INVITATION TO BID COVER PAGE - Granicussumterclerk.granicus.com/DocumentViewer.php?file=sumter...RESOLVED, that acombination of any two 01 the Chairman of the Board. the President,

Sumter County C-470 Water Main Extension ORIGINAL ITB # 011-0-2013/AT

PART 4BID DOCUMENTS

INVITATION TO BID COVER PAGE

-.

Name of Firm, Entity or Organization:

Harris-McBurney Company

Federal Employer Identification Number (FEIN): 38-2278214

State of Florida License Number (If Applicable):

Name of Contact Person: Gerry Gilbert

Title: President

E-Mail Address: [email protected]

Mailing Address: 2120 North US Highway 301, Tampa, FL 33619

Street Address (if different):

City, State, Zip:

Telephone: (813)626-7171 Fax: (813)623-5618

Organizational Structure - Please Check One:

Corporation flfPartnership 0 Proprietorship 0 Joint Venture 0 Other 0

If Corporation: Harris-McBurney Company

Date of Incorporation: 0 t b 1979 State of Incorporation: Michigancoer

States Registered in as Foreign Corporation: N/A

Authorized Signature:Ge'¢? ,. -,Print Name: ) , • • ~~:: • ," ~l~~i

,...... ......, .. _,. 1II ......" ...~ .':' -. ..~~

Signature:.....' .c... 1I .,;' I ".

~ ,,' <:--.'-==!. ~. ... .,. !-: ~ i .... ~ ~. ~ ~I ~ ,,::. :

~ : c, uJ '-' :Title: • President ~. c., ~.." -.'.~ .;

~.., .. c;; •.,,"~/• '1:); •• ''7

Phone: (813)626-7171 _~"I "".\';'... 4J~""

This document must be completed and returned with your Submittal,

Sumter County Board of County Commissioners Page 16 of40

PART 6EXHIBITS

Exhibit CBid Schedule

SUMMARY OF PAY ITEMSITEM NO. PAY ITEM DESCRIPTION QTY UNIT UNIT PRICE TOTAL

1 MOBILIZATION 1 LS $48,021.00 $48,021.00

2 MAINTENANCE OF TRAFFIC 1 LS $10,440.00 $10,440.00

3 CLEARING AND GRUBBING 1 LS $11,760.00 $11,760.00

4 TESTING & DISINFECTING 1 LS $22,360.00 $22,360.00

24" STEEL CASING JACK & BORE WI SPACERS, S.S.5 STRAPS & ALL APPURTENANCES PER DETAIL U-4, F&I 85 LF $491.00 $41,735.00

6 UTILITY PIPE, F&I, PVC, WATER, 6" 10 LF $29.00 $290.00

7 UTILITY PIPE, F&I, DIP, WATER, 12" 125 LF $57.00 $7,125.00

8 UTILITY PIPE, F&I, PVC, WATER, 12" 16970 LF $30.00 $509,100.00

9 UTILITY PIPE, F&I HDD, HDPE, WATER, 14" 376 LF $122.00 $45,872.00

10 UTILITY FiniNG, F&I, DI/CI, ELBOW, 12" 27 EA $616.00 $16,632.00

11 UTILITY FiniNG, F&I, DI/CI, TEE, 12" 1 EA $924.00 $924.00

12 UTILITY FiniNG, F&I, DI/CI, TEE, 6"X12" 2 EA $710.00 $1,420.00

13 UTILITY FiniNG, F&I, DI/CI, REDUCER, 10"X12" 1 EA $587.00 $587.00

14 UTILITY FIXTURE, F&I, WET-TAP ASSEMBLY, 10"x10" 1 EA $6,049.00 $6,049.00

15 UTILITY FIXTURE, F&I, MJ CAP, 6" 2 EA $475.00 $950.00

UTILITY FIXTURE, F&I, VALVE ASSEMBLY, 6",

16 2 $1,041.00 $2,082.00

17 UTILITY FIXTURE, F&I, VALVE ASSEMBLY, 12" 23 EA $2,360.00 $54,280.00

18 UTILITY FiniNG, F&I, 2" BLOW OFF ASSEMBLY 2 EA $2,084.00 $4,168.00

UTILITY CROSSING CONFLICT RESOLUTION PER DETAIL19 U-3, F&I 10 EA $5,249.00 $52,490.00

20 FIRE HYDRANT ASSEMBLY WI GATE VALVE, F&I 19 EA $3,989.00 $75,791.00

21 SERVICE CONNECTION ASSEMBLY WI 2" POLY PIPE, F&I 6 EA $2,217.00 $13,302.00

22 SODDING 17940 SY $3.50 $62,790.00ASPHALT PAVEMENT & SUBGRADE ROAD I DRIVEWAY

23 REPAIR 872 SY $67.00 $58,424.00

24 L1MEROCK I GRAVEL ROAD I DRIVEWAY REPAIR 406 SY $28.00 $11,368.0025 SILT FENCE 500 LF $2.40 $1,200.00

TOTAL: $1,059,160.00

Bond No.: N/A--=-..:.:.:...:-_-----

THE AMERICAN INSTITUTE OF ARCHITECTS

AlA Document A310

Bid Bond

KNOW ALL MEN BY THESE PRESENTS, that weHarris-McBurney Company, 2120 N. U.S. Hwy 301, Tampa, FL 33619

as Principal, hereinafter called the Principal, andDevelopers Surety and Indemnity Company, 100 2nd Ave. South, St. Petersburg, FL 33701

a corporation duly organized under the laws of the State of Iowaas Surety, hereinafter called the Surety, are held and firmly bound untoSumter County Board of Commissioners7375 Powell Road, Wildwood, FL 34785

as Obligee, hereinafter called the Obligee, in the sum of Five Percent of Amount Bid in Dollars forthe payment of which sum well and truly to be made, the said Principal and the said Surety, bindourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly bythese presents.

