the event that the insurance coverage expires prior to the completion of the project, a
renewal certificate shall be issued 30 days prior to said expiration date.
c, All limits are per occurrence and must include Bodily Injury and Property Damage.
I All policies must be written on occurrence form, not on claims made Forni, except for Pr**SSiOnal
Liability -
g. Self-losared retentions shall be allowed on gLny liability coverage.
h. In the notification of cancellation; The City of Sanford shall be endo r -sed onto the policy as a
cancellation notice recipient. Should any of the above described policies of Saolord in
accordance with the policy provisions'.
i, All insurers must have an A.M. rating of at least A-VIL
It is the responsibility of the Prime CONTRACTOR to ensure that all sub -contractors retained by the
Prime CONTRACTOR shall provide coverage as defined here -in before and after and are, the
responsibility of said Prime CONTRACTOR in all respects.
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 407.688.502815030 Fax 407.688.502 1,
tn. All certificates of insurance, notices etc. must be provided to the above address.
41 Rev 03120) 6
Title
COUNTY OF
STATE OF FLORIDA
On this day of IN % k-xl
personally appeared I
instrument, and he/she/they
known to me or has vroduce
SEAL
r-'�'
20 1 1 , before me, the undersigned Notary Public of the State of Florida,
fTE'S whose name(s) is/are subscribed to the within
that he/shelthey executed it. WITNESS my hand and official seal. He/She is personally
bf-hx)z' as identification.
(Notary Public in and for the County and State Aforementioned)
My commission expires:
NARIA KELLY
Notary Publk - Srate of Florida
Commission# GG098361
My COMM, Expires Aug 22, 2021
The City reserves the unilateral right to modify the insurance requirements set fort h at any time during the process of solicitation
or subsequent thereto.
PLEASE COMPLETE AND SUBMIT WITH YOUR IFB RESPONSE
12"Failure to submit this form may be grounds for disqualification of your submittal'
10
AC40MO CERTIFICATE OF LIABILITY INSURANCE
OATEWMIDD"Y)
1211912018
THIS CERTIFICATE It 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(ios) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain, policies may reqvirp an endorse . Ast fit on
statement
this certificate does not confer rights to the certificate holder In lieu of such endorsement(s).
PRODUCER
SIHLE INSURANCE GROUP, INC.407-869-5490
P. C. BOX 160398
ALTAMONTE SPRINGS FL 32716
certificate oepariment
FAX 9-3580
C. 40� F we. nai. 407-38
lon"pin.,
Cerffficatesftihlexom
INSURER(S)AFFORDIMaCOVERAGE
MAIC f
INSURERA- Westfield Insurance Group
24112
6/28/2019
INSURED MIMSCON-01
Mims Construction Company
LMCC Specially Contractors, Inc,
P.O. Box 681554
INSURER e. Bridgefield Employers Ins, car
10701
CLANS41ME LZ -1i OCCUR
INSURER D;
INSURER I-
Orlando FL 32818
INSURERF:
MED EXP (Any one Person)
S 1 ADD
COVERAGES CERTIFICATE NUMBER. 2073451101 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, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POI ICIE& LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
WWI
LIR
TYPEOFINSURANCE
ADOLSUBR
JLoa
wvn
POUCYRUMBER
POUCY EFF
'IMMADO
POLICY EXP
MMIDD
LIMITS
A
X COMMERCIALGENERALLI"IL11Y'
WP3942915
612M018
6/28/2019
EACH OCCURRENCE
$1,000,000
CLANS41ME LZ -1i OCCUR
D--
MM)
$150,000
MED EXP (Any one Person)
S 1 ADD
X Contractual Lab
X :ACU
PERSONAL &ADV INJURY
s 1,00D,000
GEN'L AGGREGATE LIMITAPPLIES PER,
GENERALAGGREGATE
$2.000,000
potICY '---I PRO-
JFr
Ln -i T 1x] 10C
PRODUCTS - COMPIOP Ar -4
$2,000.000
$
OTHER
A
AU'TOMOSILELIABILtrY
C11YP3942915
612812018612812019
Coms' NEDSINGLEMIT
as ddrsnll
1,000.000
BODILY INJURY (Per person)
X ANYAUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
X tiUfftfek NON4WNED
A ONLY Ix AUTOS ONLY
SUOfLY INJURY (Pot aw&-pt)
$
kMAGE
pip
5
A
X
UMSRELtA U -AS
OCCUR
CWP3942915
612131201e
I 612812019
EACIj OCCURRENCE
$ 5.000.A)00
AGGREGATE
s 5,000,00
EXCESS UM
CLAWS -MADE
i
UED I =MTEWflON-1
a
WORKeRSCOMPtN$A11O04
AND EMPLOYERS' L"ILITY YIN,
ANYPROPRIETORMARTNIERMXEC""'Ef-�
OFFICERMEMBERE)(CLUDED?
