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2395 IRFQ 20/21-106 1st St String Lights-Holiday Lightscapes Inc()Y OF SXNF0FJ3 FINANCE DEPARTMENT Wednesday, December 01, 2021 yq�I ill 1pilq `Co: City Clerk RE: IRFQ 20/21-106 1 st St. String Lights- Holiday Lightscapes Inc. 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 F] Performance Bond ❑ Payment Bond ❑ Resolution ❑ City Manager Signature City Clerk Attest/Signature ❑ City Attorney/Signature Once completed, please: F-1 Return originals to Purchasing- Department ❑ Return copies Special Hm T:\Dept_forms\City Clerk Transmittal Memo - 2009.doc 1 -Dec -21 Date FINANCE DEPA E�T Thursday, July 08, 2021 PURCHASING DEPAR7'MeNT TO: City Clerk/Mayor RE: IRFQ 20/21-106 11' Street String Lights — Holiday Lightscapes Inc. The item(s) noted below is/ar.1-1.1, arded to your office for the following action(s): F] Development Ordq r-1 Final Plat (original F� Letter of Credit ❑ Maintenance Bond ❑ Ordinance ❑ Payment & Performance F] Resolution n Once completed, please: Z Return originals to Purchasing- Department F-1 Return copies 0 Mayor's signature Safe keepi ng -(V a u I t) Payment Bond City Manager Signature City Clerk Attest/Signature City Attorney/Signature Special Instructions: The city processed an Informal Quote and the lowest bidder was awarded the contract for 1St Street String Lights. Vendor is Holidqy Lightscqpes Inc the purchase will be less than 50k per year not require commission approval. Ma,ri yo-{. Orat�z From Date TADept_forms\City Clerk Transmittal Memo - 2009.doe AGREEMENT BETWEEN CITY OF SANFORD AND HOLIDAY LIGHTSCAPES INC./IRFQ NUMBER 20121-106; 1ST STREET STRING LIGHTS THIS AGREEMENT (hereinafter the "Agreement") is made and entered into this day of 2021, 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 Holiday Lightscapes Inc., a Florida corporation, whose principal address is 3855 Tucks Road, Boynton Beach, Florida 33436, (hereinafter referred to as "Holiday"). The City and Holiday 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 the Provision of Goods and Services. (a). This Agreement is for the provision of goods and services set forth in the City's solicitation relating to Informal Requests For Quotes (IRFQ) Number 20/21-106 and the City's Solicitation Tabulation Sheet Form which are the only attachments hereto and Holiday agrees to accomplish the provision of goods and services specified in the said attachments relating the provision of 1st Street String Lights and related services as set forth in the attachment. The terms and conditions set forth in Holiday's response to the City's IRFQ are specifically rejected and not part of this Agreement and were inappropriately submitted by Holiday to the City. (b). It is recognized that Holiday shall provide goods and services as directed by the City. (c). The City's contact/project manager for all purposes under this Agreement shall be the following: Marisol Ordofiez 11 P a g e Purchasing Manager Finance -Purchasing Division City of Sanford Post Office Box 1788 Sanford, Florida 32772-1788 Phone: 407-688- 5028 Email: Marisol.ordonez@sanfordfl.gov 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. Further, this Agreement shall be in effect for a term of 1 year with the opportunity for additional 1 -year renewal periods when in the best interest of the City in its sole discretion. However, the total length of this Agreement, including all renewals, shall not exceed 5 years. The decision to renew or extend this Agreement shall be at the discretion of the City. Holiday shall review the quality and status of the goods and services pertaining to the provision of lighting with the City on an annual basis at which time(s) the City may terminate this Agreement is its sole and absolute discretion. In any event, this Agreement shall remain in effect until the goods and services to be provided by Holiday to the City under each purchase 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 and services being provided by Holiday. No goods, services or actions have been provided prior to the execution of this Agreement that would entitle Holiday for any compensation therefor. Section 5. Compensation. The parties agree to compensation to be paid by the City to Holiday as follows: $27,230.00 for one year for approximately 3,940 feet light -emitting diode (LED) market lights: $9,850.00; and equipment, hardware, materials, labor for installation of lights and tree trimming: $15,800.00, and quarterly maintenance for year-round lighting: $395.00 per quarter. Additional goods and services may be provided as may be agreed upon by the parties as set forth in issued purchase orders. Section 6. Standard Contractual Terms and Conditions. All "Standard Contractual Terms and Conditions", as provided on the City's website, apply to this Agreement. Such Terms and Conditions may be found at the City's website; which can be reached at: (hftps://www.sanfordfl.gov/departments/finance/purchasing/contract- terms-and conditions or www. Sanford FL.gov). The parties shall also be bound by the purchasing policies and procedures of the City as well as the controlling provisions of Florida law. Purchase 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. 