WHEREAS the Principal has submitted a bid forITB-11-0-2013/AT - County Road 470 Water Main Ext

(Seal)(Witness)

NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enterinto a Contract with the Obligee in accordance with the terms of such bid, and give such bond or bondsas may be specified in the bidding or Contract Documents with good and sufficient surety for the faithfulperformance of such Contract and for the prompt payment of labor and material furnished in theprosecution thereof, or in the event of the failure of the Principal to enter such Contract and give suchbond or bonds, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereofbetween the amount specified in said bid and such larger amount for which the Obligee may in goodfaith contract with another party to perform the Work covered by said bid, then this obligation shall·be' ,: .null and void, otherwise to remain in full force and effect. ..' '. 'J -':'.,:::'. • ••••••

':'.. ~~- ......4.. ..-......# .. ~,,"" • '.. ~

• / ~. .... CI..

Signed and sealed this 24 day of May, 2013 ~;{: ~~. •

.:- :.. c:~ ('(..I r:) 10-

, ~ '. C.:J---:....:=..:...:..=-.:::.;=.~~~-=..:..:.=.::::.:.L. ---'-.., """""7-':":"'",, •

--: _,~ ,:•. ... .".,,~ .. "'iI·

Brenda Thomas (Witness) As to Surety

Develo and Indemnit

The ProSure Group, Inc.• 7217 Benjamin Rd.• Tampa. FL 33634(813) 243-1110 Phone" (813) 243-1109 Fax

POWER OF ATTORNEY FORDEVELOPERS SURETY AND INDEMNITY COMPANY

PO Box 19725, IRVINE, CA 92623 (949) 263·3300

KNOW ALL BY THESE PRESENTS that except as expressly limited, DEVELOPERS SURETY AND II~DEMNITY COMPANY, does hereby make, constitute and appoint:

·--David B. Shick--·

as its lrue and lawful Altorney{s)·in-Fact, to make, execute, deliver and acknowledge, for and on behalf of said corporation, as surety, bonds, undertakings and contracts of surelyshipgiving and granting unto said Allorney{s)-in·Fact full power and authority to do and to perform every act necessary, requisite or proper to be done in connection therewith as each of saidcorporation could do, but reserving to each of said corporation full power of substitution and revocation, and all of the acls of said Altorney(s)-in-Fact, pursuant to these presents, arehereby ratified and confirmed.

This Power of Attorney is granted and is signed by facsimile under and by authority of Ihe follov~ng resolution adopted by the Board of Directors of DEVELOPERS SURETY ANDINDEMNITY COMPANY, effective as of January 1sl, 2008.

RESOLVED, that a combination of any two 01 the Chairman of the Board. the President, any Executive Vice·President, Senior Vice-President or Vice-President of thecorporation be, and lhat each of them hereby is, alllllorized to execute this Power of Allorney, qualifying lIle atlorney{s) named in the Power of Attorney to execute, on bellalf of thecorporation, bonds, undertakings and contracts of suretyship: and thai the Secretary or any Assistant Secretary of the corporation be, and each of them hereby is, authorized to attest theexecution of any such Power of Attorney;

RESOLVED, FURTHER, thai the signatures of such officers may be affixed to any such Power of Attorney or to any certificate retating thereto by facsimile, and any suchPower of Attorney or certificate bearing such facsimile signatures shall be valid and binding upon the corporation when so affixed and in the future with respect to any bond, undertakingor contract of suretyship to which it is atlached.

IN WITNESS WHEREOF, DEVELOPERS SURETY AND INDEMNITY COMPANY has caused these presents to be signed by its officers and attested by its Secretary or AssistantSecrelary this October 4th, 2011.

BYD1;2~¥~BS~a~~"-y. .__.__. Z.---"'-~_

Steve A. Tvedt. Vice-President

State of CaliforniaCounty of Orange

On October 4,2011Date

___ before me, ._ _Ao.:;n",to",n.::;io::.;A,-"I;..:va.::;ra",d",o,,-,Nc:.o:..:t"'ary-'-':-P-=:ub"'li:.::,c _Here Insert Name and Title of the Officer

personally appeared . . _ Daniel Young and SIeve A. TvedtName(s) of Signer{s)

i certify under PENALTY OF PERJURY under the laws of the Slate of California thallhe foregoing paragraph is

true and correct.

WITNESS my hand and official seal.~~.

Signature ._. --=~=_:___,.,_-==_:_:_~_=~:__---.:.---- ..-.-_.--_.--...-...Antonio Alvarado, Notary Public

-----·-·~--------·-~·---------·----~J~~~~d to ~~ ~n the basi~~~atisfactory evidence to be the person(s) whose name(s) is/are subscribed to

tile within instrument and acknowiedged to me that he/slle/they executed the same in his/her/their authorizedcapacity(ies), and lIlat by his/l1er/their signature(s) on lhe instrument the person{s), or the entily upon behalf ofwhich the person(s) acted, executed lhe instrument.ANTONIO ALVARADO I~

COMM. ## 1860643 :fNOTARY PUBUC CAUFORNIA ~

ORANGE COUNTY I\i

My comm. expires Aug. 9. 2013 It; • i • • • • • • 4 + +

t +. t .. « e),'!+"e!h @q'At "$wAh.""

Place Notary Seal Above

CERTIFICATE

,-m~ .f)ot.3.

The undersigned, as Secretary or Assislant Secretary of DEVELOPERS SURETY AND INDEMNITY COMPANY does l1ereby certify thai the foregoing Power of Attorney .remains in full force and l1as nol been revoked and. furthermore, that the provisions of tile resolution of the Board of Directors of Said corporation set forth In the Power of Attorney are In

force as of the dale of Ihis Certificate.