NIA
83056225
11112019
1 11112020
X�ARTUTE OETRH-
EL EACH ACCIDENT
$1,000;000
EJ.. DISEASE SA EMPLOYEE
S 100.000
(Mandatory In NN)
40scobe under 99dwriON OF OPERATIONS batow
I
EJ.. DISEASE POUCY LIMIT
51,000;000
A
ContradomEquipment
CWP3942915
Lensed & Rented EqWp
OedudWe
$25,000
$500
DESCRIPTION OFOPatA*noNs/LOCATIONS IVEHICLES tACORD 101, AddiflormiAeroarks Sthodula, may beaftachod 1fraom spa(* Isrequired)
For Bid andfor Informational Purposes Only
@ 1988-2015 ACORD CORPORATION, All rights reserved.
ACORD 25 (20161011 The ACORD name and logo are registered marks of ACORD
ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BE -FORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS,
For Informalion Only
AUTHORIZEDRSPRESENTATiVE
@ 1988-2015 ACORD CORPORATION, All rights reserved.
ACORD 25 (20161011 The ACORD name and logo are registered marks of ACORD
The undersigned aclutowledges receipt of the following addenda to the solicitation document(s) (Give number and date of each):
Addendum leo.
Addendum No.
Addendurrs ti,
Addendum No.
Addendum No.
Luted„
Dated!
Em
Dated:
By the. signature(s) below, I/we, the undersigned, as authorized signatory to commit the firm, certify that the information as provided
in Arracbment `IN" Addendum Receipt Acknowledgement Certification, is truthful and correct at the time of submission.
Bidder/Contractor Name_
Mailing Address_
Telephone l`+Tumber:1!2H� _L'3(� Fax Number; �=l'3 --_7E-mail Address:�— r)io
�/,- > t5 FTN:
d ignatory Printed Name
._ei
Title Pate
PLEASE COMPLETE � SUBMIT t'TH YOUR IFIL RESPONSE
�' Fail re to submit this form may be grounds for disqualification of our suhmjttal`1�0
Attachment 11011
References
Bidder shall submit as a part of their bid response, a minimum of five (5) of the most significant projects similar in size and scope
which were performed within the last three (3) years. The contact person shall be someone who has personal knowledge of the
Bidder's performance for the specific requirements listed and is aware the City may be contacting them.
Project #1:
PEoject Name:
d
lype of Project/Service: rze_tz_ :5 Ic T ->'L'* LA A-e(L-._ 'V,?, = c Y-." v7e ur-
Address:L,
LLYI'1_
Contracting Ag!Client :
Contact Name and Phone #: r 4 ax. x & -j'-Itc* c�lrlts - Lf 04 Ll 5; 119 to i
Contact Email Address and Fax i-4 t �,<, AW /Ui = dset i'14 s' r1 C CIY-^
Contract Amount: to t 9 S c) Start Date: 9 20(r�' End gate: 5. 1 Z' of cl
Project 01,
Project Name- I-cLIC-a- C_ X-f-ro K-ce
Typeof Project/Service: Lc-- 6- eL.LA It(. I-) 'cAc
Contracting Agenc yClient: 0 re- 1o,,ndc)
Contact Name and Phone #:—t,/ tie - 2 - -f vi -9 SO
Contact Email Address and Fax #: T V :Tme-C, e -r,, ba r%n\4L�J. 41 E� Z - 2_q _9+0S
Contract Amount: 16 Z r :3 5 45y 0 0 Start D C End Date:
Project #3.