2 1 P a o e zn Section 7. Holiday's Mandatory Compliance with Chapter 119, Florida Statutes, and Public Records Requests. (a). In order to comply with Section 119.070 1, Florida Statutes, public records laws, Holiday must: (1). Keep and maintain public records that ordinarily and necessarily would be required by the City in order to provide goods and services. (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 cast 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 Holiday 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 Holiday does not comply with a public records request, the City shall enforce the contract provisions in accordance with this Agreement. (c). Failure by Holiday to grant such public access and comply with public records requests shall be grounds for immediate unilateral cancellation of this Agreement by the City. Holiday shall promptly provide the City with a copy of any request to inspect or copy public records in possession of Holiday and shall promptly provide the City with a copy of Holiday'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, MMC, FCRM, CITY CLERK, CITY OF SANFORD, CITY HALL, 300 NORTH PARK AVENUE, SANFORD, FLORIDA 32771, TRACI.HOU CHI N a@SANFORDFL.GOV. 31P_ao e 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 Holiday and supersedes and controls over any and all prior agreements, understandings, representations, correspondence and statements whether written or oral in connection therewith and all the terms and provisions contained herein constitute the full and complete agreement between the parties hereto to the date hereof. This Agreement may only be amended, supplemented or modified by a formal written amendment of equal dignity herewith. In the event that Holiday issues a purchase order, memorandum, letter, or any other instrument addressing the goods and sevices 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. 4 1 P a g e Each party hereto represents to the other that it has undertaken all necessary actions to execute this Agreement, and that it has the legal authority to enter into this Agreement and to undertake all obligations imposed on it. The signatories hereof represent that they have the requisite and legal authority to execute this Agreement and bind the respective parties herein. Section 15. Remedies. The rights and remedies of the parties, provided for under this Agreement, are in addition to any other rights and remedies provided by law or otherwise necessary in the public interest. Section 16. Governing law, Venue and Interpretation. This Agreement is to be governed by the laws of the State of Florida. Venue for any legal proceeding related to this Agreement shall be in the Eighteenth Judicial Circuit Court in and for Seminole County, Florida. This Agreement is the result of bona fide arms length negotiations between the City and Holiday, 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 Holiday have executed this instrument for the purpose herein expressed and Holiday represents and affirms that the signatories below have full and lawful authority to bind Holiday in every respect. A TTES T.- CITY OF 9A001 4JAiN A EM Traci Houchin, MMC, FCRM City Clerk Approved as to form and legal sufficiency. Art Wo cTruff, Mayor Date: 5 1 P a ge �11 �4-111 T �l ATTESTIWITNESSES: Witness # 1 Signature Witness # 1 Printed Name; Witness # 2 Signature Witness # 2 Printed Nam HOLIDAY LIGHTSCAPES INC., a Florida corporation. By: Sean P. W/olfb. Sole Corporate Officer 6111 a g c Holiday Lightscapes 3855 Tucks Road Boynton Beach, Florida 33436 Phone: 561.827.4357 www.holiday[ightscar)es.com infoOd holidaylightscapes.com To: Mike Cash - Publics Works Engineer - purchasinq@sandfordfi.qov Project Title: City of Sanford Year-round Lighting 2021 Submitted on: 5/3/2021 Job Description: Holiday Lightscapes will install and maintain the following lighting year-round. All lighting will be maintained on a quarterly basis. Holiday Lightscapes will light all areas specified below with commercial grade LED products and decor. The overall project objective is to provide City of Sanford with a beautiful display that will be enjoyed throughout the year. The project is broken down by section and details are provided below. Any additional services to be added require further bid and AREA I - 1st STREET STRING LIGHTS • Approx. 