This Certificate is executed in Ihe City of Irvine, California, this ~ I{ day of

By:~_Jl ~!stant Secretary

ID-1438{Rev.10/11 )

"

Sumter County C·470 Water Main Extension ITB # 011-0-2013/AT

BID DOCUMENTS CHECKLIST OF ITEMS REQUIRED TO BE SUMBITTEDThe following documents and forms in the following arrangement must accompany each bid oralternate bid submitted:

• Sid Cover Page. This is to be used as the first page of the ITS. This form must be fullycompleted and signed by an authorized officer of the vendor.

• Sid Document Checklist of Items Required to be Submitted.

• A separate sheet or sheets, clearly identified and numbered, of Exceptions or Deviationsfrom the minimum specifications, must be attached to the Sid Form (if applicable).

• Proposer Certification / Addenda Acknowledgement Form.

• Sid I Price Form.

• Statement of General Terms and Conditions.

• A sworn, notarized Statement of Contractor's Experience and Personnel.

• A sworn, notarized Drug Free Work Place Certificate must accompany each bid oralternate bid.

• Disclosure of Subcontractors, Sub-consultants and Suppliers.

• Hold Harmless Agreement.

• E-Verify Certification Form.

• Anti-Collusion Statement.

• Statement of Public Entity Crimes.

• One (1) original bid, clearly labeled "Original"; three (3) printed copies of the bid in itsentirety; and one (1) electronic version not password protected of the original submittedbid in its entirety.

• A Certificate of Insurability, acceptable to the County, shall accompany each bid oralternate bid, in the amounts as prescribed by State and Sumter County SOCC

o All insurance policies shall be written on companies authorized to do business inthe State of Florida and satisfactory to the Sumter County SOCC. Prior tocommencing services pursuant to the award of this bid, the Contractor shallfurnish to the Sumter County SOCC certificates of insurance showing therequired coverage has been procured and paid for in advance. Within thirty (30)days prior to expiration, the Contractor shall provide the Sumter County SOCCwith proof that required coverage has been extended.


Sumter County C-470 Water Main Extension

Date: May 24th, 2013

ITB # 011-D-2013/AT

I, Gerry Gilbert (name), an authorized officer of Harris-McBurney Company

(company/vendor), confirm that the above listed documents are provided in our company's bidbeing submitted to Sumter County and confirm I have read and understand the ITS document inits entirety.


Sumter County C·470 Water Main Extension

PROPOSER'S CERTIFICATION

ITS # 011·0·2013IAT

Submit To: Sumter County Board of County CommissionersSUMTER COUNTY BOARD OF COUNTY COMMISSIONERS

7375 Powell RoadWildwood, FL 34785 INVITATION TO BID (ITB) CERTIFICATIONPhone 352-689-4435

Fax 352-689-4436 AND ADDENDA ACKNOWLEDGMENT

DUE DATE: May 24, 2013 I DUE TIME: 11 :00 a.m. I ITS # 011-0-2013/AT

TITLE: Sumter County C-470 Waterline ExtensionVENDOR NAME: PHONE NUMBER:

Harris-McBurney Company (813)626-7171VENDOR MAILING ADDRESS: FAX NUMBER:

2120 North US Highway 301 (813)623-5618CITY/STATE/ZIP: E-MAIL ADDRESS:

Tampa, FL 33619 [email protected]

"I, the undersigned, certify that I have reviewed the addenda listed below (list all addenda received to date). I understand that timelycommencement will be considered in award of this ITB and that cancellation of award will be considered if commencement time isnot met, and that untimely commencement may be cause for assessment of liquidated damages claims. I further certify that theservices will meet or exceed the ITB requirements. I, the undersigned, declare that I have carefully examined the ITB,specifications, terms and conditions as applicable for this Request, and that I am thoroughly familiar with all provisions and thequality and type of coverage and services specified. I further declare that I have not divulged, discussed, or compared this ITB withany other Offeror and have not colluded with any Offerors or parties to an ITB whatsoever for any fraudulent purpose."

1 2Addendum # Addendum # Addendum # Addendum # Addendum #

"I certify that this quote is made without prior understanding, agreement, or connection with any corporation, firm, or personsubmitting an ITB for the same material, supplies, equipment or services and is in all respects fair and without collusion Q,r.IfrMa' Iagree to abide by all conditions of this ITB and certify that I am authorized to sign this response and that the offer is il1,CO!lWliance..•with all requirements of the ITB, including but not limited to certification requirements. In conducting offers with an a-g,eflcy-fcif"Sumter County Board of County Commissioners (BOCC), respondent agrees that if this bid is accepted, the respondent-wl1l ~vey,sell, assign, or transfer to the Sumter County BOCC all rights, title and interest in and to all causes of action it may noy.' - Der~c;.fteL

,,,,"'m "<>de, the ",,-,,",t "", of the Uo,ed Stete, fo< po", fudog ml,ti",t~~Oditi'"0< "M&,!iu" , o(acquired by the COUNTY. At the Sumter County BOCC discretion, such asslgnme sh be ade and become-~ffi?eu.ye he;.time the purchasing agency renders final payment to the respondent." vI"')(j) ..... -;;

Gerrv Gilbert ,President 5/2 4 '1-2,Q1.3 •Authorized Agent Name, Title (Print) tAuthorized Signature Date',

"t .. ~

This document must be completed and returned with your Submittal

Sumter County Soard of County Commissioners Page 17 of40

Sumter County C·470 Water Main Extension ITB # 011-o-2013/AT

STATEMENT OF TERMS AND CONDITIONS

2013May 24th,, President(Signature and Date)