Project Name: P 64-tZJe_
Type of Lroject/Service: u,4 1 K_ ,
J , S & d- , 4cis C
Addre=_V_,? 0 0 0 i-C_A&e cl j!;; 11--" r� Rd , -C,-T. 6 u d. [�:-Y a�407'2
Contracting Agenc yXiient:4
C "�_'
Contact Name and Phone #: :204t/ Z 2 Ll q 5'2
Contact Email Address and Fax #: da.,j. J--er-)4,Ade Zq_1XC 1401 e0-1-1 1
Contract Amount: - �6 /j��
0 L1, V Start Date: -7
End Date:
Project 44;
Project Name: I -xi ii k I CL,, C10 7� Tjv-,-:,,J
Type of Project/Service. 0 t)^C I C' r, +e -L-, Ra
Address: a T A Gj 6_,-Aa.,Cf _'k Y.
Contracting Agency/Client: 1_�Y_71 Y_
Contact Name and Phone #: 9'V"e?_
Contact Email Address and Fax #:(2J_Ar_ ezie- C b r -,i e z Com, 44- 4-6 4 5--S -__'2 L4-T!j
Contract Amount: if gca
t Start Date: I --I- End Date. 8-2tJS
Projed 45:
Project Name: t -,LL e, ±t. txJU_ O_Aef-()�xe
Type of Project/Service: 0 or -w-6 , C -L-1--6 & a -> "CLe-Ul, A I VS kw6-2_',-X r+'Ve We,
Address: z-:; '1 5 0 '5. 6 -e 6 1 cc a2 e""Z 1
.Contracting Agenc ytqlient:C4 6le-o-40
Contact Name and Phone #: '7T ' )LKJ e V'Z.
SC t,. 7 r
Contact Email Address and Fax C 0 t 5 r, b ebe*41-n etj , Ccar, 3,5 2 -'-1-2- cl - &7 C,
Contract Amount: Start Date: End Date:
I PLEASE COMPLETE AND SUBMIT WITH YOUR IFB RESPONSE
-Failure to submit this form may be grounds for disqualification of your submittal-
is
Attachment "P11
Organizational Information
The Bidder must include a copy of then- State Certificate of Good Statiding/Articies of Incorporation, which lists the corporate
officers, In addition to the aforementioned documents The Bidder/Bidder must include necessary information to verify the individual
signing this proposal/bid and or any contract documentbas been authorized to bind the corporation. Examples include'
k A copy of theArtiales of Incorporation listin g the approved signatories of the corporation,
B, A copy of aresolution listing the inembers, of staff as authorized signatories for the company,
C. A letter from a corporate officer listing the members of staff that are authorized signatories for the company,
By the signature(s) below, I/Nve, the undersigned, as authorized signatory to commit the fim, certify that the information as provided
in Attachment IT", Organizational Information, is truthful and correct at the time of submission.
Bidder/Contructor Name: Pe ciej C �C,_ D
1_71_'De
MailingAddress: V U � 9 4, ()12
NumberA-PI --+-30- 4 , E-mail Address: b-jY)Y)t2
FEIN. 56 -3*4 B
Title ate
PLEASE COMPLETE AND suBmiTwITtt Yo uR In RESPONSE
17'Fallure to submit this for may be grounds for disqualification of your submittal'v
TYPE OF ORGANIZATION
(Please place a check mark (y) next to applicable type)
corporation
Partnership
Non -Profit
Joint Venture
Sole Proprietorship
Other (Riease specify)
State of Incorporation
Principal Place of Business
(Enter address)
oe
40 3 7—
Federal I.D. or Social Security
Number
- 344- q- 9 3 18
By the signature(s) below, I/Nve, the undersigned, as authorized signatory to commit the fim, certify that the information as provided
in Attachment IT", Organizational Information, is truthful and correct at the time of submission.