3,940ft - LED Market lights - One time purchase from City of Sanford TOTAL = $9,850.00 • Equipment, hardware, materials, labor for installation of lights and tree trimming TOTAL = $15,800.00 1 -TIME PRODUCT PURCHASE AGREEMENT: $25,650.00 QUARTERLY MAINTENANCE FOR YEAR-ROUND LIGHTING: $395.00/QUARTER ALL PRICING ABOVE INCLUDES PRODUCT, MATERIAL, EQUIPMENT and LABOR ** INSTALLATION WITH QUARTERLY MAINTENCE** 2021 FLORIDA PROFIT CORPORATION ANNUAL REPORT DOCUMENT# P05000156020 Entity Name: HOLIDAY LIGHTSCAPES INC. Current Principal Place of Business: 3855 TUCKS ROAD BOYNTON BEACH, FL 33436 Current Mailing Address: 3855 TUCKS ROAD BOYNTON BEACH, FL 33436 US FEI Number: 20-3853106 Name and Address of Current Registered Agent: WOLFE, SEAN P 3855 TUCKS ROAD BOYNTON BEACH, FL 33436 US FILED Jan 26, 2021 Secretary of State 7362080428CC 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: SEAN P WOLFE 01/26/2021 Electronic Signature of Registered Agent Date Officer/Director Detail Title PRES Name WOLFE, SEAN P Address 3855 TUCKS ROAD City -State -Zip: BOYNTON BEACH FL 33436 I hereby certify that the information indicated on this report or supplemental report is titre and accurate and that my electronic signature shaft have the same legal effect as if made under oath; that I am an officer or director of the corporation or the receiver or trustee empowered to execute this report as required by Chapter 607, Florida Statutes; and that my name appears above, or on an attachment with all other like empowered. SIGNATURE: SEAN PATRICK WOLFE PRESIDENT 01/26/2021 Electronic Signature of Signing Officer/Director Detail Date Nr►I a Ir..ni IKINr. CERTIFICATE OF LIABILITY INSURANCE DATE51312021) 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 of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CN2NTEACT .M• _ J Meyers Insurance Agency 5003 Old Cheney Hwy Orlando, FL 32807 AIC, N , Ext): (407) 273-0230 FAX No): Epp IL . info@jmeyers.com t�SURERIS) AFFORDING COVERAGE NAIC # CLAIMS-MADEX OCCUR INSURER A: Colony Insurance Co 39993_-___ 101 GL 0125830-01 6/20/2020 INSURED INSURERS: INSURER C : Holiday Lightscapes Inc INSURER D: INSURER E:— 3855 Tucks Rd Boynton Beach, FL 33436 INSURER F : COVFRAnFS CFRTIFICATF NIJMRFR- 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 MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS_ OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.LTR NSR — TYPE OF INSURANCE _ AD SUER POLICY NUMBER — POLICY EFF POLICY EXP LIMITS INSOA X COMMERCIAL GENERAL LIABILITY AUTHORIZED REPRESENTATIVE `�...:lmMl"'"-'"rte EACH OCCURRENCE S 1'000'000 CLAIMS-MADEX OCCUR X 101 GL 0125830-01 6/20/2020 6!20/2021 DAMAGE TO RENTED PR MISES (Ea occurcence 100,000 S MED EXP-IAny_ona_ersonL__ _S— 5,000 & ADV INJURY $ 1'000'000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑ i%ef 1:1 LOC _PERSONAL GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMPIOPAGG S 2,000,000 OTHER' $ AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT BODILY INJURY Per erson S __ SC OWNED HEDULED AUTOS ONLY AUTOS AUTOS ONLY NON ONL� I BODILY INJURY Per accident I S PPer. dentDAMAGE !S UMBRELLA LIAR EXCESS LIAB _ OCCUR CLAIMS -MADE. EACH OCCURRENCE_. _ AGGREGATE �S $ DED RETENTIONS I i S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIIETgOERR/PARTNERtEXECUTIVE � f STATUTE�EERH E.L. EACH ACCIDENT EXCLUDED? El deRory N I A W.F.1 in NH) E.L. DISEASE - EA EMPLOYEE_$___._ E.L. DISEASE -POLICY LIMIT S If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Sanford is included as additional insured With respects to the general liability when required by written contract CFRTIFICATF I-IOI DFR CANCELLATION ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Ci of Sanford Purchasing Division City 9 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 300 N. Park Ave Sanford, FL 32771 AUTHORIZED REPRESENTATIVE `�...:lmMl"'"-'"rte ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID: 432E0034-1746-4733-A77A-6984AF21A2F2 Form = .9 Request for Taxpayer Give Form to the (Rev. August2013)Identification Number and Certification requester. ot Department of the Treasury I . send to the IRS. Internal Revenue Service Name (as shown on your income tax return) Holiday Lightscapes Inc N Business name/disregarded entity name, if different from above a� css ca C Check appropriate box for federal tax classification: Exemptions (see instructions): o ❑Individual/sole proprietor ElC Corporation R] S Corporation F1Partnership ❑ Trust/estate y Q p Exempt payee code (if any) Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) ► Exemption from FATCA reporting o N code (if any) c CL ❑ Other (see instructions) ► Address (number, street, and apt. or suite no.) Requester's name and address (optional) 3855 Tucks Road ami City, state, and ZIP code Boynton Beach, FL 33436 List account number(s) here (optional) EMU Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on the "Name" line social security number avoid backup withholding. For individuals, this is your social security number However, for resident alien, sole proprietor, or disregarded entity, see the Part I instructions onn page 3. For other re _ 11:1 _ entities. it is vour emolaver identification number (EIN). If you do not have a number, see How to qet a TIN on page 3. Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose number to enter. Under penalties of perjury, I certify that: 1. The number shown on this farm is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and 2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and 3. 