BOARD OF SUMTER COUNTY COMMISSIONERS. are political subdivisions of the Stale of Florida, and reserve theright to reject any and/or all submittals, reserve the right to waive any informalities or irregularities in the examinationprocess, and reserve the right to award contracts and/or in the best interest of the Boards. Submittals not meetingstated minimum terms and qualifications may be rejected by the Boards as non-responsive. The Boartls reserve theright to reject any or all submittals without cause. The Boards reserves the right to reject the submission of anyVendor in arrears or in default upon any debt or contract to the Boards, or who has failed to perform faithfully anyprevious contract with the Boards or with other governmental agencies.PUBLIC RECORDS LAW: Correspondence, materials and documents received pursuant to this RFP/BID becomepublic recortls subject to the provisions of Chapter 119, Florida Statutes.VERIFICATION OF TIME: Nextel time is hereby established as the Official Time of the Boartls.PREPARATION OF BIDS/BIDS:Signature of the Bidder: The Bidder must sign the RFP/Blo FORMS in the space provided for the signature. If theProposer/Bidder is an individual, the words -doing business as ~ must appear beneath suchsignature. In the case of a partnership, the signature of at least one of the partners must follow the firm name and thewords, "Member of the Firm" should be written beneath such signature. If the Proposer/Bidder is a corporation, thetitle of the officer signing the RFP/BID on behalf of the corporation must be stated and evidence of his authority to signthe RFP/BID ITklst be submitted. The Proposer/Bidder shall state in the RFP/BID FORMS the name and address ofeach person interested therein.Basis for Bidding: The price proposed for each item shall be on a lump sum or unit price basis according tospecifications on the RFP/SID FORM. The proposed prices shall remain unchanged for the duration of the Contractand no claims for cost escalation during the progress of the work will be considered, unless otherwise provided herein.Total Proposed PricelTotal Contract Sum Proposed: If applicable, the total price bid for the work shall be theaggregate of the lump sum prices proposed and/or unit prices multiplied by the appropriate estimated quantities for theindividual items and shall be stated in figures in the appropriate place on the RFP/BID FORM. In the event that thereis a discrepancy on the RFPIBID FORM due to unit price extensions or additions, the corrected extensions andadditions shall be used to determine the project bid amount.TABULATION: Those wishing to receive an official tabulation of the results of the opening of this RFP/BID are tosubmit a self-addressed, stamped business size (No. 10) envelope, prominently marked on the front lower left side,with the RFP identification. Tabulation requested by telephone, fax or electronic media will not be accepted.OBLIGATION OF WINNING BIDDER: The contents of the RFP/810 of the successful proposerlbidder will becomecontractual obligations if acquisition action ensues. Failure of the successful ProposerlBidder to accept theseobligations in a contract may resutt in cancellation of the awartl and such vendor may be removed from futureparticipation.AWARD OF BID: It is the Boards' intent to select a vendor within sixty (60) calendar days of the deadline for receiptof Bids/Bids. However, Bids/Bids must be firm and valid for awartl for at least ninety (90) calendar days after thedeadline for receipt of the RFP/BID.ADDITIONAL REQUIREMENTS: The firms shall furnish such additional information as the Boards may reasonablyrequire. This includes information which indicates financial resources as well as ability to provide the services. TheBoards reserve the right to make investigations of the qualifications of the firm as it deems appropriate.PREPARATION COSTS: The Boards shall not be obligated or be liable for any costs incurred by Proposers/Biddersprior to issuance of a contract All costs to prepare and submit a response to this RFPIBIO shall be bome by theProposer/Bidder.TIMELINESS: All work will commence upon authorization from the Boards' representative (Financial ServicesManager). All work will proceed in a timely manner without delays. The Contractor shall commence the work UPONRECEIPT OF NOTICE TO PROCEED andlor ORDER PLACED (PURCHASE ORDER PRESENTED), and shalldeliver in accortlance to the terms and conditions outlined and agreed upon herein.DELIVERY: All prices shalf be FOB Destination, Sumter County, Florida, inside delivery unless otherwise specified.ADDITIONAL SERVICES/PURCHASES BY OTHER PUBUC AGENCIES ("PIGGY-BACK"):The Vendor by submitting a Bid acknolNtedges that other Public Agencies may seek to "Piggy-Back" under the sameterms and conditions, during the effective period of any resulting contract - services and/or purchases being offered inthis Bid, for the same prices and/or terms proposed. Vendor has the option to agree or disagree to allow contractPiggy-Backs on a case-by-case basis. Before a Public Agency is allowed to Piggy-Back any contract, the Agencymust first obtain the vendor's approval- without the vendor's approval, the seeking Agency cannot Piggy-Back.PLANS, FORMS & SPECIFICATIONS: Bid Packages are available from the Financial Services Manager. Thesepackages are available for pickup or by mail. If requested to mail, the Proposer/Bidder must supply a courier accountnumber (UPS, FedEx, etc). ProposerslBidders are required to use the official RFP/BIO FORMS, and all attachmentsitemized herein, are to be submitted as a single document. Any variation from the minimum specifications must beclearty stated on the RFPIBID FORM and/or Exceptions/Deviations Sheet(s). Onty one set of plans, forms, andspecifications will be fumished each colll>any or corporation interested in submitting a bidlbid. RFP/BID FORMdocuments for this project are free of charge and are available on-line and are downloadable (vendor must pay anyDemandStar fees or any shipping).MANUFACTURER'S NAME AND APPROVED EQUNALENTS: Any manufacturer's names, trade names, brandnames, information and/or catalog numbers listed in a specification are for information and not intended to limitcompetition unless otherwise indicated. The Proposer/Bidder may offer any brand for which he is an authorizedrepresentative, which meets or exceeds the RFP/SID specification for any item(s). If RFP's/BID's are based onequivalent products, indicate on the RFP/BID FORM the manufacturer's product name and literature, and/or completespecifications. Reference to literature submitted with a previous RFP/BIO will not satisfy this provision. ThePropose~/Bidder shall expl.ain in detail the reason(s) why the proposed equivalent will meet the specifications and notb~ c~nsldered an exceptIon thereto. RFP'slBlo's which do not comply with these requirements are subject torejection. RFP'slBID's lacking any written indication of intent to quote an alternate brand will be received andconsidered in complete compliance with the specifications as listed on the RFP/BID FORM. The Financial ServicesManager. is to be notified, in writing, of any proposed changes in materials used, manufacturing process, orconst~ctlon. HOYJe.ver, ~ange~ shall not be binding upon the Boards unless evidenced by a Change Notice issuedand SIgned by the FinanCial Services Manager, or designated representative.QUANTITIES: The quantities as specified in this RFP/BID are estimates only and are not to be construed asguaranteed minimums.SAMPLES: Samples of items, when called for, shall be fumished free of expense, and if not destroyed may, uponrequest, be retumed at the Proposer's/Bidder's expense. Each sample shall be labeled with the Proposer's/Bidder'sname, manufacturer brand name and number, RFP/BID number and item reference. Samples of successfulProposer's/Bidder's items may remain on file for the term of the contract. Request for retum of samples shall beaccompanied by inst~ctions VYtlich include shipping authorization and must be received at time of opening. Samplesnot retumed may be disposed of by the Boards within a reasonable time as deemed appropriate.DOCUMEN.T RE-CREATIO . endor may choose to re-create any document(s) required for this solicitation, but mustdo so at hrs 0 sire uired information in the original Board format must be included in any re-createddocument. mittal may deemed non·responsive ff required information is not included in any re-createddocument