Bidder/Contructor Name: Pe ciej C �C,_ D
1_71_'De
MailingAddress: V U � 9 4, ()12
NumberA-PI --+-30- 4 , E-mail Address: b-jY)Y)t2
FEIN. 56 -3*4 B
Title ate
PLEASE COMPLETE AND suBmiTwITtt Yo uR In RESPONSE
17'Fallure to submit this for may be grounds for disqualification of your submittal'v
116 1
K No Subcontracting (of any kind) will be utilized on this project.
Solicitation Number: IFS 18/19-07
Title: Chemicals for City WRFs
Total Project Amount:
Subcontractor Minority
Code if applicable)
Federal ID
Company Name
Address Phone, Fax, Email
Trade, Services or
Materials portion to be
subcontracted
Percent C/o) of
Scope/Contract
Dollar Value
Asian/Pacific Islander
W
Woman
H
Hispanic
SDVBE
Service Disabled Veteran
N
PERCENTAGE
TOTALS FOR SUBCONTRACTOR PARTICIPATION
PERCENTAGE TOTALS FOR MINORITY SUBCONTRACTOR PARTICIPATION
Minority Code
Code Description
Minor i!y Code
Code Description
AA
African American
NA
Native American
A
Asian/Pacific Islander
W
Woman
H
Hispanic
SDVBE
Service Disabled Veteran
When applicable, the Bidder, will enter into a formal agreement with the subcontractors identified herein for work listed in this
schedule conditioned upon execution of a contract with the City. By the signature(s) below, I/we, the undersigned, as authorized
signatory to commit the firm, certify that the information as provided in Attachment 111111, Proposed Schedule of Subcontractor
Participation, is truthful and correct at the time of submission.
Bidder/Contractor Name:
Mailing Address. r-IDe4-de,
Title
NumberAV 1'0`l� -&_ 3* Fax Number: 40-4— 430 —:?!r(c& E-mail Address:
F-Sth'atory Printed Name
cid I, 1�0
PLEASE COMPLETE AND SUBMIT WITH YOUR IFB RESPONSE
,v"Failure to submit this form may be grounds for disqualification of your submittal-
CO N ST it U CTMNI LYNN MIMS
Proje,n. Exccz,_ftive
Executive Profile: Lynn has over 35 years of experience in the construction industry and 28 years as president and
Owner of Mims Construction Company, a local M/WBE firm specializing in Construction Management, Concrete,
Masonry and related construction services. Mims Construction success comes through developing strong
relationships and building rapports with clients, architects, engineers, vendors and members of the project team.
Mims Construction Company is supported by a staff of construction experts in various building systems including
design -build, foundations, structural elevated stabs, mechanical, electrical, building envelope, site logistic and
LEER certification. Mims Construction was named (2) times by the Patin Beach County School Board as
Construction Manager of the year. As project director, Ms. Mims will work with the team on GMP development,
manage bid packages / review, schedule development, value engineering and design / constructability reviews. As
project director, Ms. Mims will work with the team on the GMP developed, managed bid packages/ review,
schedule development, value engineering and design / constructability reviews. Ms. Mims will work with the team
to ensure all minority participation and workforce is utilized to the maximum percentages.
Citrus Bowl
(CaniphigWorld Stadium)
Orlando, Florida
Orlando International Airport
Orlando, Florida
Tampa International Airport
Tampa, Florida
Page 1 of 2
30 years — President Mims Construction Company
0
0
Project Executive
0
M/WBE Coordinator
U
0
OSHA 30 -Hour Certification
0
Primavera p6 Certification
0
First Aid /CPR
0
Florida Licensed General Contractor
CY
Executive Profile: Lynn has over 35 years of experience in the construction industry and 28 years as president and
Owner of Mims Construction Company, a local M/WBE firm specializing in Construction Management, Concrete,
Masonry and related construction services. Mims Construction success comes through developing strong
relationships and building rapports with clients, architects, engineers, vendors and members of the project team.