1 am a U.S. citizen or other U.S. person (defined below), and 4. The FATCA code(s) entered on this form (if any) 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 or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions on page 3. btgn Signature of (� u(�"f� Here U.S. person 10-J W, Date ► 10J16/2020 General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. The IRS has created a page on IRS.gov for information about Form W-9, at www.irs.gov/w9. Information about any future developments affecting Form W-9 (such as legislation enacted after we release it) will be posted on that page. Purpose of Form A person who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) to report, for example, income paid to you, payments made to you in settlement of payment card and third parry network transactions, real estate transactions, mortgage interest you paid, acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an IRA. Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN to the person requesting it (the requester) and, when applicable, to: 1. Certify 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 withholding tax on foreign partners' share of effectively connected income, and 4. Certify that FATCA code(s) entered on this form (if any) indicating that you are exempt from the FATCA reporting, is correct. Note. If you are a U.S. person and a requester gives you a form other than Form W-9 to request your TIN, you must use the requester's form if it is substantially similar to this Form W-9. Definition of a U.S. person. For federal tax purposes, you are considered a U.S. person if you are: • An individual who is a U.S. citizen or U.S. resident alien, • A partnership, corporation, company, or association created or organized in the United States or under the laws of the United States, • An estate (other than a foreign estate), or • A domestic trust (as defined in Regulations section 301.7701-7). Special rules for partnerships. Partnerships that conduct a trade or business in the United States are generally required to pay a withholding tax under section 1446 on any foreign partners' share of effectively connected taxable income from such business. Further, in certain cases where a Form W-9 has not been received, the rules under section 1446 require a partnership to presume that a partner is a foreign person, and pay the section 1446 withholding tax. Therefore, if you are a U.S. person that is a partner in a partnership conducting a trade or business in the U 't d St t r 'd F W-9 t th artnershi to establish our U S status 3. Claim exemption from backup withholding if you are a U.S. exempt payee. If m e a es, p avi e orm o -1- p y . . applicable, you are also certifying that as a U.S. person, your allocable share of and avoid section 1446 withholding on your share of partnership income. any partnership income from a U.S. trade or business is not subject to the Cat. No. 10231X Form vii -9 (Rev. 8-2013) City of Sanford I Finance Department I Purchasing Division 300 N. Park Avenue 2al Floor Suite 236 Sanford, Florida 32771 CITY OF A -- Phone: 407.688.5028 or 50301 Fax: 407.688,5021 FINANCE 01FAMMEW INFORMAL REQUEST FOR QUOTE (MFQ) I TERM CONTRACT I TITLE: 1' STREET STRING LIGHTS 11 SECTION 00432 NON COLLUSION AFFIDAVIT The undersigned, by signing this document hereby certifies that the company named below hereby is or does: I 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. Holiday Lightscapes Inc. Bidder 1-5:7 6/15/2021 Signaturuthonzed Representative (Affiant) Date Sean Wolfe - Owner Printed or Typed Name and Title of Authorized Representative (Affiant) SECTION 00432-1 City of Sanford I Finance Department I Purchasing Division 300 N. Park Avenue 2nd Floor Suite 236 Sanford, Florida 32771 S CITY OF ORD Phone: 407.688.5028 or 5030 1 Fox-, 407.688.5021 FINANCE DEPARTMENT INFORMAL REQUEST FOR QUOTE (IRFQ) TERM CONTRACT TITLE: V STREET STRING LIGHTS STATE OF FLORIDA COUNTY OF V3"-VCt--k I HEREBY CERTIFY that on this day, efo n officer city authorized to administer oaths and Ire take acknowledgments,�ON onolW appeal edc--,VAVJ M0 -, - Vy {) who is personally known to me or {-Y-V�ho produced k� s identification and acknowledged before me that s1he exepilited the s mIr!I. Sworn and subscribed before me, by " \4-s-, A by means of (u)-oysical presence or online notarization on the day of , 202_\,, , the said person did take an oath and was first duly sworn by me, on oath, said person, her, deposing and saying that s/he has read the foregoing and that the statements and allegations contained herein are true and correct. WITNESS my hand and official seal in the County and State last aforesaid thls,4, day of 202,ea ( '/ d (Notary Public in and f6i tM County and State Aforementioned) SEAL My commission expires: SECTION 00432-2 END OF SECTION ow Public Stale of Flonds Robert Douglas Guido on GG 226256 � :U-- 0610512022 6P'j "0"" RER I City of Sanford I Finance Department I Purchasing Division 300 N. Park Avenue 2 od Floor Suite 236 Sanford, Florida 32771 S CITY OF RD Phone: 407.688.5028 or 5030 1 Fax- 407.688.5021 FINANCE DEAMOMEW INFORMAL REQUEST FOR QUOTE (IRFQ) TERM CONTRACT TI/LE:V STREET STRING LIGHTS SECTION 00434 CONFLICT OF INTEREST STATEMENT A. I em the with m local office in [insert Title] Name] OMendoFL and principal office in Boynton Beach, FL B. The entity hereby submits an offer toIRFQ 20/21~1061�Street Stri—ng