ACKN~7

Ger, GilbertHal' is-McBurney CompanyCorporation


PUBLIC ENTITY CRIME: A person or affiliate ......no has been placed on the convicted vendor list following aconviction for a public entity crime may not submit a Bid/Bid on a contract to provide any goods or services to apublic entity, for the construction or repair of a public building or public INOrk, may not submit Bids/Bids onleases of real property to a public entity, may not be awarded or perform work as a contractor, supplier,subcontractor, or consultant under a contract with any public entity, and may not transact business YJith anypublic entity in excess of the threshold amount provided in Section 287.017, for CATEGORY TWO for a periodof 36 months from the date of being placed on the convicted vendor list.INDEMNIFICATION: The Contractor agrees to indermify and hold harmless Board of Sumter CountyCommissioners, and their elected officials, employees and volunteers from and against all claims, losses andexpenses, including legal costs, arising out of or resulting from, the performance of this contract, provided thatany such claims, damage, loss of expenses is attributed to bodily injury, sickness, disease, personal injury ordeath, or to injury to or destruction of tangible property including the loss or loss of use resulting there from andis caused in whole or in part by any negligent act or omission of the tenant.PROHIBITION OF LOBBYING: During the black out period which is, the period between the time thesubmittals for Invitation to Bid or the Request for Bid, or Qualifications, or information, as applicable, arereceived at Contracts / Purchasing and the time the Board awartls the contract, no proposer, no lobbyist,principal, or other person may lobby, on behalf of a competing party in a particular procurement matter, anymember of the Board, or any Board employee other than the Financial Services Manager. Violation of thisprovision may result in disqualification of violating party. All questions regarding this Request for Bid (RFP) orInvitation to Bid (BID) must be submitted in writing to the Board's Financial Services Manager.ANTI TRUST LAWS: By submission of a signed RFP or BID, the successful Vendor acknowledges compliancewith all antitrust laws of the United States and the State of Florida, in order to protect the public from restraint oftrade, VYtlich illegally increases prices.CONFLICT OF INTEREST: The award of the contract hereunder is subject to the provisions of Chapter 112 ofthe Florida Statutes. Vendors shall disclose the name of any Officer, Director, Partner, Associate, or Agent VYtlois also an Officer, Appointee, or Employee of any of the Boards at the time of the RFP or BID, or at the time ofoccurrence of the Conflict of Interest thereafter.INTERPRETATION, CLARIFICATIONS AND ADDENDA: No oral interpretations will be made to any vendoras to the meaning of the RFP/BID Contract Documents. My inquiry or request for interpretation received bythe Financial Services Manager before the date listed herein will be given consideration. All such changes orinterpretations will be made in writing in the form of an addendum and, if issued, will be distributed at or afterthe Pre-Bid/Pre-Bid Conference, mailed or sent by available or electronic means to all attending prospediveSubmitters prior to the established RFP/BID opening date. Each Vendor shall acknowledge receipt of suchaddenda in the space provided. In case any Proposer/Bidder fails to acknowledge receipt of such addenda oraddendum, his offer will nevertheless be construed as though it had been received and acknowledged and thesubmission of his bid will constitute acknowledgment of the receipt of same. An addenda are a part of theRFP/BID FORMS and each Proposer/Bidder will be bound by such addenda, whether or not received by him. Itis the responsibility of each proposer/bidder to verify that he has received all addenda issued beforeRFP's/Blo's are opened. In the case of unit price items, the quantities of work to be done and materials to befurnished under this RFP/BID Contract are to be considered as approximate only and are to be used solely forthe comparison of RFP'slBID's received. The Boartl andJor his CONSULTANT do not expressly or byimplication represent that the actual quantities involved will correspond exactly therewith; nor shall the Vendorplead misunderstanding or deception because of such estimate or quantities of work performed or materialfurnished in accordance with the Specifications and/or Drawings and other Bid/Bid Documents, and it isunderstood that the quantities may be increased or diminished as provided herein without in any wayinvalidating any of the unit or lump sum prices bid.GOVERNING LAWS AND REGULATIONS: The vendor is required to be familiar with and shall be responsiblefor complying with all federal, state and local laws, ordinances, rules and regulations that in any manner affectthe work.PROPRIETARY/CONFIDENTIAL INFORMATION: Vendors are herby notified that all information submittedas part of, or in support of RFP's/BID's, will be available for public inspection ten days after opening of theRFP's/BID's or until a short list is recommended whichever comes first, in compliance with Chapter 119, and287 of the Florida Statutes. Any person wishing to view the RFP's/BID's must make an appointment by callingthe Financial Services Manager at (352) 689-4400. All RFP's/BIO's submitted in response to this solicitationbecome the property of the Board. Unless information submitted is proprietary, copy written, trademarked, orpatented, the Boartl reserves the right to utilize any or all information, ideas, conceptions, or portions of anyRFP/BID, in its best interest.TAXES: The Board of Sumter County Commissioners is exempt from any taxes imposed by the State and/orFederal Government. Exemption certificates will be provided upon request.NON~OLLUSION DECLARATION: By signing this RFPIBID, all Vendors shall affirm that they shall notcollude, conspire, connive or agree, directly or indirectly, with any other Proposer, firm, or person to submit acollusive or sham Bid in connection with the IM>rk for VYtlich their RFPIBID has been submitted; or to refrain fromBidding in connection with such work; or have in any manner, directly or indirectly, sought by person to fix theprice or prices in the RFP/BID or of any other Bidder, or to fix any overhead, profit, or cost elements of theRFP/BID price or the RFP/BID price of any other Bidder, or to secure through any collusion, conspiracy,connivance, or unlawful agreement any advantage against any other Bidder, or any person interested in theproposed 'vWrk.PROPOSER RESPONSIBILITY: Invitation by the Boards to vendors is based on the recipient's specificrequest and application to DemandStar by Onvia at W'MY.DemandStar.com [(800) 711-1712] or as the result ofresponse by the public to the legal advertisements required by State law. Firms or individuals submit theirresponses on a voluntary basis, and therefore are not entitled to compensation of any kind.OWNERSHIP OF SUBMITTALS: All responses, inquiries or correspondence relating to or in reference to thisRFP/BID, and all other reports, charts, displays, schedules, exhibits and other documentation submitted by thevendors will become the property of the Board. Reference to literature submitted with a previous RFP/BID willnot relieve the Bidder from including any required documents with this RFP/BID.EXAMINATION OF BID DOCUMENTS: Each Bidder shall carefully examine the RFP/Blo Document to ensureall pages have been received, all drawings and/or Specifications and other applicable documents are included,and shall inform himself thoroughly regarding any and all conditions and requirements that may in any manneraffect cost, progress or performance of the IM)rk to be performed under the Contract. Ignorance on the part ofthe CONTRACTOR will in no way relieve him of the obligations and responsibilities assumed under theContract.VENDOR RESPONSIBILITY: Vendors are fully and completely responsible for the labeling, identification anddelivery of their submittals. The Financial Services Manager will not be responsible for any mislabeled ormisdirected submissions, nor those handled by delivery persons, couriers, or the US Postal Service.DRUG FREE WORKPLACE: All Proposers/Bidders shall submit the enclosed, duly signed and notarizedform entitled "Drug Free Workplace Certificate". The Drug Free Workplace Vendor shall have theburden of demonstrating that his program complies with Section 287.087 of the Florida Statutes, andany other applicable state law.


