2221 PBA 19/20-71 Ferguson Ent - piggyback contractTo: City Clerk/Mayor 1,
RE: Plumbing Supplies- Ferguson Enterprises
The item(s) noted below is/are attached and forwarded to your office for the following action(s):
❑
Development Order
F]
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
F-1 Return copies
D
Special Instructions:
1- .v r3o1a.&zi4eAr
From
SharePoint—Finance—Purchasing_Foriiis - 2018.doc
51712-02-0
Date
Ferguson Enterprises, LLC Piggyback Contract (PBA 19/20-71) Relating To
Plumbing Supplies
The City of Sanford ("City") enters this "Piggyback" Contract with Ferguson
Enterprises, LLC, a Virginia limited liability company, which formerly conducted business
as Ferguson Enterprises, Inc., (hereinafter referred to as the "Vendor"), whose address
is 12500 Jefferson Avenue, Newport News, Virginia 23602, under the terms and
conditions hereinafter provided. The City and the Vendor agree as follows:
(1). The Purchasing Policy for the City of Sanford allows for "piggybacking"
contracts. Pursuant to this procedure, the City is allowed to piggyback an existing
government contract, and there is no need to obtain formal or informal quotations,
proposals or bids. The parties agree that the Vendor has entered a contract with the
Government of Volusia County, Florida, said contract being identified as the "Master
Agreement" for plumbing supplies, "Solicitation Number: 17-B-109VB", as may have
been amended from time -to -time, in order for the Vendor to provide an array of
plumbing supplies and related goods and services to the City as the City may deem
desirable under the provisions of this Contract (the original contract being referred to
herein as the "original government contract").
(2). The original government contract documents are incorporated herein by
reference and is attached as Exhibit "A" to this Contract. All of the terms and
conditions set out in the original government contract are fully binding on the parties
and said terms and conditions are incorporated herein; provided, however, that the
City will negotiate and enter work orders/purchase orders with the Vendor in
accordance with City policies and procedures for particular goods and services. All
pricing shall be F.O.B., City Hall, City of Sanford with most favored nation pricing.
(3). Notwithstanding the requirement that the original government contract
is fully binding on the parties, the parties have agreed to modify certain technical
provisions of the original government contract as applied to this Contract between
the Vendor and the City, as follows:
(a). Time Period ("Term") of this Contract: (state N/A if this is not applicable).
N/A. Notwithstanding any provisions, however, this Contract shall not be operative
for a period of time exceeding 5 years.
(b). Insurance Requirements of this Contract: N/A.
(c). Any other provisions of the original government contract that will be
modified: (state N/A if this is not applicable). N/A.
(d). Address change for the City: Notwithstanding the address and contact
information for the government entity as set out in the original government contract, the
Vendor agrees that he/she/it shall send notices, invoices and shall conduct all business
with the City to the attention of City Manager, at: City of Sanford, 300 North Park Avenue;
Sanford, Florida 32771. The City Manager's designated representative for this Contract
is:
Ms. Marisol Ordofiez
Purchasing Manager
Finance -Purchasing Division
City of Sanford
Post Office Box 1788
Sanford, Florida 32772
Phone: 407.688.5028
E-mail address: Marisol.Ordonez@Sanfordfl.gov
(e). Notwithstanding anything in the original government contract to the
contrary, the venue of any dispute will be in Seminole County, Florida. Litigation between
the parties arising out of this Contract shall be in Seminole County, Florida in the Court
2
of appropriate jurisdiction. The law of Florida shall control any dispute between the parties
arising out of or related to this Contract, the performance thereof or any products or
services delivered pursuant to such Contract.
(f). Notwithstanding any other provision in the original government contract to
the contrary, there shall be no arbitration with respect to any dispute between the parties
arising out of this Contract. Dispute resolution shall be through voluntary and non-binding
mediation, negotiation or litigation in the court of appropriate jurisdiction in Seminole
County, Florida, with the parties bearing the costs of their own legal fees with respect to
any dispute resolution, including litigation.
(g). All the goods and services to be provided or performed shall be in
conformance with commonly accepted industry and professional codes and standards,
standards of the City, and the laws of any Federal, State or local regulatory agency.
(h).
(1). IF THE CONTRACTORIVENDOR 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.
(II). In order to comply with Section 119.0701, Florida Statutes, public
records laws, the Vendor must:
(A). Keep and maintain public records that ordinarily and necessarily would
be required by the City in order to perform the service.
(B). 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.
(C). Ensure that public records that are exempt or confidential and exempt
from public records disclosure requirements are not disclosed except as authorized
by law.
(D). Meet all requirements for retaining public records and transfer, at no
cost, to the City all public records in possession of the Vendor 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.
(III). If the Vendor does not comply with a public records request, the City
shall enforce the contract provisions in accordance with this Agreement.
(IV). Failure by the Vendor to grant such public access and comply with public
records requests shall be grounds for immediate unilateral cancellation of this
Agreement by the City. The Vendor shall promptly provide the City with a copy of any
request to inspect or copy public records in possession of the Vendor and shall
promptly provide the City with a copy of the Vendor's response to each such request.
4
(i). All other provisions in the original government contract are fully binding on
the parties and will represent the agreement between the City and the Vendor.
Entered the date last set forth below or, in the event that the Vendor fails to date,
the date of execution by the City.
Attest:
" < - q-:
Greg Pullis
Municipal Sales ep
Attest:
Ferguson Enterprises, LLC, a Virginia
limited liability company.
By:
Justin ontandon
Manager
Date: L -I It
City Of Sanford
Ll j PP 0 By:
Traci Houchin, City Clerk, CMC, FCRM Jeff
Approved as to form and legal suffi ien*."
Q ?�KeIWCTty Ak0mE6,/'
/"o /V f &V1 J 2)
5
Exhibit "A"
[Attach original government contract]
411
Volusia County
FLORIDA
Date Issued: 08/17/2017
TERM: 2017-08-07 to 2020-08-07
NO. 870 3945 - 1
Page 1 of 2
Vendor contact:
County contact:
Unit
Bill To:
Name: JUSTIN MONTANDON
Name: PHILLIP DREWRY
67000
County of Volusia
Phone: 407-859-7473 Ext.:
Phone: 386-248-1760 Ext,:
AS REQUIRED BY
E-mail: JUSTIN.MONTANDON@FERGUSON.CC
E-mail: pdrewry@volusia.org
USING DEPARTMENT
VOLUSIA COUNTY, FL 32720
Vendor Name: Vendor No.
FEE22900000
Ship To:
FERGUSON ENTERPRISES INC
AS REQUIRED BY
USING DEPARTMENT
801 THORPE ROAD
VOLUSIA COUNTY, FL 32720
ORLANDO, FL 32824-8016
Purchasinq
VICTORIA BERTLING
Solicitation Number: 17-B-109VB
Phone:
386-626-6626 Ext:
E-mail:
vbertling@volusia.org
Award Date: 2017-07-20
Payment Terms:
Net 45 Days, FOB Dest, Freight allowed
Award Authorization: COUNCIL
Document Description:
Plumbing Supplies
Line
Item
Commodity
Code
Unit
Description
Unit Price or
Contract Amount
1
67000
EA
Plumbing supplies with discounts per attached price list
0.000000
rrlr �- k -
Jeaniene Jennings CPPB
Purchasing & Contracts Director
Remainder of page is blank
County of Volusia
Sales Tax Exemption Number
85-80126223930-9
A delivery order is required for the release of items / services from the referenced Master Agreement If a solicitation number is referenced then the terms and conditions of
said solicitation become part of the Master Agreement. Deviation from prices stated is not permitted without a signed corrected Change Order.
If vendor terms and conditions conflict with Count of Volusia Terms and Conditions, the County's Terms and Conditions prevail. See reverse side for terms and conditions.
File Number: 4857
Date: 07/20/2017 AGENDA ITEM
Page 1 of 2
Item: I
1 0 Ordinance ( p Resolution 1 [] Budget Resolution I [X] Other I
County Goals
0
Thriving
n
Economic &
0
Excellence In
[X]
NA
Communities
Financial Vitality
Government
Department: Business Services
Division: Central Services
Subject: Agreements for plumbing supplies, 17-13-109VB.
Rhonda Orr Jeaniene Jennings Legal County Manager's Office
Director Business Director Purchasing
ServicesDaniel D. Eckert Donna de Peyster
. _j� County Attorney Deputy County
C. l Director Legal Manager
Approved in Department
Department Approval Accordance with
Purchasing Policies and Y"
Procedures
George Baker Tammy Bong Approved as to Form
f Director Management and Legality
' and Budget
l
Division Approval
Approved as to Budget
Requirements
Council Action: Approved As Recommended
Modification:
Fund Number(s): Description: Amount:
001 General Fund 001-870-4000-4611 Facility Maintenance $47,000.00
Materials
999 Various Countywide $86,000.00
Total Item Budget: $133,000.00
Staff Contact(s): Phone: Ext.
Rhonda Orr 386 822 5738 15738
George Baker 386 254 1595 11850
Summary/Highlights:
The county received four bids to provide plumbing supplies, as detailed on the attached
recommendation of award sheet. Staff recommends a multiple award to Ferguson Enterprises,
Inc., Daytona Beach, FL; Hajoca dba Gorman Company, Holly Hill, FL; Hajoca dba Hughes
Supply Daytona, Daytona Beach, FL; and Osceola Plumbing Supplies and Well Drilling, Inc.,
Holly Hill, FL for an initial term of three years with two subsequent one-year renewals upon
county council approval. Awarding the contract to multiple vendors will allow staff to purchase
at locations closest to the need and also provide competitive pricing for larger projects.
Budget 2-2
File Number: 4857
Page 2 of 2
Estimated annual expenditures are approximately $133,000. While central services is the lead
for this agreement, it will be available for county -wide use.
A copy of the solicitation (agreement) is attached. Copies of the full agreements (contracts)
and applicable exhibits with the same terms and conditions as described in the solicitation are
available in the purchasing and contracts division.
Recommended Motion: Approval.
Budget 2-2
SUBMIT TO:
COUNTY OF VOLUSIA
PURCHASING & CONTRACTS
123 W. INDIANA AVE., RM. 302
DELAND, FL 32720.4608
AN EQUAL OPPORTUNITY EMPLOYER
CONTACT PERSON: INVITATION TO BID
Vikky Bertling .....................386-626-6626
Email: ..................... vbertling@volusie.org www.volusia.org/ourchasing
DELAND: ........................... 386-736-5935
DAYTONA BEACH: ........... 3W257-6000
NEW SMYRNA BEACH: .... 386-423-3300
TITLE: NUMBER: SUBMITTAL DEADLINE:
Plumbing Supplies 17-B-109VB Tuesday June 6, 2017,
at 3:00 p.m., EST
DO NOT RESPOND TO THIS SOLICITATION ON LINE — SEE SECTION 2.5, DELIVERY OF BIDS
PRE BID DATE, TIME AND LOCATION:
SUBMnTALS RECEIVED AFTER
A pre-bid conference will be held in the Management & Budget A BOVE DA TE AND TIME WILL NOT
Conference Room, 123 W. Indiana Avenue, 3rd Floor, Deland, FL, at 10:00 BE CONSIDERED
a.m., EST, Tuesday, May 16, 2017
Matthew Venier
FIRM'S NAME:
840 Jimmy Ann Dr.
MAILING ADDRESS:
Daytona Beach, FL 32114
CITY — STATE — ZIP:
matthew.venier@ferguson.com
E-MAIL ADDRESS:
888-334-0004
PHONE NUMBER:
888-334-8112
FAX NUMBER:
The vendor acknowledges that Information provided In
this Bid Is true and correct and agree to all terms and
conditions contained intvis Pid and related Exhibits.
je
A171 prized Signature Date
Matthew Venier
Printed Name
Outside Sales - Commercial MRO
Title
FEDERAL I.D. or SOCIAL SECURITY NUMBER:
54-1211771
THIS FORM MUST BE COMPLETED AND RETURNED WITH YOUR RESPONSE
17-13-10M, Plumbing Supplies.docx
Page I of 33
2017 FOREIGN PROFIT CORPORATION ANNUAL REPORT
DOCUMENT# 855377
Entity Name: FERGUSON ENTERPRISES, INC.