Lights. C. The AFFIANT has made diligent inquiry and provided the Information |nthis statement affidavit based upon its full knowledge. D. The AFFIANT e&obaa that only one submittal for this solicitation has been submitted and tendered by the oppnmpdabs 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 an8b/ has directly or indirectly entered into any agreement, participated in any collusion or collusive acUvty, or otherwise taken any action which in any way restricts or restraints the competitive nature of this solicitation, including but not Um|hod 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|ntbbsdinitmUono,aoyuonbacthmfd7mwtheraofterhyanygov*rnmmntentity. G. Neither the entity nor Its affiliates, nor anyone associated with them, have any pnbanUo| conflict of interest because and due to any other clients, contracts, or property interests in this solicitation or the resulting project, H. | hereby also certify that no member oftha an0h/s ownership ormanagement orstaff has a vested interest in any City Division/Department/Office. |. | certify that no member ofthe mnUh/a ownership or management is presently mpp|ying, actively seeking, or has been oe|aubad 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 inwriting. By the signature(s) below, I/we, the undersigned, as authorized signatory to commit the firm, certify that the information as provided In Section 00434, Conflict of Interest Statement, is truthful and correct at the time of submission. Sean Wolfe Typed Name of AFFUNT SECTION 00434-1 City of Sanford I Finance Department I Purchasing Division 300 N. Park Avenue 2s)d Floor Suite 236 Sanford, Florida 32771 S city OF I�TFFORD Phone: 407.688.5028 or 5030 1 Fax: 407.688.5021 FINANCE DEPARTMENT INFORMAL REQUEST FOR QUOTE (IRFQ) TERM CONTRACT TITLE: I" STREET STRING LIGHTS STATE OF FLO COUNTY OF M L� I HEREBY CERTIFY that on this day -efbrp me, n,offl duly authorized to administer oaths and take acpowledgments, p zonally appeared,,- rc W`b1T-1�'<-- , { ) who is personally known to me or Jho produced as identification and acknowledged before me that s/he exte th —v�Nge Sworn and subscribed before me, by Al by means of {:� �physical presence or online notarization on the day of , 202_L, the said person did take an oath and was first duly sworn by me, on oath, said person, Ydrther, deposing and saying that s/he has read the foregoing and that the statements and allegations contained herein are true and correct. WITNESS my hand and official seal in the County 2020:,?( (Notary Public in and SEAL My commission expires: this�day of County and State Aforementioned) PLEASE COMPLETE AND SUBMIT WITH YOUR IRFQ RESPONSE 4 -Failure to submit this form may be grounds for disqualification of your submittal -v SECTION 00434-2 END OF SECTION Notary Pubk State of Florida Robert DoAlas Guido My Comminion GG 225255 061`0512022 Expiras F I City of Sanford I Finance Department I Purchasing Division 300 N. Park Avenue 211 Floor Suite 236 Sanford, Florida 32771 A of Phone: 407.688.5028 or 50301 Fax; 407.688.5021 FINANCE DEPARTMENT I INFORMAL REQUEST FOR QUOTE (IRFQ) TERM CONTRACT TITLE: 1St STREET STRING LIGHTS Section 00436 Florida Public Entity Crimes Statement SWORN STATEMENT UNDER SECTION 287.133(3) (a), FLORIDA STATUTES: THIS FORM MUST BE SIGNED IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICER AUTHORIZED TO ADMINISTER OATHS. A. This sworn statement is submitted with Bid, or Contract Number IPXQ 20/21-106 16t Street String Lights. B. This sworn statement is submitted by Holiday Lightscapes Inc. whose business address is 3855 Tucks Road Boynton Beach FL 33436ame of entity submitting sworn statement] 3'n , and (if applicable) it's Federal Employer Identification Number (FEIN) is 20-3853106 (If the entity has no FEIN, include the Social Security Number of the individual signing this sworn statement: C. My name is Sean Wolfe and my relationship to the above is Owner/President . [Please print name of individual signing] D. I understand that a "public entity crime" as defined in section 287.133(1)(g), Florida Statutes, means a violation of any state or federal law by a person with respect to and directly related to the transaction of business with any public entity in Florida or with an agency or political subdivision of any other state or with the United States, including, but not limited to; any bid or contract for goods or services to be provided to any public entity or an agency or political subdivision and involving antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material misrepresentation. E. I understand that "convicted" or "conviction" as defined in section 287.133(1) (b), Florida Statutes, means a finding of guilt or a conviction of a public entity crime, with or without an adjudication of guilt, in any federal or state trial court of record relating to charges brought by indictment or information after July 1, 1989, as a result of a jury verdict, non jury trial, or entry of a plea of guilty or nolo contenders. F. I understand that "affiliate" as defined in section 287.133(1) (a), Florida Statutes, means: i. A predecessor or