Sumter County C·470 Water Main Extension ITS # 011·D-2013IAT

STATEMENT OF CONTRACTOR'S EXPERIENCE AND PERSONNEL

(Contractor may also provide any supplemental company or personnel information that willassist the Selection Committee in evaluating your bid).

CONTRACTOR: Harris-McBurney Company

DATE: May 24th, 2013

1. How many years has your organization been in business as a general contractor under yourpresent business name? _2_5_.:.y_e_a_r_s_t_o_t_a_l _

2. List all previous business names of your organization:N/A

3. How many years experience in general contracting? _7_S _

Prime Contractor _7;...S"'-- Subcontractor --=-N:.L/..=A-=-- _

4. List all officers and directors of your organization:

NAME

Linda Gilbert

Gerry Gilbert

Terry S Moats

Christine S Richards

POSITIONfTlTLE

CEO/Shareholder

President/Shareholder

Treasurer/Shareholder

Corporate Secretary

5. Have you ever failed to complete any work awarded to you in the last 3 years?Yes __No~. If yes, where and why?

EXPERIENCE

1. Describe any experience of the principal individuals (Foremen, Superintendents, etc.) who areresponsible for the actual general contracting work of your organization?

Shawn Gilbert, GCNameWater and TelephoneType of Work

Sumter County Board of County CommIssIoners

11Yrs. Experience

Project ManagerPosition11

Yrs. With Firm

Page 19 of40


Robert C Johnson, GCNameTelephone, Cell Sites, ExcatatorType of Work

Michael ForresterNameWater, Sewer and ExcavationType of Work

Rodney WithamNameWater, Sewer and ExcavationType of Work

20+Yrs. Experience

20+Yrs. Experience

20+Yrs. Experience

ITS # 011-Q-2013/AT

Project ManagerPosition

2Yrs. With Firm


5Yrs. With Firm


3 MonthsYrs. With Firm

Kenny TillmanNameWater, Sewer, TelecommunicationsType of Work

20+Yrs. Experience

Lead ForemanPosition

5Yrs. With Firm

2. List/describe five (5) construction contracts that you currently have.

Fire Protection Improvement Program- Alafia River RidgeProject

5/1/2013Date

Riverview, FLLocation

$1,216,048.00Contract Amount

Metzger + Willard, Inc - Joe Martelli. P.E. (813)977-6005Project Architect Contact Name and Phone Number