Current Principal Place of Business:
12500 JEFFERSON AVENUE
NEWPORT NEWS, VA 23602
Current Mailing Address:
P.O. BOX 2778
NEWPORT NEWS, VA 23602
FEI Number: 54-1211771
Name and Address of Current Registered Agent:
CORPORATE CREATIONS NETWORK INC.
11380 PROSPERITY FARMS ROAD #221E
PALM BEACH GARDENS, FL 33410 US
FILED
Apr 26, 2017
Secretary of State
CC1554006748
Certificate of Status Desired: No
The above named entity submits this statement for the purpose of changing Its registered office or registered agent; or both, in the State of Florida.
SIGNATURE:
Electronic Signature of Registered Agent Date
Officer/Director Detail :
Title
TREASURER, DIRECTOR
Title
PRESIDENT, DIRECTOR, CEO
Name
KELTNER, DAVID L
Name
ROACH, FRANK W
Address
12500 JEFFERSON AVENUE
Address
12500 JEFFERSON AVENUE
City -State -Zip:
NEWPORT NEWS VA 23602
City -State -Zip:
NEWPORT NEWS VA 23602
Title
DIRECTOR, COO
Title
DIRECTOR
Name
MURPHY, KEVIN M
Name
CROSS, JAMES K
Address
12500 JEFFERSON AVENUE
Address
12500 JEFFERSON AVENUE
City -State -Zip:
NEWPORT NEWS VA 23602
City -State -Zip:
NEWPORT NEWS VA 23602
Title
DIRECTOR
Title
DIRECTOR
Name
WILCOX, JOHN L
Name
VANDERVENNET, KEITH D
Address
12500 JEFFERSON AVENUE
Address
12500 JEFFERSON AVENUE
City -State -Zip:
NEWPORT NEWS VA 23602
City -State -Zip:
NEWPORT NEWS VA 23602
Title
DIRECTOR, SENIOR VICE PRESIDENT
Title
DIRECTOR
& SECRETARY, CHIEF LEGAL
Name
PETOCK , STEVEN D
OFFICER
Name
LEMERE , MARY ANN G
Address
12500 JEFFERSON AVENUE
City -State -Zip:
NEWPORT NEWS VA 23602
Address
12500 JEFFERSON AVENUE
City -State -Zip: NEWPORT NEWS VA 23602 Continues on page 2
I hereby carffy that the Infemragon indicated on this report orsupptamental report is true and accurate and that my etoctronic signature shall have the same legal effect as if made, under
oath; that 1 am on after or dkeclor of the corporation or the receiver or trustee empowered to execute this report as required by Chapter fief, Florida Statutes; and that my name appears
above, eon an attachment wr7h all other hka empowered.
SIGNATURE: FRANK W. ROACH, PRESIDENT DIANA SERRA AS 0412612017
ATTORNEY-IN-FACT
Electronic Signature of Signing Officer/Director Detail Date
Officer/Director Detail Continued .
Title
DIRECTOR
Name
GROSSLIGHT, STEVEN F
Address
12500 JEFFERSON AVENUE
City -State -Zip:
NEWPORT NEWS VA 23602
Title DIRECTOR
Name RUSSELL, W. SCOTT
Address 12500 JEFFERSON AVENUE
City -State -Zip: NEWPORT NEWS VA 23602
Title
ASSISTANT SECRETARY
Name
MEEKER, DAVID N.
Address
12600 JEFFERSON AVENUE
City -State -Zip:
NEWPORT NEWS VA 23602
Title
ASSISTANT SECRETARY
Name
BLANKINSHIP, JOHN R.
Address
12500 JEFFERSON AVENUE
City -State -Zip:
NEWPORT NEWS VA 23602
Title
DIRECTOR
Name
ROZNOWSKI, STEVEN M
Address
12500 JEFFERSON AVENUE
City -State -Zip:
NEWPORT NEWS VA 23602
Title
ASSISTANT SECRETARY
Name
GALLO, ERIC A.
Address
12500 JEFFERSON AVENUE
City -State -Zip:
NEWPORT NEWS VA 23602
Title CFO, DIRECTOR
Name BRUNDAGE, WILLIAM S.
Address 12500 JEFFERSON AVENUE
City -State -Zip: NEWPORT NEWS VA 23602
5/22/2017 . 2017
TO: County of Volusia, Florida
Office of Director of Purchasing and Contracts
123 W. Indiana Avenue, Room 302
Deland, FL 32720-4608
The undersigned hereby declare(s) that [firm name] Ferguson Enterprises, Inc
has carefully examined the specifications to furnish Plumbing
Supplies, for which Bid Submittals were advertised to be received no later than 3:00 p.m., EST,
on Tuesday June 6, 2017, and further declares that the firm will furnish the Plumbing Supplies
according to specifications.
Complete Attachment A and return with bid submittal
(Open Attachment A from website, perform "file save as' and save spreadsheet to your computer. Fill in
pricing, preferably electronically.)
documents.
The County reserves the right to negotiate with the awarded vendor for additional services
similar in nature not known at the time of Bid closing.
Sole Proprietor ❑ Yes ❑ No Total number employees ...............
F.O.B. Destination, freight allowed
The following information is required in order to be granted a price redetermination.
Assuming that the prices quoted include costs for vehicles, maintenance, repair, insurance, fuel,
wages, insurances and other employee benefits, materials, overhead, operating expenses, etc.,
what percentage of the rate is directly attributed to the cost of fuel? ............................ %
Which does the firm use: ❑ Diesel fuel or ❑ Gasoline?
Assuming that the prices quoted include costs for vehicles, maintenance, repair, insurance, fuel,
wages, materials, overhead, operating expenses, etc., what percentage of the rate is directly
attributed to the cost of wages? ..................................................................................... %
Assuming that the prices quoted include costs for vehicles, maintenance, repair, insurance, fuel,
wages, insurances and other employee benefits, materials, overhead, operating expenses, etc.,
what percentage of the rate is directly attributed to the cost of materials? ................... .... %
Delivery / Availability:
Prompt payment discount, if applicable: NIA N/A Days; Net 45 Days
Do you accept electronic funds transfer (EFT)? VYES ❑ NO
Do you offer a discount for electronic funds transfer (EFT)? ❑ YES, _ % Mt NO
17-13-109V13, Plumbing Supplies.docx Page 15 of 33
The County of Volusia reserves the right to reject any or all proposals, to waive informalities, and
to accept all or any part of any proposal as may be deemed to be in the best interest of the County.
I hereby certify that i have read and understand the requirements and terms and conditions of
this Invitation to Bid No. 17-B-109VB, "Plumbing Supplies", including all exhibits and
attachments {as amended} and that 1, as the Bidder, will comply with all requirements, and that I
am duly authorized to execute this proposal/offer document and any Agreement{s} and/or other
transactions required by award of this ITB.
Further, as attested to by below signature, I will provide the required insurance, per Exhibit 11,
Insurance, upon notification of recommendation of award.
X
that information provided in this Bid is true and correct:
1.0.
Matthew Venier
Printed Name
Outside Sales - Commercial MRO 5/22/2017
Title Date
Ferguson Enterprises, Inc
Company Name
840 Jimmy Ann Dr, Daytona Beach, FL 32114
Full Address
888-334-0004 888-334-8112 contact.centera@ferguson.com
Telephone Fax E-mail Address
Dunn & Bradstreet # Federal I.D. #
54-1211771
17-B-109VB, Plumbing Supplies.docx Page 16 of 33
6.0 REFERENCES �-• t � - Q , ` _,C--�T PAOC_�
Agency #1
Address
City, State, ZIP
Contact Person
E-mail
Phone:
Date(s) of Service
Type of Service
Comments:
Agency #2
Address
City, State, ZIP
Contact Person
E-mail
Phone:
Date(s) of Service
Type of Service
Comments:
Agency #3
Address
City, State, ZIP
Contact Person
E-mail
Phone:
Date(s) of Service
Type of Service
Comments:
17-B-109VB, Plumbing SuppliesAocx Page 17 of 33
12500 Jefferson Avenue
Newport Naws, VA 23002-4314
Phone: (767) 074-7795
FAC: (757) 988-2501
Reply to: P.O. Box 0400
Hampton, VA 23070
RE: Credit References
To Whom It May Concern:
We are sending this letter and credit Information to Introduce you to Ferguson Enterprises, Inc., Its divisions and subsidiaries (W-9
attached). This letter and Uie enclosed data contain information needed for credit analysis. Due to the volume of credit applications
requested daily, rve do not complete vendors' credit appkeallons
Ferguson Is the nation's largest wholesale distributor of plumbing, pipe valve and fittings, HVAC, watenvorks and industrial
products. Please refer to our Dun & Bradstreet credit report under Ferguson Enterprises, Inc., Newport News, Virginia for additional
financial Information. Our current Dun & Bradstreet raling is 6A2.
Ferguson Enterprises, inc., a Virginia corporation, was founded in July 1953; today we operate over 1,400 locations In 50 states,
the District of Columbia, Puerto Rica, Mexico, and the Caribbean. Since June 1992, we have operated as a wholly owned
subsidiary of Wolseloy plc, a publicly traded United Kingdom corporation. Consolidated financial statements for Wolseley are
Included In Its annual report available online at tvww. wolseley. coni. Accordingly, we are prohibited from distributing out Internal
financial statements.
We require purchase order numbers on all invoices. All accounts will be paid in accordance with our purchase order payment terms
unless agreed otherwise at the time of order placement, In width case we will pay In accordance with the agreed upon terms.
Please send all POs1 invoices, If possible, to the purchasing location or to Ferguson Headquarters, P.O. Box 9406, Hampton, VA
231370. if Interested In sending invoices electronically rather than via postal mail, please contact PEI at 767-999-4011 in order to
discuss possibilities.
Arrangements have been made with the trade references and banks listed on the attached Credit fnformallon Data Sheet, please
feel free to contact them. Ali Information obtained shall solely be used for the purpose of granihng credit,
Thank you for your consideration In opening our account.
For questions, please contact Ferguson location snaking; purchase or 767-989-2456.