successor of a person convicted of a public entity crime, or 2. An entity tinder the control of any natural person who is active in the management of the entity and who has been convicted of a public entity crime. The term "affiliate" includes those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in the management of an affiliate. The 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 arm's length agreement, shall be a prima facie case that one person controls another person. A person who knowingly enters into a joint venture with a person who has been convicted of a public entity crime in Florida during the preceding thirty-six (36) months shall be considered an affiliate. G. I understand that a "person" as defined in section 287.133(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 bid on contracts for the provision of goods or services let by a public entity, or which otherwise transacts or applies to transact business with a public entity. The term "person" includes those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in management of an entity. H. Based on information and belief, the statement, which I have marked below, is true in relation to the entity submitting this sworn. statement. [Please indicate with a check mark (✓) which statement applies]. SW 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. City of Sanford I Finance Department I Purchasing Division 300 N. Park Avenue 2,,d Floor Suite 236 Sanford, Florida 32771 CITY OF Phone: 407.688.5028 or 5030 1 Fax: 407.688.5021 S ORD FINANCE DEPARTMENT INFORMAL REQUEST FOR QUOTE OWQ) TERM CONTRACT TITLE: 1St STREET STRING LIGHTS 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 fist [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 signature(s) below, I/we, the undersigned, as authorized signatory to commit the firm, certify that the information as provided in Section 00436, Public Entity Crimes Statement, is tnithful and correct at the time of submission. AFFIAGNATURE Sean Wolfe Typed Name of AFFIANT Owner/President Title STATE OF FLORIDA COUNTY OF I HEREBY CERTIFY that on this day, efore, gn offilyoduly authorized to administer oaths and take ac nowled me ts, sovally; l�peared V-(- who is personally known to me or (-rwho produced a as identification and acknowledged before me that s/he exeQuted the saT1w orn and subscribed before me, by (06 by means of {physical presence or online notarization on the _L�p_ day of 202, the said person did take an oath and was first duly sworn by me, on oath, said person,'Mrther, deposing and saying that s/he has read the foregoing and that the statements and allegations contained herein are true and correct. WITNESS my hand and official seal in the County a�d State last aforesaid this4day of .611 1 2020',�k :- I _I--- U l O'� NftrY Public State of 0V* Robert oougla, (3u,MY COMIT114slon GG 2 Expires 06105/2022 Public in bhWfor the County and State Aforementioned} ETE AND SUBMIT WITH YOUR IRFQ RESPONSE lv*Failure to submit this form may be grounds for disqualification of your submiftal*W SECTION 00436-2 END OF SECTION City of Sanford I Finance Department I Purchasing Division 300 N. Park Avenue 21111 Floor Suite 236 Sanford, Florida 32771 S CITY OF ORD Phone: 407.688.5028 or 50301 Fax* 407.688.5021 FINANCEDEPARTMEW INFORMAL REQUEST FOR QUOTE (IRFQ) TERM CONTRACT TITLE: I't STREET STRING LIGHTS SECTION 00438 COMPLIANCE WITH THE PUBLIC RECORDS LAW AFFIDAVIT I. If and when the City of Sanford transmits records to the ContractorNendor which are exempt from public disclosure, the ContractorNendor shall execute an "Acknowledgement of Receipt of Exempt Public Records and Agreement to Safeguard" which will be provided with the exempt records. A sample form is attached for the bidder/proposer's information. [I. 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 Statutes, and Section 24(a), Article I of the Constitution of the State of Florida, 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 package are exempt from the Public Records Laws, identifying the specific 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 Proposers/Bidders 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. 00438-1 City of Sanford I Finance Department I Purchasing Division 300 N. Park Avenue 20d Floor Suite 236 Sanford, Florida 32771 clri°; Phone: 407,688.5028 or 5030 1 Fax: 407.688.5021 INFORMAL REQUEST FOR QUOTE (IRFQ) TERM CONTRACT TITLE: V' STREET STRING LIGHTS Holiday Lightscapes Inc Proposer/Bidder Signature of Authorized Representative (Affiant) Date Sean Wolfe - Owner/President Printed or Typed Name and Title of Authorized Representative (Affiant) STATE OF FLO!!DA COUNTY OF I HEREBY CERTIFY that on this day <-0efqrA en nprp\duly author' ed to administer oaths and take acknowledgments, p lly appu {--Ywho is personally known to me pared jek�-J,V nq, 4— or whoroduced as identification and acknowledged before me that s/he ex Putey e th 'sa Sworn and subscribed before me, by IV �4 V.I 'f" 1 P -A d, " k. L kj ') C T, , by means of i—r-Ohysical presence or online ,A, ... ',d n 1aflzation on the day of _, 202 1 , the said person did take an oath and was first duly sworn by me, on oaTh-7s­;Md person, f rther, deposing and saying that s/he has read the foregoing and that the statements and allegations contained herein are true and correct, WITNESS my hand and official seal in the County and State last aforesaid thisA_day of -1 2020: 7,1 . 