Hillsborough County - Mark Dillman, P.M.Owner's Contact Name and Phone Number

City of Temple Terrace -US 301 FDOT Utility RelocationProject

4/10/2013

Date

City of Temple Terrace-Pierre Valles, Senior Engineer

Project Architect Contact Name and Phone Number

Same as Above

Contact Name and Phone Number

Sumter County Soard of County Commissioners

(813)209-3058

Temple Terrace, FLLocation

$296,565.00

Contract Amount

(813) 506-6564

Page 20 of40

Sumter County C-470 Water Main Extension ITB # 011-0-2013/AT

Manatee County- Force Main Replacement lA,2A & 16AProject

3/12/2013

Manatee,FLLocation

$1,496,211. 00

Date Contract Amount

CH2M Hill- Jim Bradbury, P.E. (813)874-0777 x57712Project Architect Contact Name and Phone Number

Manatee County - Brian Bates, P.M. (941) 708-7450 x7329Contact Name and Phone Number

City of Bowling Green Hardee Street Water System Improvements Bowling Green, FL

Project Location

2/20/2013 $246,858.00

Date

Envisors, LLC -Asma Boukadoum, P.E.

Contract Amount

(863) 324-1112

Project Architect Contact Name and Phone Number

Same as AboveContact Name and Phone Number

Pasco County Dual Check Valve Change Out Program Pasco, FL

Project Location

1/17/2013 $99,960.00

Date Contract Amount

N/AProject Architect Contact Name and Phone Number

Pasco County Labor Supervisor I - Martin Thomas (813) 929-7965

Contact Name and Phone Number

CONTRACTOR'S AFFIDAVIT

State of FloridaCounty of Hill sborough

Before me personally appeared Gerry Gilbert who is (tit/e) Presidentof (the company described herein) Harris-McBurney Company being duly sworn, deposes and say that the foregoing statementsare a true and accurate statement of the position of said organization as of the date thereof, and, that the statements and answersto the foregoing experience questionnaire are correct and true as of the date of this affidavit; and, that he/she understands thatintentional inclusion of false, deceptive, or fraudulent statements of this application constitutes fraud; and, agrees to furnish anypertinent information requested by The Sumter County Board of County Commissioner deemed necessary to verify the statementsmade in this application or regarding the ability, standing and general reputation of the applicant.

Personally Known _X~__ or Produced Identification _

","~~¥.~~4't> OHAISTlNE J. RiCHARDS*..~ * MY COMMISSION. DO 994502"'~ EXPIRES: September 18, 2014c;;,1'~OFF~C~<J" Bonded Thru Budget Notary Services

Christine J Richards(Print Name of Notary Public)

____ day of_M_a..:::y , 2013

LI TE OF FLORIDA(Signature of Notary Public)

(seal)

This document must be completed and returned with your SubmittalSumter County Board of County Commissioners Page 21 of40


DRUG FREE WORKPLACE CERTIFICATE

I, the undersigned, in accordance with Florida Statute 287.087, hereby certify that,


(print or type name of firm)

ITB # 011-Q-2013/AT

• Publishes a written statement notifying that the unlawful manufacture, distribution, dispensing,possession or use of a controlled substance is prohibited in the workplace named above, andspecifying actions that will be taken against violations of such prohibition.

• Informs employees about the dangers of drug abuse in the work place, the firm's policy ofmaintaining a drug free working environment, and available drug counseling, rehabilitation, andemployee assistance programs, and the penalties that my be imposed upon employees for druguse violations.

• Gives each employee engaged in providing commodities or contractual services that are underproposal or bid, a copy of the statement specified above.

• Notifies the employees that as a condition of working on the commodities or contractual servicesthat are under proposal or bid, the employee will abide by the terms of the statement and willnotify the employer of any conviction of, please or guilty or nolo contendere to, any violation ofChapter 1893, or of any controlled substance law of the State of Florida or the United States, fora violation occurring in the work place, no later than five (5) days after such conviction, andrequires employees to sign copies of such written (*) statement to acknowledge their receipt.

• Imposes a sanction on, or requires the satisfactory participation in, a drug abuse assistance orrehabilitation program, if such is available in the employee's community, by any employee who isso convicted.

• Makes a good faith effort to continue to maintain a drug free work place through theimplementation of the drug free workplace program.

• "As a person authorized to sign this statement, I certify that ecorporation complies fully with the requirements set forth ere'

May 24th, 2013Date Signed

State of: Florida

County of:Hi 11sborough

Sworn to and subscribed before me this 24th day of_M-'a-'-y'--- , 20...13

y ............-=__ or Produced Identification _-:-=-_-:-:--=:- _

(Specify Type of Identification)

/Christine J Richards

Signature of Notary

My Commission Expires September 18th, 2014

(seal)

$~~.1. ~~9r<t> QHRISTINE J. RICHARDS*"'~ 1< MY COMMISSION #DO 994502"'~'" EXPIRES: September 18, 2014~~~OF F\.o<i>'" Bonded Thru Budget Notary Services



Sumter County C-470 Water Main Extension ITB # 011-o-2013/AT

DISCLOSURE OF SUBCONTRACTORS, SUBCONSULTANTS AND SUPPLIERS

SUBCONTRACTOR LICENSE INFORMATION MUST BE SUBMITTED WITH THE ITB, INORDER FOR SUMTER COUNTY TO VERIFY THAT THE SUBCONTRACTOR ARE IN FACTLICENSE PERFORM THEIR TRADE SCOPE OF WORK.

Name of Firm Submitting Bid:


(Print or Type)

Name of Person Submitting Bid:

Gerry Gilbert

(Print or Type)

Please list all Subcontractors, or Material \ Equipment Suppliers to be used in connectionwith performance of this contract. Attach additional sheets as necessary.