Sincerely,
FERGUSON ENTERPRISES, INC,
William S. Brundage
Senior Vice President of Finance
Enclosure
160 F p{E�� R@�gOa,l;pid7p {{}ON ppo7S ppppp C
12600 dotterson nvanuo
Novena! Nows, VA 29602.4314
CREDIT INFORMATION DATA l—lEC-T
CORPORATE OFFICERS: Frank W. Roach, CEO
Dave L. Kellner, CFO
Willtani S. Brundage, Sr. VP of Finance
Mar yAnn Lemere, Chief Legal Officer
PRINCIPAL BUSINESS ACTIVITY: Wholesale distributor of plumbing, pipe valve and fittings, HVAC,
waterworks and Industrial products.
NAIL Codes: 423610, 423710, 423450, 238220, 423830, 423720
SIC codes- 5074, 6086, 8076, 800A, X051, 5084, 3089
EC-DERAL TAX NU191" :64-1211771 DUN'S NUMBER: 00.896.5171
TRADE REFERENCES
American Brass & Iron
Attn: Credit Manager
Moen Faucet
Attn., Doug Hill
26300 At Moen Dr
N113C0
Attn: Credit Mqr
P.O. Box 1167
Charlotte Pipe &Foundry
P.O. Box 36430
7825 San Leandro St
Oakland, CA 94621
North Olmstead, OH
44070
Elkhart, W 40515
Charlotte, NC 28235
Phone 800-408.4766
Phone 574-205-3000
Phone 800-438.8091
Fax 510-632.8035
Fax: 440.962.2780
Fax 574-295-3307
Fax 800.553-1605
Della Faucet
Written Confirmations Only;
66 E 111 Street
Kohler Company
Indianapolis, IN 46280
Ain: Credit References
Fax: 317-573-3401
444 Highland Drive
Attn: Joanne Johnson
Kohler, WI 53044
BANKING REFERENCES on deposit accounts only
PNC BANK Account #1019286322; Credit Investigations Department; Credit References
Via E-mail: Invests ationst: }a pnc.com or Fax: 215-749-6191
You must provide PNC with the 'following;
o This signed page, dated the day you send to PNC
a Your phone number, address & fax number
PNC will respond within 1.5 business days
OTE: SIGNATURE T4 RELEASE PNC SANKINa INFORM TION RO rE ECC U POSES ON
Vl 00 Brenda Crowder, Director of Treasury Date
_------ -_ _-_� ------------------------------------------- -------------
Bank of America Account it 3752290835
Credit Inquiries are handled through www.bankvod.com
Information Provided: Open date, type of account anti average "collected" balance. United loan Information
can also be provided If specifically requested.
**Applicable fee will be billed directly by www.bankvod.com**
Same Day Service - $25.00 per Request
a Request must be received prior to 3:00 p.m.
a Mail requests aro not accepted.
Three -Day (non-priority) Service - $10.00 per Requests are processed within 3 business days of receipt`of
the applicable charge then faxed to the requester.
Page 2 of 2
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0 )"a,(sesInstructions) Y
I Vrptntovza.-um:tvat•.,tcatsE6uat1SJ
!
c Add ones (number, attest, and api, at aulto no.)
ttaquostcr'a name and addtwo (optiana9
12600 Jefferson Avenue
y
a City, state, and VP code
ea
Newport News, VA 23602.4314
7 Lfataccount numbers) It un (aptiorul)
•
Taxser ide tlttcfftian_Number (TIN)
Enter your TEN to the applopitate box. The T(N provided must match ilie name given on One ) Ittnvohl
Social
seatuily
number
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-
hookup gallon, sofa , For ietor,duats, otta Is 1laamruiy your social I Irstru number {SSI}. However, fora
rastdani nitotr, sofa proprietor, tar dtsreftardud ont(ty, sou tits Pari [ Instrucltans on guys S. For oilierFM-
nnaraina 111a, "!'r arnninvtu htnnlf0rn4lnn nunif artrIM. if vara do not pave a ituinbtar. See How to not a
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71N an page 3. or
Nato. it the account is h1 more than one nonte, seethe Instructions for line 1 and the chart on page d for
guidelines an whosa numbarto enter.
dor pennfOes of parjury, i cattily that!
The nurnbur shows) on this tam is lily carect laxpayor identification Amnber (or b am waiting for n nwnNr to be Issued to me); and
2. 1 tun not subject to backup withholding because; (a) t am exempt (ran backup lifthol(Ong, or (b) ) have not been notified by tits httanut Revanue
Service (IRS) that I um subject to backup vdthhoiding as a result of n fafiurs to fepat nit interest or dividends, or (a) the IRs hes notified me that I am
no longer subject to backup withholding; and
3. 1 am a U,8. citizen or otter U.S, person (def(ned batcv4; and
A. The FATCA codc(s) antoted on this tam (lit any) fadfoniktg that t am exempt from FATOA rupolthig is correct.
Corifftcatlon Instructions. You must cross out item2 above it yore finite been notified by Ilia IRS that you are ctaralttiy subject to backup wlhholding
because you have fatted to ropott all Intorest and dividends on yotx lax return. Per roal estate transaction, flan 2 does not apply. For mortgugo
Internal paid, acquisition or abandonment of secured ptopetty, cancellation of debt, contributions to an Individual retirement turtutgament (1114), and
ganaralty, payments other than intatost and dividends, you are not required to alga the eertittcatton, but you must provide your eorr(et'TIN. Saa the
Instructions an page 3.
Sign I Signature of
Here I U.S, oersonl} t'/-?.........•..... If M
General Instructions
Ssctisan rotoronaas aro to rho fnteroal Rmaxato Curio avt�5onim�nfsa noteta.
Futurn davotopntonta. falatmadon about davdopmunla alkotinu Forna VI -S (such
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Purpose of f=orm
M Ind)v dual or entity(l:onn W-0 tequester) who as ra(pllfed to Me an Information
Tatum wall Ute UIS must otiMnyyour correct taxpgyvr Ydanveca(!on aunnber (MI)
which may be your sold seoudiy numinf (SSM tn"dual burpayer (dsaiRkcatian
number #11N), Adoption taxpayer ldontiDantWn number 01RI). of amp oyat
Idon1>Icallon nombor (EM. to (apart on an hafortnalIon rotum tho amount Pad to
you, or anter amount ra)xut41*1 on an Intatnnailonretum. Eaamp'.os of in(amiaiton
taturns Include, but aro not smiled to, the ta0ovt44g!
• Faint 1000,414T (interest coined at paid)
• foJnt 1000,01V (dbiidsuds; Including those from stacks or mutual hands)
t form 1090-MI5C (vruious types of Income, f lzes, awmtlk orgtoss procasds)
• fuml 1MR-11(atockortaautuni Judd sa1as and cwtaki alhit ftnnracifws by
trokols)
• tam 100g•3(Proceeds from fuel ealato transactions) -
t Farm 1000-K (tnnmhant card and third party network Initwellons)
• Fam Togo (;tomo moatga<le Iaterasi), tagg-ri (student loan latoro3l),1098 T
(luakon)
• roml 1040.0 (canca!ad dobt)
• Form IM-A(acquisitionorabandorvtrontof sec(eed pmpetty)
Use, form w.0 only fl you are it U.S. poison (including a tas?dont atlon), to
provide, your correct 71M.
Myou do not slum Form Vya to the rerruosturwilli a TIM. )bar MIP) ai be, a4MM
do NWAVO wttnflowng, See Met h bact via 17HI M CI 9 an pago 2.
By slgnlag tho filled. old form, you:
1. Certify duet Iia TIN yen are giving is eeriest (or you Eve wAhm rot a n am1wr
to bo low n),
2. CotWfliat yWi aru not sulApet to bzckup attlhtto!dfng, of
3. Chdnt oxceaption from backup ttdthtwfdrnglfyou ale s U.S. oxotnpt Pay00.If
applicable,
rippati ei�i aIncome froml o V S. Wideo U.S.
no nasal sa��ibio the ro of
whhhold;ng Lai on fore$n padnrra'sham of otfeciiwly, con, rwAad Income, and
A. Cattily that. FATCAcode(s) entoted on this (Olin (d (ny) ind icaling that you are
oxampt rani the FATCA repoding, Is careot. Sea Vft t is FATCA roporihtg9 an
Page 2 for fulthef fnforwPol.
oat. No,1023IX Farrah W -ti plev. 12.20te)
Alaska Pipe & Supply
rlitdrews Lighting & Hardware
The Ar -!ay Center
BAC Appliance Center
Bath + Beyond
Bruca-Rogers Company
Cal -Steam
City uphts Design Showroom
CFP
Cline Contract Sales
Davies Water
Dealernet
Ferguson Enterprises, Inc. utilizes the following DBA names.
ae . Tax ID No. Entity Name Tax Ib No.
1C.i T-
54-1211771
54-1211771
54-1211771
54-1211771
54-1211771
54-1211771
54-1211771
54-1211771
IEauarius Waterworks. Meter & Automation Group 154-1211771 1
Fergusolt Bath & Kitchen Gallery 54-1211771
Fereuson Batt. Kitchen and Liehtine Gallery 54-1211771
Ferguson Direct
Ferguson Enterprises, Inc.
Ferguson Facilities Supply.
Ferguson Fire & Fabrication Internal
Ferguson Heating & Cooling
Ferguson Hospitality Sales
Ferguson HVAC.- Air Cold
Ferguson HVAC - EastWest Air
Ferguson HVAC - Lon Conklin
Ferguson integrated Services
Farausmt intemational
Parts & Packaging
Valve &Automation
Waterworks
Waterworks- Municipal P1
Waterworks- Red Head
Waterworks EPPCO^
Waterworks htternationai
ath & Kitchen Showplace
.1 -Up A141110117/16
771
54-1211771
54-1211771
54-1211771
54-1211771
54-1211771
Groenl er & Company
54-1211771
Industrial Hub of thst Carollmrs
54-1211771
J & G Products
54-1211771
LD. Daddario Cont ran
54-1211771
Joseph G. Pollard Co
54-1211771
Karl's Appliances
54-1211771
Lincoln Products
511-1211771
Unwood Pipe and Supply
54-1211771
Louisiana Utilities Sulky Company
544211771
LUSCO
54-1211771
Michigan Metar
54-1211771
Mississippi Utility Suri Co. MVSCt7
54.1211771
PL Sourcing
54-1211771.
Numb Source
54.1211771
Plumbing Decor
54.1211771
Pollardwater
54-1211771
Powell Ptpe & Supply Co.
54-1211771
Professional's Bath Source
54-1211771
Ramapo Wholesalers
54-1211771
Renwes Sales
54-1211771
Redlon & Johnson
54-1211771
Reese Kitchen Bath & U&MIg Gallery
54-1211771
SG Supply Co.
54-1211771
SOS Sales
54-1211771
Tarpon Wholesale Sup Iles
54-1211771.
The Davidson Group
54-1211771
The stock Market
54-1211771
TPW Kitchen & Bath
54-1211771
Waterworks Industries
54-1211771
Webb Distributors
54-1211771
Western Atr Supply
54-1211771
Westfield Lighting
54-1211771.