Mims Construction Company is supported by a staff of construction experts in various building systems including
design -build, foundations, structural elevated stabs, mechanical, electrical, building envelope, site logistic and
LEER certification. Mims Construction was named (2) times by the Patin Beach County School Board as
Construction Manager of the year. As project director, Ms. Mims will work with the team on GMP development,
manage bid packages / review, schedule development, value engineering and design / constructability reviews. As
project director, Ms. Mims will work with the team on the GMP developed, managed bid packages/ review,
schedule development, value engineering and design / constructability reviews. Ms. Mims will work with the team
to ensure all minority participation and workforce is utilized to the maximum percentages.
Citrus Bowl
(CaniphigWorld Stadium)
Orlando, Florida
Orlando International Airport
Orlando, Florida
Tampa International Airport
Tampa, Florida
Page 1 of 2
Page 2 of 2
Andre Collins Senior Project IMANAGER / Director of Preconstruction
• University of Florida, Bachelor of Arts -
Geography
• 23 years in Constructions Industry
• OSHA 30 -Hour Certification
• License General Contractor CGC 1515197
• Numerous school projects
• Ran multiple project at same time
Manage the day to day construction activities of all subcontractors and generating a two week look
ahead to guide the progress of the project and ensure a timely completion. Issuing contracts and
change orders and reviewing submittals. Coordinate all owner/architect/contractor meetings.
Experience in road work, underground utilities, signalization, force mains, gas lines, electrical duct
banks, asphalt, concrete, masonry, drywall, framing, stucco, flooring, acoustical ceilings,
mechanical, plumbing and electrical. I am knowledgeable in Suretrak scheduling and able to
generate a recovery schedule. Coordinate Project team activities, including scheduling, quality
control, cost control, change orders, RFI's and closeout.
• Seminole County Bus Facility
• MLS Soccer Stadium
• UCF — Site Repairs
• Florida Citrus Bowl Renovation
• Dr. Phillips High Parking Renov
MR
M A04h
M I ap
C 0 N1 S T R U C T 10 N
$750,000.00
$90,000,000.00
$22,000.00
g4p
Winter Springs, FL
Orlando, FL
Orlando, FL
Orlando, FL
Orlando, FL
C-0 Ns 7 n -.., c 7 17 71 Tirnothy M.171 -110r, SE u pe ri n te n cl, en t
v) 1 9 Alcorn State - Bachelor of Science Business Administration
Turner School of Construction — Construction Management;
Business Development; Construction Contracting
Miami Dade CollegeNalencia College Dual Program
• I I years of construction experience
�J 0 5 years with Mims Construction Company
0 OSHA 30 Certificate
v I - CPR/First Aid
Tim has assisted in scheduling and daily activities of work and taking necessary actions to assure that the project
objectives of scheduling, quality, pricing, safety, and cleanliness are met and adhered to by subcontractors and vendors
as well as jobsite personnel. Implement incremental project scheduling to ensure upcoming events are on track and
are being proactively attended and met. Experienced in overseeing infrastructure, utility, road and asphalt installation,
site preparation parking amenities, striping and signage as well as new construction of building, site concrete and
masonry. Conducts pre -construction, progress and other project and staff meetings. Responsible for creating and
maintaining Project Documents and Reports per construction activities. Experience in Word, Excel Prolog (Tremble),
BIM 360, Safety Net. Tim has overseen projects ranging from 5000 sq. Ft. to 150,000 sq. Ft. and $IM to $200M in
building cost. Current Project Assignment — Assistant Superintendent
PROJECT EXPERIENCE
Current Project Assignment — Superintendent
Lake Davis to Lake Greenwood
Drainage Improvements
Orlando, Florida
Scope: Sidewalk, Brick and Curb
Owner: City of Orlando
Role: Superintendent
Lyn.v Trail
Orlando, Florida
Scope: CIP Walls, Sidewalks and Curb
Owner: Orange County, FL
Role: Superintendent
Lake Lucerne to Lake Cherokee
Drainage Inym-ovements
Orlando, Florida
Scope- Sitework, Concrete, and Hardscape
Owner: City of Orlando
Role: Superintendent
Orange and Alichigan Retail
Orlando, Florida
Scope: Sidewalk, Curb, and ADA
Owner: Rhodes
Role: Project Manager
JONAnIAN ZACHEM, SEVWFARY
Always vee&y licenses online at MyFloridaLlcensexom
Do not alter this docuMent in any form,
This is your license. it Is unlawful for anyone other than the licensee W use this document.