1 (Notary Public in andP, r County and State Aforementioned) ZNotary Pubic state of fiondta Robert Douglas Guido MY COMMISSion Gr 225256 EM*" 00512022 00438-2 END OF SECTION City of Sanford ! Finance Department j Purchasing Division 300 N. Park Avenue 201 Floor Suite 236 Sanford, Florida 32771 CITY OF Phone: 407.688.5028 or 50301 Fax: 407.688.5021 INFOR.M[A.L REQUEST FOR QUOTE (IRFQ) TERM CONTRACT TITLE: 1St STREET STRING LIGHTS 11 SECTION 00452 DISPUTES DISCLOSURE FORINT 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. Has your firm, or any of its officers, received a reprimand of any nature or been suspended by the Department of Professional Regulation or any other regulatory agency or professional association within the last five (5) years? N (Y/N) 2. Has your firm, or any member of your firm, been declared in default, terminated or removed from a contract or job related to the services your firm provides in the regular course of business within the last five (5) years? N (Y/N) 3. Has your firm had filed against it or filed any requests for equitable adjustment, contract claims or litigation in the past five (5) years that is related to the services your firm provides in the regular course of business? N (Y/N) 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 and the monetary amounts or extended contract time involved. I hereby certify that all statements made are true and agree and understand that any misstatement or misrepresentation or falsification of facts shall be cause for forfeiture of rights for further consideration of the project identified. _ Holiday Lightscapes Inc. Firm Representative Date Sean Wolfe - Owner/President Printed or Typed Name and Title of Authorized Representative SECTION 00452-1 END OF SECTION City of Sanford I Finance Department I Purchasing Division 300 N. Park Avenue 2nd Floor Suite 236 Sanford, Florida 32771 S CITY OF FORD Phone: 401.688.5028 or 50301 Fax*. 407.688.5021 FINANCEDEPARTMENT INFORMAL REQUEST FOR QUOTE (IRFQ) TERM CONTRACT TITLE: Ist STREET STRING LIGHTS SECTION 00458 E -VERIFY COMPLIANCE AFFIDAVIT The Affiant identified below attests and agrees to the following: I That the Contractor is currently in compliance with and throughout the term of the above identified project and will remain in compliance with all controlling law requiring the use of the Department of Homeland Security's Status Verification ("E -Verify") System to ensure that all employees of the Contractor and the Contractors subcontractors performing work under the above -listed Contract are legally permitted to work in the United States. 2. Each Contractor that performs work under the Project referenced above shall provide the City of Sanford, Florida, a copy of the "Edit Company Profile" screen and any other information required by the City proving, to the satisfaction of the City, enrollment in the E -Verify Program and compliance with controlling law. 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-named 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 United States government and the State of Florida, as well as any and all law enforcement agencies of whatever jurisdiction, type of nature, and to provide a copy of each such verification to that authority as well as the City. 5. 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. 6. 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 under 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 may immediately terminate the Contract with the City without notice and without penalty. The Contractor further understands and agrees that in the event of such termination, the Contractor shall be liable to the City for any and all costs incurred by the City, in any context whatsoever, as a result of the Contractor's breach. 7. The Contractor shall obtain and maintain current affidavits providing proof, to the satisfaction of the City, that each subcontractor has complied with the requirements set forth herein and all controlling law. 8. Specifically, with regard to employment eligibility, the Contractor recognizes and agrees that, upon entering a Contract with the City (to include, but not be limited to, the provision of goods or services under a City purchase order or work order), that the Contractor is obligated to comply with the provisions of Section 448.095,� Florida Statutes, entitled "Employment Eligibility", which obligation includes, but is not limited to, utilization of the E -Verify System to verify the work authorization status of all newly hired employees, and requiring all subcontractors to provide an affidavit attesting that the subcontractor does not employ, contract with, or subcontract with, an unauthorized alien. Failure of the City of Sanford I Finance Department I Purchasing Division 300 N. Park Avenue 2ad Floor Suite 236 Sanford, Florida 32771 Ty or Phone. 