Wolseley Financial Services
54-1211771
Wolseley industrial Group
54-1211771
WPCC Forwarding
54-1211771
Authorized paper check lockbox remittance used by Ferguson Enterprises, inc,
PEI ff (Main branch number)
PO Box 100280
Atlanta, GA 3038402813
OVERNIGHT - PKGS
Bank or America Lookbox Services
FEI # (Main branch number)
Lockbox # 100286
6000 Feldwood Road
College Park, GA 30349
FEI # (Main branch number)
PO Box 417592
Boston, MA 02241-7592
OVERNIGHT - PKGS
Bank of America Lockbox Services
FEI # (Main branch number) LBtt 417892
MA5-527-02-07
2 Morrissey Blvd.
Dorchester, MA 02125
FEI flMain branch number)
PO Box 847411
Dallas, TX 75284-7411
OVERNIGHT - PKGS
FEI # (Main branch number)
Lockbox # 8,17411
1950 N. Stemmons FRWY
Ste. 5010
75207
BOA- Los Angeles -749M(
FEI # (Main branch number)
PO BOX 740827
Los An eles CA 90074-0827
OVERNIGHT • PKGS
Bank of America Lookbox Services
FEI # (Main branch number)
Lockbox 740827
2706 Media Center Drive
Los Angeles, CA 80065-1733
PNC - Chicago - 802817 MI
PEI # (Main branch number)
PO Box 802817
Chicago, IL 60680-2817
OVERNIGHT - PKGS
Ferguson Gnierprises Iris
Lockbox 802817
360 East Devon Avenue
FEI # (Main branch number)
PO Box 827066
PNC Bank
Lockbox 827066
Route 38 and East Gate Drive
Moorestown, NJ 08067
# (Main brands• number)
Box 644054
PNC Bank
Lockbox 644064
Firstside Center
500 First Avenue
Pittsburgh, PA 15219
Weiss Fargo Bank
Dent # 34261
PO BOX39000
San Francisco CA 94139
Wells Fargo Bank
Lockbox 043090
MIS 90
PO Box 4300
Portland, OR 97208
44.0 PROOF OF EXEMPTION
S 1 �
Volusla County
I'LORIDA
certify that the
BUSINESS SERVICES
REVENUE DIVISION
123 W. INDIANA AVE. - ROOM 103 - DELAND, FL 32720-4602
PHONE: 386-736-5938 a FAX: 386-822-5729
www.uolusia.orr�lreWAue
business known as (business name)
,•e-tssloo Q*P-064 NTAL I providing
4t� services, which is located at (street address)
(city) WSJ t 11 , falls under the business tax exemption
described In:
❑ Florida Statute 205.063 ❑ Florida Statute 205.065 ❑ Florida Statute 206.191
❑ Florida Statute 205. 064 ❑ Florida Statute 205. 162 ❑ Florida Statute 205.192
❑ Florida Statute 205.171
www volusla org/revenue/local business taxtbusiness tax frequently -asked -questions stml
OR is the type of business indicated below:
❑ Child Care — Residential ❑ Insurance Adjuster, Agent, ❑ Radio/Television Station
❑ Commercial Rentals or Company ❑ Religious Institution
❑ Door to Door/Peddler Sales ❑ Pharmacist/Pharmacy ❑ Residential Rentals over
6months
(Prescription Drugs Only) ❑ Sale of Alcoholic Products only
"OL�J
(Au orized Signature) (Printed Name)
STATE OF
COUNTY OF f 2 r f�/gle D
Sworn to and subscribed before rhe this day of4G , ZO�, by
j f j►�� 1 �{�/�y)1 �' i+' ho tslare persono known
to me or who has/have produced as identification.
NOTARY PUBLIC — STATE OF
KAREN M. ATKINSON
Notary pubtic - State of Florida
Commission # FF980329
z,? My Comm. Expires Apr 27, 2020
Sonded throuo National Bary Assn.
print name:
17-B-109VB, Plumbing Supplies ioex Page 29 of 33
(Seat)
Expires:
Commission
A business that falls under one of the exempt classifications listed above Is not required to have a Voiusia
County Business Tax Receipt.
Revenue Director/Designee
17-13-10M, Plumbing Supplieshocx Page 30 of 33
,a16. t CERTIFICATE OF LIABILITY INSURANCE page 1 of 2
04/12/20
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions ofthe policy, certain policies may require an endorsement. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER
Willis of Pennsylvania
100 Matsonford Road
Building wive, Suite 200
Radnor, PA 19087^9582
CONTACT
PHONNEFFAX
_ =- 610-964-87.0 I rA+c Not 61_Q-2 . 4-
E -MAI`,
certificates@willis com
INSURER(S)AFFOROINGCOVE•RAGE NAICII
_
INSURE_RA:National Union Fire Ins, Co. of Pittsburg 19445-002
INSURED Ferguson Enterprises, Inc. and Subsidiaries
(See Attached Named Insured Schedule)
INSURERS: National Union Fire Ins. Co. of Pittsburg 19445-000
INSURERC:National Union Fire Ins. Co. of Pittsburg 19445-001
INSURER D: New Hampshire Insurance Company 23841-001
12500 Jefferson Avenue
Newport News, VA 23602
MED EXP (Anyone mon $ 101000.
INSURER E: _.
INSURER F:
nr�lrr_DA n�c� I%CbT1r!d%ATC►!"RAOC15 nch1 0G10 RF111RInN Nt IMRFR•
----------
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 MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN BY PAID CLAIMS.
INSETITR
TYPEOFlNSURANCE
DOL
Slis
POLICY NUMBER
_REDUCED
POL-ICY EFF
POLiCYEXP
LIMITS
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS-MADEFOOCCUR
GL712-9880
/1/2017
5/1/2018
EpEDAA�6CHAt�OCC7CURRFENN7CE $ 2.000.000
PRkA11SES a-SccurEeace) $ l -0 _0Q,
MED EXP (Anyone mon $ 101000.
PERSONAL &ADV INJURY $ 2,000,000
GENI AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE $ 5,000,000
PRODUCTS -COMP/OPAGG $ 2,000,000
POLICY a J� a LOC
$
OTHER:
$
AUTOMOBILE LIABILITY
AOS CA1921927
/1/2017
5/1/2018
COMBINdEDSINGLELIMIT $ 5,000,000
(Eaen
BODILY INJURY(Perperson) $
B
X ANYAUTO
MA CA1921928
/1/2017
5/1/2018
BODILY INJURY(Per accident) $
C
OWNED SCHEDULED
AUTOS
X HIRED NON -OWNED
AUTOS ONLYFXXIDamacre
AUTOS ONLYAUTOS ONLY
X Self- Physical
Insured
VA CA1921929
/1/2017
5/1/2018
Peracckierd $
$
UMBRELLALIAB
OCCUR
EACHOCCURRETICE $
AGGREGATE $
EXCESS LIAR
CLAIMS -MADE
DED I RETENTION $
1 $
1
D
WORKERS COMPENSATION
AND EMPLOYERS' LUIBILITY Y
ANY PROPRIETORIPARTNERIEXECUTiVE( EI
OFFICEWM�E�nnMBEREXCLUDED? i`J
tMvyeeenssdaest�ribe u�
NIA
WCO23102516
/1/2017
5/1/2018
X
EL.EACHACCIDENT $ 2,000,000
E.L.DISEASE -E_AEMPLOYEE $ 2,000,000
E.L. DISEASE -POLICY LIMIT $ 2,000,000
tDESCRIPTIONOFOPERATIONS below
DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required)
See Attached for Additional Workers' Compensation policies:
Workers' Compensation - ME
Policy No. WCO23102515
Carrier: New Hampshire Insurance Company
Policy Period: 05/1/17 - 05/01/2018
Statutory
nr-n•r�r•rn w-rC un1 r%cm r:ANr F:f i ATInN
Coll:5060707 Tpl:2142745 Cert:1591t;blzi 19 11 :i1J-"LUT0 AI:V KV1 UKYVKA 11V11t. All 1-191115 reSDrYGri.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE -
EVIDENCE OF INSURANCE
Coll:5060707 Tpl:2142745 Cert:1591t;blzi 19 11 :i1J-"LUT0 AI:V KV1 UKYVKA 11V11t. All 1-191115 reSDrYGri.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: 031419
LOC#:
AC<>RL>
i&.� ADDITIONAL REMARKS SCHEDULE Page-2—of 2
AGENCY
NAMED INSURED
Ferguson Enterprises, Inc. and Subsidiaries
Named Insured Schedule)
Willis of Pennsylvania
(See Attached
12500 Jefferson Avenue
POUCYNUMSER
Newport News, VA 23602
See First Page
�EFFECTWE
CARRIER
NAfC CODE
DATE; See First Page
,See First Pacje
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER' 1-5 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE
EL Each Accident $2,000,000
EL Disease - Each Employee 2 000 000
EL Disease - Policy Limit $V600,600
Workers' Comm;a8ion - CA
Policy No. ES'291 2514
Carrier: American Home Assurance Company
Policy Period: 05/1/2017-05/1/2018
Statutory
Limits:
EL Each Accident $2,000,000
EL Disease - Each Emploee $2 000 000
EL Disease - Polley Limit $2,666,666
Workers' Com nsation - FL
Policy No. E82310513
Carrier: Illinois National insurance Company
Policy Period: 05/1/2017-05/1/2018
Statutory
Limits:
EL Each Accident $2,000,000
EL Disease - Each Employee�2 000 000
EL Disease - Policy Limit $ 600,600
Workers' Co 231 ion
- MA & WI
Policy No. 023102518
Carrier: Now Hampshire Insurance Company
Policy Period; 05/1/2017-05/1/2018
Statutory
Limits:
EL Each Accident $2,000,000
EL Disease - Each Employee $2 000 000
EL Disease - Policy Limit $2,666,666
Workers' Compengation.- AK,AZ,IL,KY,NC,NH,NJ,PA,UT,VA,VT
PoNo.
Carrier: NewWCO2 10251
Hampshire Insurance Company
Policy Period: 03/1/2017-05/1/2018
Statutory
Limits:
EL Each Accident $2,000,000
EL Disease - Each Em loyee $2 000 000
EL Disease - Policy Eimit $2,600,600
ACORD 101 (2008/01) Coll :5060707 Tpl:214274B Cert: 25418613 (VZUUUAt;UKUL;UKrUKA[tur4.Atirignisreserves.
The ACORD name and logo are registered marks of ACORD
Ferguson Enterprises, Inc. and Subsidiaries.
List of Named Insureds
Air Cold Supply
Air Cold Supply/Webb Distributors
Alamo Pipe & Supply
Alaska Pipe & Supply
Andrews Lighting Gallery, Inc. (dba
Andrews Lighting & Hardware Gallery)
Arkansas Supply, Inc.
Ar -Jay Building Products, Inc. (dba
The Ar -Jay Center)
Atlantic American Fire Equipment Company
Arkansas Supply
The Bath + Beyond
Bruce -Rogers Company
Build.com, Inc.
Builders Appliance Center, LLC
CAL -STEAM, a Wolseley Company
Camellia Valley Supply
Castle Supply Company, Inc.
CastleNorth
Central Pipe & Supply
CFP
Chadwick
City Lights Design Showroom
Clawfoot Supply, LLC
Clayton Group, Inc.