S
4 :..
AxiYst
2017
Owerunt Business i velopm to Division`
P.O. Box 1393
Oriando, Morlda 32802-1398
a�
A0-3-'ft5 µ
Form WINKS I Request for TaxpayerGive Fort" to the
fta'U. November 2017) Iden-tifleation Number and Certification requester. Do not
*- Go to wwwJrsgov1FbrmW9 for instnictions and the latest Informatiom send to the IRS.
2 SUSIPM name'"Maroed entity I'larmi, If different from Above
Lfts Consuttiction Co.
4 Chitskappropriale bat for fed" tax classiticallon of the perwri whose name Is entered on line i, Check only to of ilia 4 Exemptions fcodris Apply only to
following seven boxes. certain Antilles, not individuals, see
idIVWUaVWIO propriety or 11 0 00"MIJO-1 M 8 COTO-Itoo C3 Partri-Mbirl Instructions on page 3),
singto-memberl-LC Exempt payee code (if ano
0 Limited liabluty company. Baer ilia tax classification JC --C corporation, S=S corporation, P=Partasisho) 0-
NoW Check the appropriate box In tire line above for the tax classification of the single -member owner. Do not check Exemption from FATCA reporting
LLO it the LLC is classified as a singlo-member LLC that Is disregarded from the owner unless the owner of the LLC is
another IA -C that Is not disranardad fn5m the owner for US. tedarat tax nutooses. Otherwise. asinota-membar LLC that I coda (if anyl
Oacitu'p wrthtelrllng, "r IniolMOUSTS, ITILS is generally YOUt SOC191 SAMMY nUMDer ftibN). However, lot a . I I
resident alien, sole proprietor, or disregarded entity, see the Instructions for Part 1, later., For other
entities, It Is your employer Identification number Alit), If you do not have a number, see Now to get a M
177, later. or,
NotA» It The account Is in more than one name, seethe Instructions for line 1. Also see What Name and I EmOloyst-Wertfi0cation, number
- T--7
Aturnber To Give the star rfor guidelines on whose number to enter. I - 5 - 1191 - 13141412131118
UMM Cettificeflon
1, The number shown on this form Is my correct taxpayer identification number {or 1 am wafting for a number to
?.1 am not subject to,backup withholding booausix, (a)1 amexempt from backup withholding, or (b) I have not b
Service (18S) that I am subject to backup vvithholding as a result of a failure to report all Interest or dividends,
no longer subject to backup wlithholding,, and
3, 1 am a J.S. cifterl or other US, person (defined below), and
4, The FATCA cod*) entered on this form (if soy) Indicating that I -am exempt from FAT= CA reporting is correct.
Agnature of ----z � & _,�.,-Vg le
General Instructions
Section references are to The Internal Fievenue Code unless otherwise
noted.
Future developments, For the latest Information about developments
related to Form W-9 and its Instniolilons, such as legislation enacted
after they were published, go to wwwJmgoo/Fe rnlW9.
Purpose of Form
An Individual or entity (Form Wwti requester) who Is required to file an
information return with the IRS must obtain your coftat taxpayer
identification number (TIN) which may be your social security nurriber
(SSBI), Individual taxpayer Identification number #TIN), adoption
taxpayer identification number (ATIN), or eiriployet Identification number
(1214), to report on an Information return the amount paid to you, or other
amount reportable on an Information return. Examples of Information
returns Include, but are riot limited to, the following.
# Form 1099 -INT (Interest earned or paid)
, --j— —. J—.— J— — — , —.
oats 0 03/2112019
• Form, 1099 -DIV (dividends, Including those from stocks or mutual
funds)
* Form 1099-MISO (various types of income, prizes, awards, or gross
proceeds)
* Form 1099-8 (stock or mutual fund sales and certain other
transactions by brokers)
• Form 1099-8 (proceeds from real estate transactiorl1)
• Form 1099-K fmarchant card and third party network transactions)
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1098-T' (fuhlon)
• Form 1099-C (canceled debt)
• Form 1099-A (acquisition or abandonment of secured property)
Use Form, W-9 only If you are a U. person (including a resident
alien), to provide your conect Tft
If you do nor retum Form W-9 to the requester with a TIN, you might
be sublect to backup Wthhotding. See What is backup withholding,
later
Document A31OTM - 2010
..