407.688.5028 or 50301 Fax: 407.688.5021 DEPARTMENT INFORMAL "QUEST FOR QUOTE (IRFQ) I TERM CONTRACT TITLE: Pt STREET STRING LIGHTS Contractor to comply will lead to termination of the Contract with the City, or if a subcontractor knowingly violates the statute, the Contractor must immediately terminate their subcontract with the subcontractor. Any challenge to termination under this provision must be filed in the Circuit Court no later than 20 calendar days after the date of termination. If the Contract with the City is terminated for a violation of the statute by the Contractor, the Contractor may not be awarded a public contract for a period of 1 year after the date of termination and the City will advise any person desiring to be advised of such termination and make such termination a public record available under controlling law for inspection and copying and otherwise available as the City determines in its sole discretion. 9. 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, as amended, implemented by the United Stated Department of Homeland Security, or its successor or associated agency, and known as the "E -Verify Program", or any successor electronic verification system that may replace the E -Verify Program. "Subcontractoe"— Any person or entity, whether a subvendor/subcontractor/subconsultant, by whatever name or type or description, assisting the Contractor in the performance of the Contract with the City. 10. The obligations set forth herein are continuing in nature, type, effect and scope. 11. The undersigned signatory, under penalty of perjury, affirms that she/he has the plenary authority to bind the Contractor to the provisions hereof. Sean Wolfe Contractor Printed Signature oWuthorized Representative (Affiant) Date Sean Wolfe Printed or Typed Name STATE OF FLORIDA COUNTY OF L/3,Az-%,11 � I HEREBY CERTIFY that on this day,_before, r, an office uly authorized to administer oaths and take a 0 rd ( �,14 Onowledgments,-pfrsprially, eare#,0o; i6ky I -- I I who is personally known to me or [I -who produced "V 1 �-- as identification and swore and acknowledged before me, unTr oak, � �f Jh t s/� he Xecuted the same. Sworn and sUbscribed before me, by rC, At of , by means +4ysical presence or online notarization on the day of 2021 the said person did take an oath and was first duly sworn by me, on oath, said person,W—rther, deposing and saying that s/he has read the foregoing and that the statements contained herein all of which are true and correct. Not" Pubk State of Flonde Robert Douglas Guido MY Commission GG 225255 City of Sanford I Finance Department I Purchasing Division 300 N. Park Avenue 21111 Floor Suite 236 Sanford, Florida 32771 Phone: 407.688.5028 or 50301 Fax: 407.688.5021 1ww FINANCE DEPARTMENI INFORMAL REQUEST FOR QUOTE (IRFQ) I TERM CONTRACT WITNESS my hand and official seal in the County and State last aforesaid thisday ofr/ 2021. 49 14 (Notary Public in anqffor the County and State Aforementioned) SEAL My commission expires: T-- -v-Failure to submit this form may be grounds for disqualification of your submittal -w END OF SECTION Randa MN Z Wo M 1.2 11 OG 225265 EXPIMS 0610512022 REE I City of Sanford I Finance Department I Purchasing Division 300 N. Park Avenue 211"Floor Suite 236 Sanford, Florida 32771 S CITY OF Phone: 407.688.5028 or 5030 1 Fax: 407.688.5021 FINANCE CEPARIMEN't INFORMAL REQUEST FOR QUOTE (IRFQ) TERM CONTRACT TITLE: 1St STREET STRING LIGHTS SECTION 460 AMERICANS WITH DISABILITIES ACT AFFIDAVIT 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. Contractor 6/1 -A-K Signature of ut orized Representative (Affiant) Date Sean Wolfe - Owner/President Printed or Typed Name and Title of Authorized Representative (Affiant) SECTION 00460-1 City of Sanford I Finance Department I Purchasing Division 300 N. Park Avenue 2°d Floor Suite 236 Sanford, Florida 32771 S �FOCITY OF RD Phone: 407.688.5028 or 50301 Fax: 407.688.5021 FINANCE DEPARTMENT INFORMAL REQUEST FOR QUOTE (IRFQ) TERM CONTRACT TITLE: I" STREET STRING LIGHTS STATE OF FLORIDA COUNTY OF I HEREBY CERTIFY that on this day, before me, an officer duty authorized to administer oaths and take �"' — -) w 0 � /\ who is acknowledgments, personally appeared personally kn9wn to me or {who produc,ed as identification and acknowledged before me that s/he,. -7 ex ( te the e. Sworn and subscribed before me, by by means of {Tphysical presence or online notarization on the day of 20the said person did take an oath and was first duly sworn by me, on oath, sai&j1erson, further, dep2% bNng and saying that s/he has read the foregoing and that the statements and allegations contained herein are true and correct. WIT SS my hand and official seal in the County and and 'itate last aforesaid this IX -day of .2021 U , (Notary Public in ar@/for the County and State Aforementioned) SEAL My commission expires: C f f PLEASE COMPLETE AND SUBMIT WITH YOUR IRFQ RESPONSE 011'Failure to submit this form may be grounds for disqualification of your submittall"O SECTION 00460-2 END OF SECTION Notary POW Slate of Florida Robert Douglas Guido T 225255 =120 6"102'0'2 2 0% NA^ 04 ER I