Clayton International, LLC
Cline Contract Sales
Colgan Cabinets
Colgan Distributors
Crow Company
Custom Lighting Incorporated
Custom Hardware and Accessories, Inc.
D & C Plumbing & Heating Supply
Davis & Warshow, Inc.
Davidson Electric Wholesale Supply
The Davidson Corporation, a Delaware
Corporation
The Davidson Group Companies, Inc
Davidson Group Leasing
Davidson Pipe Company Inc., a New York
Corporation
Davidson Pipe Supply Company, Inc.
Davies Water
Dealernet, LLC dba Dealernet
Decorative Product Source, Inc.
E & J Plumbing & Heating Supply Co.
Economy Plumbing and Heating Supply Co.
Endries International, Inc.
Energy & Process Corporation
Equarius, Inc. dba Equarius Waterworks,
Meter & Automation Group
Factory Direct Appliance
Ferguson Bath Kitchen and Lighting Gallery
Ferguson Enterprises IV, Inc.
Ferguson Enterprises of Montana, Inc.
Ferguson Enterprises of Virginia, Inc.
Ferguson Enterprises V, Inc.
Ferguson Enterprises, Inc.
Ferguson Enterprises, Inc. dba WPCC
Forwarding
Ferguson Enterprises, Inc. A Corp of Virginia
Ferguson Enterprises NY — Metro, Inc.
Ferguson Fire & Fabrication, Inc.
Ferguson Fire & Fabrication, Inc. (flea Action
Fire Fab & Supply, Inc.)
Ferguson Fire & Fabrication, Inc. (fka Sierra
Craft, Inc.)
Ferguson Full Service Supply
Ferguson Heating & Cooling
Ferguson Holdings, Inc.
Ferguson Hospitality Sales
Ferguson Industrial Plastics and Pump
Division
Ferguson Integrated Systems Division, Inc.
Ferguson intermountain Piping
Ferguson International
Ferguson Process Services
Ferguson Valve & Automation
Ferguson Waterworks
Ferguson Waterworks - Midwest Pipe
Ferguson Waterworks - Municipal Pipe
Ferguson Waterworks - Red Hed
Ferguson Waterworks EPPCO
Ferguson Waterworks International
Frischkorn, Inc.
Gabriel Scientific & Machine, LLC
Galleria Bath & Kitchen Showplace
Gilmour Supply Company, Inc.
Global HVAC Distributors, Inc.
Ferguson Enterprises, Inc. dba Groeniger
Ferguson Enterprises, Inc. and Subsidiaries.
List of Named Insureds
& Company
Gulf Refrigeration Supply
High Country Plumbing Supply
Home Equipment Company, Inc.
HP Products Corporation
HP Logistics, Inc.
Indiana Plumbing Supply Co., Inc.
Industrial Hub of the Carolinas
J&G Products
J.D. Daddario Company
Joseph G. Pollard Co., Inc.
Kandall Fabricating
Karl's Appliances, A Ferguson Enterprise
Lane Piping Co.
Lawrence Plumbing Supply Co.
Lighting Unlimited, LLC
Lincoln Products
Linwood Pipe and Supply
Living Direct, Inc.
Louisiana Utilities Supply Company
Louisiana Chemical Pipe, Valve & Fitting,
Inc. dba Wolseley Industrial Group
LUSCO
Lyon Conklin & Co., Inc.
Mastercraft Cabinets
Matera Paper Company, Inc.
McFarland Supply Co., Inc.
Michigan Meter Technology
Michigan Pipe &Valve -Flint, Inc.
Michigan Pipe &Valve -Lansing, Inc.
Monotube Pile Corporation
Northern Water Works Supply, Inc.
Onda-Lay Pipe and Rental, Inc.
Page's Appliances
Palermo Supply
Park Supply
PCS Industries d/b/a HP Products Corp.
Pipe Products
Plumbing Ddcor
Plumb Source
Powell Pipe & Supply Company
Power Equipment Direct Inc.
P.V. Sullivan Supply Co., Inc.
R Supply Company
Ramapo Wholesalers
Record Supply Company
Redlon & Johnson
Reese Kitchen, Bath & Lighting Gallery
RenWes Sales
S.G. Supply Company
S.G. Supply Company dba SG Supply Co.,
a Ferguson Enterprise
Siena Craft, Inc.
Signature Hardware
Ship-Pac, Inc. d/b/a HP Products Corp.
SOS Sales
Specialty Pipe & Tube, Inc.
Specialty Pipe & Tube of Texas, Inc.
Stock Loan Services LLC
Summer & Dunbar
Supply North Central Group
Tarpon Wholesale Supplies
T & A Valve Industries, Inc.
The Parnell -Martin Companies LLC
The Plumbers Warehouse
The Plumbing Source Inc.
The Stock Market
Tubeco Fabrication, Inc.
Underground Pipe & Valve Inc.
United Automatic
Water Works Supplies
Webb Distributors
Western Air Systems and Controls, Inc.
Westfield Lighting
WIA of California, Inc.
Wolseley Industrial Group
Wolseley Industrial Plastics
Wolseley Investments Acquisitions, Inc.
Wolseley Investments, Inc.
Wolseley NA Construction Services, LLC
Wolseley North America, Inc.
Wolseley North American Consulting, LLC
Wolseley North American Services, Inc.
WPCC Forwarding
7.0 CONFLICT OF INTEREST FORM
I HEREBY CERTIFY that
(printed
representative
of the firm
a..
name)
, am the
and the duly authorized
of (Firm Name)
whose address is
rt , `9'21.1-1 , and that I
possessthe
legal authority to make this affidavit on behalf of myself and the firm for which i am acting;
and,
2. Except as listed below, no employee, officer, or agent of the firm have any conflicts of
interest, real or apparent, due to ownership, other clients, contracts, or interests
associated with this project; and,
3. This Bid Submittal Is made without prior understanding, agreement, or connection with
any corporation, firm, or person submitting a Bid for the same services, and is in all
respects fair and without collusion or fraud.
EXCEPTIONS to items above
(List):
i�
Signature:
Printed Name:
Firm �^ �p Name:
Date: A5
STATE OF f�C�le
COUNTYOF 131-PV;4(2 t
17-B-I04VB, Plumbing Supplies loch Page 18 of 33
Sworn to and su scribed before me this J`'day of l , 20by
who is/are personally known
to me or who has/have produced
(Seal)
Expires:
�r
'j""'v"r''�
A t3� U 4y
KAREN M. ATKiN80N
¢
Notary Public - state of Florida
•
Commission fir FF980329
'••",9. ;.
My Comm. Expires Apr 27, 2020
Bonded through National Notary Assn
NOTARY PUBLIC — STATE OF
Type or print name:
Commission r
No.:
Commission
as identification.
17-13-109VB, Plumbing Supplies doox Page 19 of 33
C,
COUNTY OF VOLUSIA
PURCI3ASING & CONTRACTS DIVISION
mmm ummrG,. �
123 West Indiana Avenue, Room 302
+u'wGwuaaauww�mmmph'� 6„�
Deland, Florida 32720-4608
Voluslia County (386) 736-5935 o Fax: (386) 736-5972
FLORIDA
May 30, 2017
ADDENDUM NO. 1
Plumbing Supplies
ITB No. 17-B-109VB
TO: All firms interested in providing, the required professional services
The purpose of this addendum is to provide the following clarifications, changes, modifications and/or
additions to the solicitation documents. This addendum is an integral part of the Solicitation/Contract
Documents.
**NOTICE**
Attachments:
0 Due to the fluctuating cost of copper, a revised copy of Attachment A — Price List removing the copper
pipe has been posted to the County website. Failure to submit pricing on Attaclunent A — Revision I
may result in submittal being deemed non-responsive.
Questions:
Q 1: What are the award terms?
A I: i'er l ectita:t d?.1& oftitaa t"i"ii att �c:tri � iil lac tip aawt i::itiatl tltgcte t'l yctas' tern n �witit t➢: ; arptiost t":g° t tt': 3�
s�ibsct w;nt one ( 1) yetir rtmewaals.
Q2: Why are plumbing supplies being rebidded after the initial three (3) years?
?: 'lThe. Ctaunty is ioolcing for sa geographic diversity a��t" t��law�u�biort; sul:wialiffS.
Q: Are the products listed on Attachment A —Price List a full list?
9"it�x i::aaaltatta, Iist:w¢I z:'e :: s«tatait&cot"tlte:�ao.t �:s':I it:��tt:s 8:icl� vil9 bre used Ear licl ccrusp:urisE:di
purposes. `fire County is requawsting a percentage discount ror C':lontra:ctors t1111 cabtalog.
Q: Is the County open to "Keep Stock"?
A: &'1ae Co::¢aty iw: oi�e:: ttx karcl stt��cl<. 'I"9teac i. arra t,tsa:aasttcc, t:9 aai:ti:tta�Airt 1:tarcatat::a�s rr� 1'atturra
expendittores by tits, Cc' jray.
All other terms and conditions remain unchanged.
PND OF ADDENDUM NO. I
Total Pages: 2
If there are any questions, please contact the staff member responsible for this project, Vikky Bertling,
Procurement Analyst 1, at phone: (386) 626-6626 or via E-mail; vbertling@volusia.org.
KATHY WILIVIAMS, MBA, CPPB, CPPO
Procurement Manager
Purchasing and Contracts Division
Please sign and return with proposal 17-B-1 09VB
Vendor: 't—(C I MZ44A 1l5w;$ A—IN/
i
Signed by (Naine/1"osition):
Plione No.: (�A
_N7)(f, -, Date:
III-MAIM.''I"O IM11 MA, 1119PIA11177"41"ll'i V C-1USE 111KITOPOSAI. Yel flPRENDER
Addendum No.1
J.
Attachment A - Price List - Revision 1
�17-B-109VB
VbluP 'county.Plumbin Su hes FLOR1:0A
Ficasfo.a 9 pp
Bidder shall fill out the representative samples of plumbing products listed below.
Note: This information will be utilized as a basis for price comparison of like items between
Contractors
While Bidders are not required to bid on every item listed, substitute manufacturers will
not be accepted due to standardization of parts throughout the County,
06. Attachment A - Price List - Revision l.xlsx 2 of 2
Percentage
Cost to
Sample Item
Current Price
of Discount
Count
Delta 400 Kitchen Faucet
fi
$0.00
Delta 501 Lavatory Faucet
r
$0.00
Delta 2171 Bar Sink
�;rfi
$0.00
Brasscraft #GR19 Angle Stop (5 -pack)
L
$0.00
3/4" Full port Ball -Valve
$0.00
50 gallon/ 220 volt water heater
- r
$0.00
3/4" CPVC - 20 ft.-
OMEM
$0.00
3/4" Sch. 40 PVC Pipe - 20 ft.w
3
$0.00
, m.
2" Sch. 40 PVC pipe - 20 ft.