Bid Bond
CONTRA
4rnr�..1r, 011"1"01r01"k-
1..M. spevialty r ontra tori
Ino, We Mims coniawdlon Company
119 South Pinellas Rasta
Orland% P#.. 32811
OWNER;
14i`rirrm 14%rd shir#rsa##arlPAIra tl
C4 of Sanford
286
SUR
(MV114 Ic raf #sarrtscrrrri# k## jtrrt lr r �#rvfrt j
Ra Box 104�
OH f�
Sanford. FL 3277
BOND AMOUNT-. o the Percent of, Amount Bid
PROJECT
O'arrv. %odonoradn)vV'rdi' ,1a4# rrrrm#Ircr, 01,Y)
IFS 16119-22 Concrete and Asphalt SeMces
'this dootar enthas�trt"Ttont
tszdia~on�catttraaer_ arasarttatt�#a
villi anafforreyItonccuraved"
*th #esprit to its o0troeflon4r
Any singulu retwonvo
Contractor, qty, omeuiw
other pa sbatl be �Cartsldsred
talurolvAere appttratue,
lftttis Board 4 issood to onjwtibn (side ra subcontrxcWs bid ton Cootraator, tltc torus Cuntraator its this Bond shalt ba dseattod to
Subcontractor ond the toast OvAtersttalt be doomad to baa t ora tot
st at °oad seated this 16thday or Me � 2019
' -0054i SA0
LA .C. aps tty Contractors,
. vws Mims construawm Company
Mr*rellrrrt) 0111)
B,
t"Tltld)
The Cincinnati Insurance Compan
` VIN)
4Y.
t�s��"
MOOK�evin R. _ jttt It i;C ir as ,Rssmc-
M1
THE CINCINNATI INSURANCE Ct?"tIPANV
Fairfield. Ohio
PONVER OF ATTORNEN,
1~iNt Vk'ALL MErb: Y THESE PRESENTS, That THE Eiy;Cl�'�;STT i » l��� CCltiP �+Y, a,corptaration organised 'Under the lams of
the State of Ohio. and hawing its principal office in the City of Fairfield, Ohio, does he e'oE =c nstitutt and -appoint
Chimes I, Nialsoac David R. Hoov-tt; KcAn R. Wq,;towicZ, Charles D, Nielson; Daniel F. Oaks: Laura D..Ntosholdtr. Don BramlaLge, Entity Golccki,
,tamer`. Nteduee ; Shawn A, Hattan; Edward NIT. Clark Jessica P, Reno; lan A, Nipper: Joseph i' Kirlsoo an& -or Edwin TumierCollinj, tv
of ;Miami Takes, Florida its tru: and lawful Anorney(3)-in-Fact to sign, xtcut�-, :eat
and deliver on its behalf as Surety. and as its act and decd, any and all bonds, policies. undertakio s, or rather life instrurmcrits. as lialtokt=_
.Any such Obligations in the United States, up to
Twenty ;fit I'= and i a,' 100 Dolalrs (320,000,000-00),
This appointment is made tinder and by authority of the fallowing rtstnution passed by the Eoard of Directors of said Company,
at a meeting held in the principal office of the Company°. a quorum being present and 8oting. on the ' dao of Dccernbrr, 1938, iyitich
resolution is still in effect.
'RESOLVED. that the President or any Vice 'Pr;sidet t be her Lty authorized. and thipowtrod to appoint Attot-sicys."irt»
Fant of the Company to cxccutc any and all bonds. polici:s unewrialliogs, or othv iK-. instruments On beha.T f of the
Corporation,: and may authorize any offices or a, y° suih Attorttg4ri-Fact to affix th< corporate seat,, and may` xrith or
without cause modif or revoke any such appointment or autlinrivy, Any such writings so< x:cutwd by such Atloi-neys.in..