._v
RIM =
$0.00
Elongated toilet seat, open front - Less Cover {Box of 6}
$0.00
Sloan A -36-A Repair Kit
$0.00
Sloan B-50 Handle Repair Kit
$0.00
Sloan V-551 Vacuum Breaker
$0.00
.-
Sloan 110YB Flushometer
A
7...,w�
$0.00
Fluid Master Pro 45B Ballcocks
$0.00
Korky Red #2001 Flappers
121-10-
$000
Coast Flappers
x
` u
$0.00
PVC Glue - 1 gallon
_
$0.00
PVC Cleaner - 1 gallon
-
$0.00
1 1/2" PVC Master Trap
l Y
$0.00
Elkay EZS water cooler
l'
$0.00
Chicago Metering Vavle MN #: 770-665PSHCP
-
$0.00
Chicago Metering Kit Model #: 667-080KJKABNF
_
$0.00
Liberty 1hp PRG -Series pump
s
$0.00
American Standard 2 piece Commercial Cadet series toilet
=
Y
$0.00
Woodford 3/4" Chrome hose bib
{ r ..r
-
$0.00
06. Attachment A - Price List - Revision l.xlsx 2 of 2
Form -
Request for Taxpayer
Give Form to the
(Rsv.December 2014)Identificattion
Number and Certification
ren, Do not
DapadmentotttioTr�sury
send lia iRS.
to the
krternal Revamro �rvke
1 Name (as shown on your incorn s trot rola m). Nam is regsked an this line; do not leave this erre blank.
Ferguson Enterprises, Inc.
N
2 nuslness nameldisregarded entity name, If different from above
See attached lists for DSAS and lock box remit addresses
u
3 Check appropriate box for federal tax classification; check only one of the following seven boxes:
4 Exemptions (codes apply only to
cetiain entitles, not individuals; see
°
❑ kxkvideaysoie proptkotor or v❑ c corporation ❑ S Corporation ❑ Partnership ❑ Trusttestate
Instructions on page 3):
single -member LLc
❑ Limited liability company. Enter Ills tax classllication (C=C corporation, S=S corporation, P«partnership) P
Exempt payee code of any) 5
`o
Note. For a single -member LLC that is disregarded, do not check LLC; check the appropriate bout in the tine above
Exemption from FATCA reporting
E
•a'',
the tax classification of the single -member owner.
code (f any)
❑Qtirarlaceinsiructions)D
Mppc:sroucowvrM.WA:,sdamnaaurUSI
U
0 Address (number, street, and apt, or suite hie.)
Requester's name and address (optional)
12500 Jefferson Avenue
6 City, state, and 2IP code
cin
Newport News, VA 23602-4314
7 Ust account numbers) hero (optional)
Taxpayer Identification Number IN
Enter your TiN in the appropriate box. The TIN provided trust match the name given on line 1 to avoid
I social security number
backup withholding. For individuals, this is generally your social security number (SSN). However, for a
resident amen, sole proprietor, or disregarded entity, see the Part I Instructions on page 3. For other
[Tfl-M-=-
entities. It Is your ernnlovar Identification number (E1N). If you do not have a number. see Now to Act a
wN on page 3. or
Note. If the account is In more than one name, see the instructions for tine 1 and the chart on page 4 for Employer ident
gulciallnes on whose number to enter.
5 4 — F,
Under penalties of perjury, I certify that:
1. The number stlown on this font is my correct taxpayer Identii)caWn number (or i am waiting for a number to be issued to me); and
2, t am riot subject to backup withholding because: (a) I am exempt from backup withholding, or (b) t 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 (e) the IRS has notified me that I ant
no longer subject to backup withholding; and
3. 1 am a U.S. citizen or other U.S, person (defined below); and
4, The FATCA code(s) entered on this form (it arty) indicating that i am exempt from FATCA reporting is correct,
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 w 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 correct TIN. See the
instructions on page S.
sign Signature of -7
Here I U.S. person I-- •„„ Data P f } 7
General Instructions
Section references are to IN Internal Revenue Code unbess otherwise rioted.
Future developments. Information about developments affecting form W-0 (such
as legislation enacted after we release it) is at ivww.1 mgovlhv9.
Purpose of Form
An individual or entity (form W-0 requasim) who Is required to Ale an infoinwtion
return with the IRS must obtain your correct taxpayer Identification number (TIN)
wtdah may be your social security number (8811), individual taxpayer Identification
number (ITIN), adaption taxpayer Identification nurnher (ATIN), or employer
Identification number (EMI), 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 not limited to, Ilia hollowing:
• Form 1099 -INT (interest- earned or pail)
• Form 1099 -DN (dividends, Including those from stacks or mutual funds)
• Form 1099-MISC (various types of income, prizes, awards, or gross proceeds)
• Form 1099-8 (stack or mutual fund sales and certain other transactions by
brokers)
• Form 1099-5 (proceeds from real estate transactions)
• Form 1099-K.(merchant card and third party network transactions)
• Form 1098 (home mortgags interest), 1098-E (student loan Interest),1008 r
(tuition)
• Form 1099-C (canceled debt)
• Form 1099-A (acquisition or abandonment of secured property)
Use Form W-9 only If you are a U,S. person [including a resident alien), to
provide your carroc(. TIN.
11 you do not return corm W-9 fo the requester with a TtN, you mV it be subject
to backup wittiliokdbog. Soo Wlraf is crackup withholding? on page 2.
By signing tiro filled -out form, you:
I. Codify that the TIN you are giving is correct (or you are waiting for a number
to be Issued),
2. Certify that you are not subject to backup withholding, or.
3. Claim exemption from backup withholding it you are a U.S. exempt payee. If
applicable, you are else codifying that as a U.S. person. your allpcWa share of
any patinership income from a U.S. trade at business is not subject to the
vAthholding tax on foreign partners' share of of factively connected income, and
4. Certify that FATCA codes) entered on this form (if any) Indicating that you are
exempt from the FATCA reporting, Is correct. Sea What is FATCA reporting? on
page 2 for further information.
Cat. No. 10231X Form W-9 (Rev. 12.2014)
Ferguson Enterprises, Inc. utilizes the fallowing DRA names:
Entity Name Tax 1D No. Entity Name Tax ID No.
Alaska Pipe & supply
54-1211771
Industrial Hub of the Carolinas 54-1211771
Andrews Lighting & Hardware Gallery
54-1211771
J & G Products 54-1211771
The Ar -Jay Center
54-1211771
J.D. Daddario Company 54-1211771
BAC Appliance Center
54-1211771
Joseph G. Pollard Co 54-1211771
Bath -r Beyond
54-1211771
Karl's Appliances 54-1211771
Bruce -Rogers Company
54-1211771
Lincoln Products 54-1211771
cal -Steam
54-1211771
Unwood Pipe and Supply 54-1211771
City Lights Design Showroom
541211771
Louisiana Utilities Supply Company 54-1211771
CFP
54-1211771
LUSCQ 54=1217.771
Cline Contract Sales
54-1211771.
McFarland Stipply 54-1211771
Davies Water
54-1211771
Michigan Meter 54-1211771
Dealernet
54-1211771
MISSISSIPPI Utility Supply Co. MUSCQj 54-1211771
E uarlus Waterworks, Meter & Automation Group
54-1211771
PL Sourcing 54-1211771
Factory Direct Appliance
54-1211771.
Plumb Source 54-1211771
!e &u� pn Bath & Kitchen Gallery
54-1211771
Plumbing DAcor 54-1211771
Ferguson Bath, Kitchen and Lighting Gallery
54-1211771
Pollardwater 541211771
Ferguson.com
54-1211771
Powell Pipe & Supply Co. 54.1211771
Ferguson Direct
54-1211771
Professional's Bath Sourco 54-1211771
Ferguson Enterprises, Inc.
541211771
Ramapo Wholesalers 54-1211771
Ferguson Facilities Supply T
54-1.211771
Renwus Sales 54-1211771
Ferguson Fire & Fabrication International
54-1217.771
Redlon &Johnson 541211771
Ferguson Heating & Cooling
544211771
Reese Kitchen, Bath & Ughting Gallery 54-1211771
Ferguson Hospitality Sales
54-1211771
SG Supply Co, 54-:1211771
_
Ferguson MVAC - Air Cold
54-1211771
1
SOS Sales 54-1211771
Ferguson MVAC - EastWest Air
54-1211771
Tarpon Wholesale Supplies 54-1211771
Ferguson HVAC - Lyon Conklin
54-1211771
The Davidson Group 54-1211771
Ferguson Integrated Services
54-1211771
The Plumbing Source ---54-1211771
The Stock Market 54-1211771
Ferguson internatlonal
544211771
Fer uson Parts & Packaghig
54-12_11771
54-1211771
TPW Kitchen & Bath _ 54-1211771
Ferguson Valve & Automation
Waterworks industries 54-1211771
Fer uson Waterworks
54-1211771
Webb Distributors 541211771
Ferguson Waterworks- Municipal Pipe
54-1211771
Western Air Supply 541211771
Ferguson Waterworks- Red Head
54-1211771
Westfield Lighting_ 54-12.11771
Ferguson Waterworks EPPCO
54-1211771
Wolseley Financial Services 54-1211771
Ferguson Waterworks International
54-1211771
Wolseley Industrial Group 54-1211771
Galleria Bath & Kitchen Showplace
54-1211771
WPCC Forwarding 54;[211771
Groeniger & Company
541211771
--
1114Eunttated 11104110
Authorized paper chock lockbox remittance used by Ferguson Enterprises, Inc.
FEI # (Main branch number)
PO Box 100286
Atlanta, GA 30384-0286
OVERNIGHT - PKCS
Bank of America lockbox Services
FEI # (Main branch number)
Lockbox # 100286
6000 Feldwood Road
College Park, GA 30349
FEI # (Main branch number)
PO Box 417592
Boston, MA 02241-7592
OVERNIGHT - PKGS
Bank of America Lockbox Services
FEI W. (Main branch number) Lia# 417592
MA5-527-02-07
2 Morrissey Blvd.
Dorchester, MA 02'125
FEI it (Main branch number)
PO Box 847411
Dallas, TX 76284-7411
iOVERNIGHT - PKCS
FEI # (Main branch number)
Lockbox # 847411
1950 N. Stemmons FRWY
Ste. 5010
75207
FEI it (Main branch number)
PO BOX 740827
Los Angeles, CA 90074-0827
OVERNIGHT -PKGS
Bank of America Lockbox Services
FEI # (Main branch number)
Lockbox 740827
2706 Media Center Drive
Los Angeles, CA 90065-1733
FEI # (Main branch number)
PO Box 802817
Chlcaw. iL 60680-2817
UUF-jNlNl Jrll rlr%%2%7
Ferguson Enterprises Inc
Lockbox 802817
350 East Devon Avenue
Itasca, IL 60143
FEI # (Main branch number)
PO Box 827066
Philadelphia. PA 19182`7066
PNC Bank
Lockbox 827066
Route 38 and East Gate Drive
Moorestown, NJ 08057
- Pittsburgh - 644054
# (Main branch number)
Box 644054
sburah. PA 15264-4054
Bank
(box 644054
side Center
First Avenue
Wells Fargo Bank
Dept # 34261
PO Box 39000
San Francisco, CA 94,139
Wells Fargo Bank
Lockbox. 043090
M/S 90
PO Box 4300
Portland, OR 97208
11.0 CERTIFICATION AFFIDAVIT BY CONTRACTOR AS LOCAL BUSINESS
This form must be signed and sworn to in the presence of a notary public or other official
authorized to administer oaths.
A. This sworn statement is submitted to County of Volusia, FL, Purchasing and Contracts;
By:
(Authorized individuals name and title)
W-
ndividual submitting sworn statement)
B. Local Preference Eligibility
1 Vendor has been in business for a minimum of six (6) months prior to e date of
Bids or quote Vyes 0No
2. Vendor has proof of local business in the form of a business tax receipt from a
local jurisdiction per Volusia County Local Preference ordinance S"*Yes 0 No
I understand that the submission of this form to the contracting officer for Volusia County,
Florida, is valid through the end of term of the awarded Agreement. I also understand that
failure to notify the County of Volusia of a change in address out of the local area may
result in breach of reement.
(Sikature)
STATE OF
COUNTYOF
Sworn to and subscribed before me this
day of IV) e' 4,� 20 17 by
vi? s'i k ea" who)islare personally known
tome or who has/have produced as identification.
Maricel M. Hawley
State of Florida NOTARY PUBLIC ZSTATE OF
My Commission Expires 08/1812019 Type or print name:
Commission No. FF 910580 1 A,2
'F
Commission No.: F
17-B-109VB, Plumbing Supplies.docx Page 24 of 33
(Seal)
Expires:
commis7ion 1.
17-B-109VB, Plumbing Supplics.docx Page 25 of 33
F
THE CITY OF DAYTONA BEACH
BUSINESS TAX LICENSE # BT -35714
THE CITY OF DAYTONA BEACH
301 S. RIDGEWOOD, SUITE# 127
DAYTONA BEACH, FL 32114
BUSINESSNAME: FERGUSON ENTERPRISES, INC
LOCATION: 840 JIMMY ANN DR
BUSINESS TYPE: WHOLESALE DIST
MAIL TO:
CASTLE SUPPLY CO, INC
P.O. BOK 2778
ATTN: BUSINESS LICENSE
NEWPORT NEWS VA 23609
DEVELOPMENT SERVICES DEPARTMENT
PERMIT & LICENSING DIVISION
Phone: 386.671-8140
BT -35714
TAX RECEIPT NO.
35714
ACCOUNT NO.
09/01/1988
VALID FROM
09130/2017
VALID TO
09/20/2016
DATE PAID
90.00
ANNUAL FEES
Fes Code Description
2105 WHOLESALE DISTRIBUTOR
DISPLAY AT PLACE OF BUSINESS FOR PUBLIC INSPECTION TAX RECEIPT
THE CITY DOES NOT CERTIFY OR IMPLY COMPETENCE OF BUSINESS.
THE, CITY OF DAYTONA BEACH
. BUSINESS TAX LICENSE # BT -35714
FERGUSON ENTERPRISES, INC
840 JIMMY ANN DR
THE CITY OF DAYTONA BEACH
301 S. RIDGEWOOD, SUITE# 127
• DAYTONA BEACH, FL 32114
Fee Code Description Rererence Arnl Paid pale Paid Pay Method
2105 WHOLESALE DISTRIBUTOR 2017 90.00 09/20/16 CHECK -REMIT
Fees Paid: $90.00
Chronology action: 912112
8.0 DRUG-FREE WORK PLACE
The undersigned firm, in accordance with Florida statute 287.087, hereby certifies that
Ferguson Enterprises, Inc does:
(Name of Firm)
Publish a statement notifying employees that the unlawful manufacture, distribution,
dispensing, possession, or use of a controlled substance is prohibited in the workplace
and specifying the actions that will be taken against employees for violations of such
prohibition.
2. Inform employees about the dangers of drug abuse in the workplace, the business's policy
of maintaining a drug-free workplace, any available drug counseling, rehabilitation, and
employee assistance programs, and the penalties that may be imposed upon employees
for drug abuse violations.
Give each employee engaged in providing the commodities or contractual services that
are proposed a copy of the statement specified in subsection (1).
4. In the statement specified in subsection (1), notify the employees that, as a condition of
working on the commodities or contractual services that are under proposal, the employee
will propose by the terms of the statement and will notify the employer of any conviction
of, or plea of guilty or nolo contender to, any violation of Chapter 893 or of any controlled
substance law of the United States or any state, for a violation occurring in the workplace
no later than five (5) days after such conviction.
5. Impose a sanction on, or require the satisfactory participation in a drug abuse assistance
or rehabilitation program if such is available in the employee's community, by any
employee who is so convicted.
6. Make a good faith effort to continue to maintain a drug-free workplace through
implementation of this section.
As the person authorized to sign the statement, I certify that this firm complies fully with the above
requirements.
Matt Venier - Outside Sales Commercial MRO
me Titl t'-
IF
Sig ture
Ferguson Enterprises, Inc
Firm
840 Jimmy Ann Dr
Street address
Daytona Beach, Ft_ 32114
City, State, Zip
5/22/2017
Date
17-B-109VB, Plumbing Supplies.docx Page 20 of 33
17-B-104VB, Plumbing SuppliesAocx Page 21 of 33
9.0 CERTIFICATION REGARDING DEBARMENT
Certification Regarding
Debarment, Suspension,
And Other Responsibility Matters
Primary Covered Transactions
TO BE COMPLETED BY CONTRACTOR
A. The prospective primary participant (contractor) certifies to the best of its knowledge and
belief, that it and its principals (subcontractors and suppliers):
1. Are not presently debarred, suspended, proposed for debarment, declared
ineligible, or voluntarily excluded from covered transactions by any Federal
department or agency;
2. Have not within a three (3) year period preceding this bid proposal been convicted
of or had a civil judgment rendered against them for commission of fraud or a
criminal offense in connection with obtaining, attempting to obtain, or performing a
public (Federal, State, or local) transaction or contract under a public transaction;
violation of Federal or State antitrust statutes or commission of embezzlement,
theft, forgery, bribery, falsification or destruction of records, making false
statements, or receiving stolen property.
3. Are not presently indicted for or otherwise criminally or civilly charged by a
government entity (Federal, State, or local) with commission of any of the offenses
enumerated in paragraph (1) (b) of this certification; and
4. Have not within a three-year period preceding this bid proposal had one or more
public transactions (Federal, State, or local) terminated for cause or default.
B. Where the prospective primary participant is unable to certify to any of the statements in
this certification, such prospective participant shall attach an explanation to this bid
proposal.
Matthew Venier - Outside Sales Commercial MRO
e itl
Si nature
Ferguson Enterprises, Inc
Firm
840 Jimmy Ann Dr
Street address
Daytona Beach, FL 32114
City, State, Zip
5/22/2017
Date
17-B-109VB, Plumbing Supplies.docx Page 22 of 33
ArONWANFERSU ON FERGUSON ENTERPRISES #2024 Deliver To: FRANK
��~~ -- ENTERPRISES, ��T�H���N��From: Matthew Vanier
NNWINC.. MELBOURNE, pLo2un4-1y1u
Phone: 321-837-5411
Fax.- 321-676-2703
18:57:47JUN O22O17 Page of
FERGUSON ENTERPRISES #2O24
PdoeOuotahon
Phone: 321-837-5411
Fax: 321-676-2703
Bid No: B977788
Bid Date: 05/587
Quoted By: M8V
Customer: COUNTY OFVOLUSIA
3D11TIGER BAY ROAD
T/V3#PA75176
DAYTONA BEACH, FL 32124
CumtPO# ZV17PLUMBING BID
CmstPhmne: 386-248- 1760
Ship To: COUNTY OF VOLUSIA
3H11TIGER BAY ROAD
TAG#PA75176
DAYTONABEACH, FL82124
Job Name: 2017PLUMBING BID
Item Description Quantity Net Price Vm Total
D40oD8T
CCYLF1.8 1HDL KIT FCTY0SPRYCP
1
98.550
G4
88.55
D501 DST
CCYLF1.2GPM CC BATH FCTSGL HDL
1
75.340
EA
75.3*
D2171 LF
CC/LF1.5uHDLBLD uHBAR FOTADA
1
81.160
EA
81.16
BOCR18XC
LF1/aCOMP Xm8COMP ANG 8T
1
*.390
EA
4.39
NTFP600ALFF
LF 3/4 FOBS 600# THRDFP BV
1
8.570
EA
8.57
N8FP6008LFF
LF04FOBS O0O#SWT FP8V
1
0.570
EA
8.57
AENT50208172845
eu84.5KW24oVIPHVYHTRALUM
/
802.180
EA
302.13
CPF8PF10
n/4X1oCPYCFLOWGUARoGOLD PIPE
mu
46.868
O
3.37
P40PF10
o14X10PVC oYVVG4oPEPIPE
cu
e3.908
C
4.78
p40PK1O
2X1OFTPVC DWVSwVPEPIPE
uV
65.708
C
1314
PFrOCOFE2000mH
EBCL8TSEAT COMM OFLCWHIT
1
13,337
EA
13.34
G3301036
A88A4.5CL8TREP KIT
1
13.543
GA
13.54
85302305
850AHDL REP KIT
1
2.093
EA
2.08
G33231$2
V5s1AVBREP KIT F/V-5VO'A
1
8.020
EA
282
83080153
3.aGPF11oXLREG 3.5FVYWSWT
1
EA
82.40
FPRO4eB
^paOGERFILL VLVeRS SHK
1
10.430
EA
10/3
Le0018P
KDRKYPLUS FLAPPER
1
2.880
EA
2.88
LPP111088PK
BLUE VINYL FLAPPER COAST TYPE 5PK
1
6.230
PK
8.23
031010
1GAL PVC REG CLROMNT
1
18.960
EA
18.96
030759
1GAL PURPPRMR-NSF LISTED
1
18.e60
EA
18,96
PFPTP100
1'1/4X1'1/2PuASPTRAP GJW/MCWH
1
1.220
EA
1.22
EBG8L
LF88SGL UNIT WM WTR COLR ADA
1
403.090
EA
403.09
C770665PSHCP
YVM8|GTRTVLVCP
1
88.000
EA
88.00
C8870e0KJKABNF
LFMVP METERING CART
1
3e.5e8
EA
3e.52
u"nG102A2
1Hp000v1PoPRG SER GRINDER PuMP
1
838.880
Ex
838.88A8517A101020
CCY1.u�1.6 GPFADAE8°CAOETVVHD'
1
112.625
EA
112.60
a41884004020
CCN 1.6GPF12R|TANK *CADET WHIT
1
55.210
EA
e521
W24PI2
*NP 1/oFPT|NLNFAREA WALL FCTRC
1
32.630
EA
32.63
Net Total:
$2356.03
Tax:
$0.00
Freight:
$0.00
As FER� Page 2 of 2
ff w -ENTER RISES, FERGUSON ENTERPRISES #2024
INC® PW
Price Quotation
Fax: 321-676-2703
13:57:47 JUN 02 2017
Reference No: B977798
Quoted prices are based upon receipt of the total quantity for immediate shipment (48 hours). SHIPMENTS BEYOND 48 HOURS SHALL BE
AT THE PRICE IN EFFECT AT TIME OF SHIPMENT UNLESS NOTED OTHERWISE. QUOTES FOR PRODUCTS SHIPPED FOR RESALE
ARE NOT FIRM UNLESS NOTED OTHERWISE.