Fact shall be binding upon the Company as if the„ lend t�= duly nx cutod and adeno%vl4dged iii the rc ukul�,- lei t
taffrccrs of the
h Company, "
This Power of Attorney is signed and waled by ta;tder and by (k autiiorlty cif"the folk Wing Resolutttsti adopted by ov
Board of Directors of tilt Company at a meeting duty tatted and held on the :" da} of Dezember, 19-73,
RESOLVED, that the signature of the PNSident or a tic,: Pr ident and the seat of the Company rnay; aff1iXedd lay,
facsimile on any povver of attorney gmnlod, and ili. signature a the S, rstary or Assistant. Secretary and the stent rat the
Company may be affixed by facsimile to any ccrttfr .at.. o:" any ,t~mh power and tin;. such trorser of certificate bearing
such facsimil,c signature and seat shall be valid and bidding on the Company. n; such poorer so executed and staled
and certified ley certificate so executed and stated shall, with rzips t to a :y° bond or undertaking to which it is attached.
continue to be valid and binding on (tie Coompany '
3t
WHEREOF, THE CNCIN* +;ATI INSURANCE NCE CDNiPANN' hers eaes.d these prk}ents to be seated v0th its cotpuratc
Vice President this V, day of tareh, 20 li
STATE OF OHIO,COUNTY OF BUTLER
1 ss
Viet Pr:sidem
On this P da.; of Ntarch. 2017before ri: co:u-, t:.. a�opt-nil:ti.d Vie President of TIIE CNCINNATl t;tiSt RANCE
comm -.NY, to M4 personally known to be tate officer described h.'rein., and at r,,i lcdg d that 0C 54,11 affixed to ttic preceding insau rient is
the eorporate seal ofsai,i Company and the corporate si al a^d the sianatu:: o. It.a: offscz), N+ e t duty ata.xzd and sttbscribtd to said instrument.
t y the aut ority, and i .cit n of said corporation,
laiEti J.1—'--XLLF.R. Attorney at Law
NOTAPY P00LIC , $TATF.OF carnet
My coi"rmissiori hes 00 Upirattaai
irate, Socilort 141.,0 t3.MC,
t. trap undersigned Sc t.tai trs° .lssistttnt Secy racy at`�l t`tF; i''I C'1* -,I ' fl ls» tvfP.,kN E coDmi?i \Y. hari�by ccrlir; that, th aboc°
is a true and 4orreel copy of t4c Original Power of Anornt.% i�isal-.3 b. --aid Cp neafr-, a, A do horabl further coni the said Po ;4'r of
t;torn ) is still 'it) full %ret nand'Iffeet.
der rn„� hand and scat
� s �,t1i, f�ri:t3a':4" at 1'�'ii�"«t, ��air3 � $"t��x# 4�
Chia da;• ofi SEAL
ifCEt
�i� � — _ - •�� � �" � ra� * � �'S/ mss`
3\;.1 Elms t3 17)
MimsCONS TRUCTION
List of Equipmen-E
1, Roll of Dumpster
2, Dump Trailer (2)
3. Concrete Saws (10)
4, Walk behind Saw (2)
5. Jack hammer'-?/ attacIment (5)
6. Generator (5)
7. Tamp (4)
8. MOT Equiptuent
9. Bobcat (2) / I
Post Office Box 6815541 Orlando, Florida 32868-1554
Office 407,298.69361 Fax 407,290.1217
www.rni sconstruction.com
MMASIMS
CONSTPUCTION
List of Mirns Construction Personnel
1. Lyn Mims — President — Oversite
2. Tim Mixon — Superintendent — Self Perform Oversite
I Andre Collins — Project manager
4. Johnny cgee — Quality Control — Safety
5. Alfonso N%te — Carpenter Foreman
6. Kevin Gaskin — Carpenter Foreman
7, Choice Mcgee— Super — Concrete
8. Brandon Hughes — Labor Foreman
9r Concrete Finishers (6)
10. Skilled Labors (5)
11. Labors —(5)
Post Office Box 6815541 Orlando, Florida 32868-1554
office 407.298.69361 Fax 407,290,1217
w!AoLw.rnirnsconstructionxorn