CONTACT YOUR SALES REPRESENTATIVE IMMEDIATELY FOR ASSISTANCE WITH DBE/MBE/WBE/SMALL BUSINESS REQUIREMENTS.
Seller not responsible for delays, lack of product or increase of pricing due to causes beyond our control, and/or based upon
Local, State and Federal laws governing type of products that can be sold or put into commerce. This Quote is offered contingent upon the
Buyer's acceptance of Seller's terms and conditions, which are incorporated by reference and found either following this document, or
on the web at httpJ/wolseleyna.com/terms_conditionsSale.html.
Govt Buyers: All items are open market unless noted otherwise.
LEAD LAW WARNING: It is illegal to Install products that are not "lead free" in accordance with US Federal or other applicable law in potable water
systems anticipated for human consumption. Products with *NP in the description are NOT lead free and can only be installed in non -potable
applications. Buyer is solely responsible for product selection.
Attachment A - Price List - Revision I
Wlusia County, 17-B-109VB Vblu , sla County
FL O R I OA Plumbing Supplies FLORMA
Bidder shall fill out the representative samples of plumbing products listed below.
Note: This information will be utilized as a basis for price comparison of like items between
Contractors
While Bidders are not required to bid on every item listed, substitute manufacturers will
not be accepted due to standardization of parts throughout the County.
Sample Item
Current
Cost to
Delta 400 Kitchen Faucet
"3
$96.55
Delta 501 Lavatory Faucet
�
9 31
OX
$75.34
Delta 2171 Bar Sink
8543
$81.16
Brasscraft #CR 19 Angle Stop (5 -pack)
$4.39
3/4" Full port Ball -Valve
$8.57
50 gallon/ 220 volt water heater
$302.13
3/4" CPVC - 20 ft.
$9.37
3/4" Sch. 40 PVC Pipe - 20 ft.
0%
$4.78
2" Sch. 40 PVC pipe - 20 ft.
$13.14
Elongated toilet seat, open front - Less Cover (Box of 6)
5
$13.34
Sloan A -36-A Repair Kit
i a. 92
_-3
$13.54
Sloan B-50 Handle Repair Kit
2P
$2.09
ISloan V-551 Vacuum Breaker
$2.021
Sloan 11 OYB Flushometer
$92AU
Fluid Master Pro 45B Ballcocks
OX
$10.43
Korky Red #2001 Flappers
$2.88
Coast Flappers
$6.23
PVC Glue - I gallon
$18.96
PVC Cleaner - I gallon
$18.96
1 1/2" PVC Master Trap
$1.22
Elkay EZ8 water cooler
$403.09
Chicago Metering Vavle MN #: 770-665PSHCP
$88.00
Chicago Metering Kit Model 667-080KJKABNF
5
$39.52
Liberty 1 hp PRG -Series pump
$838.88
American Standard 2 piece Commercial Cadet series toilet
2P
$167.84
lWoodford 3/4" Chrome hose bib
$32.63
Plumbing Bid 2017 - Attactunetit A Price List.xlsm 2 of 2
Attachment A - Price List
17-B-109VB
volusia. County Volusia County-'
PIORIVA, Plumbing Supplies FLORFOA
Bidder may bid a fixed discount or a discount that is variable by Manufacturer. Contractor
must choose one or the other. If additional lines are required for listing manufacturers and the
corresponding discounts, please attach on a separate sheet. If the variable discount is
offered, please provide an explanation of how the discounts will be applied. All discounts
shall be applied to prices that would be paid by the general public.
Fixed Discount % Bidder Name:
'06A
OR
Discount off retail by manufacturer. List manufactures and corresponding discounts below.
Manufacturer
Discount
American Flow Control- Valves
55%
Sigma Corporation- Restraints
60%
Tyler Union- Fittings
55%
Custom Fab- Sewer Items
50%
Multifittings- PVC Fittings
70%
Femco-standard couplings
70%
Femco- shielded couplings
35%
Ford- Brass Items
45%
Ford repair Clamps
55%
Ford- Tapping sleeves / Saddles
45%
PVC Pipe- (C900, sch40, etc)
5%
Backfiows (wilkins)
50%
Air release valves (ARI)
5%
American Flow control- hydrants
50%
American Flow Control- Hydrant parts
10%
Proselect (Bolt Kits)
15%
Meritt- Brass Fittings (lead Free)
60%
Meritt- Brass Nipples
95%
jPollard Water
2%
Note: Contractor shall clearly show the method of discount on all receipts and/or
packing lists for purchases made by the County, whether choosing the fixed discount
method or discount off retail by manufacturer method.
ManufacturesListI.x1sx 1 of
Volusia Counter
F-10RIDA
Attachment A - Price List
17-B-109VB
Plumbing Supplies
Volusia County
FLORIDA
Bidder may bid a fixed discount or a discount that is variable by Manufacturer. Contractor
must choose one or the other. If additional lines are required for listing manufacturers and the
corresponding discounts, please attach on a separate sheet. If the variable discount is
offered, please provide an explanation of how the discounts will be applied. All discounts
shall be applied to prices that would be paid by the general public.
'�-�Z k",
Fixed Discount % Bidder Name:
OR
Discount off retail by manufacturer. List manufactures and corresponding discounts below.
Manufacturer
Discount
Spears- sch40 fittings (standard)
60%
Spears-Sch84 Fittings (standard)
70%
Ferguson- tools (Discount off Ferguson suggested retail)
10%
Mueller- Meters
15%
American Ductile Pipe
5%
Meritt- Domestic Lead Free Brass
80%
Tyler Union- Domestic Fittings
15%
Carson- Meter Boxes
10%
Romac- Alpha / Macro Couplings
40%
Dixon- camlocks
30%
FIP- HDPE risers / Fittings
10%
Endot- Poly Tubing
2%
Oatey-clue / cleaner
50%
Ferguson- Paint / Valves repair parts-MSRP
10%
Note: Contractor shall clearly show the method of discount on all receipts and/or
packing lists for purchases made by the County, whether choosing the fixed discount
method or discount off retail by manufacturer method.
ManufacturesListlxlsx 1 of
r
COUNTY OF VOLUSIA
PURCHASING & CONTRACTS ,DIVISION
123 West Indiana Avenue, Room 302
Del -and, Florida 32720-4608
Volusia County(386) 736-5935 o Fax: (386) 736-5972
FLORIDA �"aw,Volt. sia.orc
May 31, 2017
ADDENDUM NO.2
Plumbing Supplies
ITB No. 17-B-109VB
`f0: All firms interested in providing the required professional services
The purpose of this addendum is to provide the following clarifications, changes, modifications and/or
additions to the solicitation documents. This addendum is an integral part of the Solicitation/Contract
Documents.
"NOTICE'S*
Questions:
Q1: On Attachment 1 -Price List, what does "Current Price" mean?
AI: current N-icc is cqual to the current 116CO ChM-L,!Cd to 1110 i)Ubk It 111e time, til'
All other terms and conditions remain unchanged._
END OF ADDENDUM NO, 2
Total Pages: 1
If there are any questions, please contact the staff member responsible for this project, Vikky Bertling,
Procurement Analyst 1, at plione: (386) 626-6626 or via E-mail: vbertling@volusia.org.
I<A'rHY WIL AMS, MBA, CPPB, CPPD
Procurement Mnager
Purchasing and Contracts Division
Please sien and return with nronosal 17-B-109VB
Vendor:
Signed by (Name/Position): ` /�"'' W ` + USX, (✓
Phone No.: (3S i )03 k(,o Dater
1-iI11.111t1. 7'0 R7:"I URNT1Y1b' FOR111 W1 I'll VIE 1111DSVJ;,1117T4I. Jf. 1 V C 41,WE Tf11i 1"P101'C15'.,1t. TO tih:7Pds:A'pddlltli1) rAOX-RP'SPOrAS]P7i
Agency #1
Volusia County School Board
Address
3750 Olson Dr.
City, State, ZIP
Daytona Beach, FL, 32124
Contact Person
Shelly Stevens
E-mail
sasteven@volusia.k12.fl.us Phone: 386-947-8786
Date(s) of Service
2002 - Present
Type of Service
Plumbing & other MRO Supplies
Comments,
Agency #2
Daytona Beach Housing Authority
Address
211 N. Ridgewood Ave.
City, State, ZIP
Daytona Beach, FL, 32114
Contact Person
Kelly Schroeder
E-mail
schroederk@dbhafl.org Phone: 386-253-5653
Date(s) of Service
2008 - Present
Type of Service
Plumbing & MRO Supplies
Comments:
Agency #3
Daytona International Speedway
Address
1801 W. International Speedway Blvd
City, State, ZIP
Daytona Beach, FL, 32114
Contact Person
John Walter
E-mail
jwalter@daytonainternationalspeedway.com Phone: 386-681-6493
Date(s) of Service
2012 - Present
Type of Service
Plumbing & MRO Supplies
Comments:
17-B-109VB, Plumbing Supplies.doex Page 17 of 33
SUBMIT TO:
COUNTY OF VOLUSIA
PURCHASING & CONTRACTS
123 W. INDIANA AVE., RM. 302
DELAND, FL 32720.4608
AN EQUAL OPPORTUNITY EMPLOYER
_5
Voluslia County
FLORIDA
CONTACT PERSON: INVITATION TO BID
Vikky Bertling ....................386-626-6626
Email: ..................... vberfling@volusia.org WWW.V0IL1sia.o /pu[ghq�sin
DELAND: ........................... 386-736-5935
DAYTONA BEACH: ........... 386-257-6000
NEW SMYRNA BEACH: .... 386-423-3300
TITLE: NUMBER: SUBMITTAL DEADLINE:
Plumbing Supplies 17-B-1 09VB Tuesday June 6, 2017,
at 3:00 p.m., EST
DO NOT RESPOND TO THIS SOLICITATION ON LINE - SEE SECTION 2.5, DELIVERY OF BIDS
PRE BID DATE, TIME AND LOCATION:
SUBMITTALS RECEIVED AFTER
A pre-bid conference will be held in the Management & Budget ABOVE DATE AND TIME WILL NOT
Conference Room, 123 W. Indiana Avenue, 3rd Floor, DeLand, FL, at 10:00 BE CONSIDERED
a.m., EST, Tuesday, May 16, 2017
Ferguson Enterprises, Inc
FIRM'S NAME:
840 Jimmy Ann Dr.
MAILING ADDRESS:
Daytona Beach - FL - 32117
CITY - STATE - ZIP:
matthew.venier@ferguson.com
E-MAIL ADDRESS:
888-334-0004
PHONE NUMBER*
888-334-8112
FAX NUMBER:
The vendor acknowledges that Information provided In
this Bid Is true and correct and agree to all terms and
conditions contained in hi Bid and related Exhibits.
1.7
Aul0orized Signature Date
Matthew Venier
Printed Name
Outside Sales - Commercial MRO
Title
FEDERAL I.D. or SOCIAL SECURITY NUMBER:
54-1211771
THIS FORM MUST BE COMPLETED AND RETURNED WITH YOUR RESPONSE
17-B- 109VB, Plumbing Supplies.doex
Page I of 33