Name of Firm or Agency: Florida Contractors Video Service

Address: P.o. Box 907 Valrico, FL 33595-0907

Telephone: (813) 737-1774

Contractor's License numberContact Name / Title: Norma Oosting, Owner

Name of Firm or Agency: GeoSurv, LLCAddress: 5707 19th Street West, Bradenton, Fl. 34207

Telephone: (877) 407 -3 734

Contractor's License numberContact Name / Title: David J. Coughlin, Jr. Survey Proj ect Manager

Name of Firm or Agency: Blevins Road BoringAddress: 15044 Reginald Lane, Hudson, FL 34667

Telephone: (727) 863 - 9647Contractor's License number CUC 0 5 7 384

Contact Name / Title: James R Baker, Estimator

Name of Firm or Agency:Address:Telephone:Contractor's License numberContact Name / Title:

Name of Firm or Agency:Address:Telephone:


Sumter County C·470 Water Main Extension

Contractor's License number

Contact Name / Title:

Name of Firm or Agency:Address:Telephone:

Contractor's License number


Sumter County Board of County Commissioners

ITB # 011·Q-2013IAT

Page 24 of40


HOLD HARMLESS AGREEMENT

The ContractorNendor is required to purchase and maintain minimum limits of $1,000,000 peroccurrence for all liability, which includes general liability and, if applicable, automobile liability. Othercoverage may be required where applicable.

The ContractorNendor agrees to hold the Board of Sumter County Commissioners harmless againstall claims for bodily injury, sickness, disease, death or personal injury or damage to property or loss ofuse resulting there from, arising out of the agreement, unless such claims are a result of the County'ssole negligence.

The ContractorNendor shall purchase and maintain workers' compensation insurance for all workers'compensation obligations imposed by state law and employer's liability limits of at least $100,000 eachaccident and $100,000 each employee/$500,000 policy limit for disease. Even if theContractorNendor is not required by state law to secure workers' compensation insurance, theContractorNendor shall purchase and maintain worker's compensation insurance in order to performor provide services to Sumter County. This is the standard requirement however; the FinancialServices Department can perform a special review as needed on a case-by-case basis for theContractorNendor.

"

ContractorNendor-Print NameHarris-McBurney Company

The ContractorNendor shall also purchase any other coverage required by law for the benefit ofemployees.

Required insurance shall be documented in Certificates of Insurance and shall be provided to t.h~ :::"~.:~;~:~;~':")J""~,,County representative requesting the service. " ..<"", ..<.... -0;..

_ ~ ,....' .--J ... '"

By signature upon this form the ContractorNendor stipulates that he/sh..--.. ..Y......ees to the Hold ~§~ . 'e. ~'~ .~ ~~ EAgreement, and to abide by all insurance requirements. :. -' ~ r'. J v:: '-- • '. "-0 V? - :-I",., c.::, -Go '.:J ",,~'4

"" .,,/ ~~~ -. ...• lor ........ v·

--r~~~.f-=:="'::>.-_=-=-_-,----_---!..,~P~re::.:s~id::=.:~~..n~t:."-o~.......,.Signature ~;~:- 0- .

COUNTY ROAD 470 WATER MAIN EXTENSION

Project NameMay 24th, 2013

Date

The effective dates of this Hold Harmless Agreement shall be for the current Fiscal Year.




E-Verify Vendor/Contractor/Subcontractor Certification

The Sumter County Board of County Commissioners has mandated that effective August 1,2012, allvendors, contractors and subcontractors doing business with Sumter County must certify that they haveimplemented the federal E-Verify program.

E-Verify is a federal system established by the Department of Homeland Security to determine theimmigration and work-eligibility status of prospective employees. Detailed E-Verify program informationfor employers can be found at http://www.dhs.gov/e-verify.

Prior to providing goods or services to Sumter County, vendors must certify compliance with the federalE-Verify program. In the case of contractors, this includes obtaining written certification from allsubcontractors who will participate in the performance of the contract. The certification below has beenprepared for all vendors and contractors to use for this purpose. All subcontractor certifications must bekept on file with the contract vendor and made available to the state and/or County upon request.

CERTIFICATION(In accordance with Executive Order No. 11-02)

I certify that the company shown below is in compliance with the above statement and that I amauthorized to sign on its behalf.

NameclCompany _H_a_~~r~i~s~-M~c~B=u~r~~.~om_p_a_n_y~~~~~~~~~~~~~~~~~~~~_

A~ho~~sign~uffi:~~_~~=~._~~~~~~~~~~~~~~~~~~~~~~~~~~Christine J Richards, Corporate Secretary/Compliance OfficerPrinted name & Title:~~~~~~~~~-'---~----==-~~~~~~-=-.:.~----==-~~~~~~~~~~

Address: 2120 North US Highway 301, Tampa, FL 33619

Date: May 24th, 2013

Telephone Number: --'-(-"8'-=1=3'-')'--'6"'-'2"'-6"'--------"-7-='1'--'-7--=1~~~~~~~~~~~~~~~~~~~~~_

E-mail address:[email protected]

Sumter County reserves the right to determine how it will respond to any instances of non-compliance orfalse certification of compliance. Potential County actions include, but are not limited to, cancellation ofthe contract and/or suspending or debarring the contract vendor from performing services in any aspectto the County.

Please send the completed form to the Financial Services Department, 7375 Powell Road, Suite 206,Wild~ood, FL 34785, or fax the form to (352)-689-4436. Once the form is received by the FinancialServices Department the completed form will remain on file according to the Sumter County RetentionPolicy.

Please contact the Financial Services Department at 352-689-4435 with questions regarding thisrequirement.

This document must be completed and returned with your Submittal.



ANTI-COLLUSION STATEMENT

ITB # 011·D-2013IAT

By signing this form, the vendor agrees that this quote is made without any other understanding,agreement, or connection with any person, corporation, or firm submitting a quote for the samepurpose and that the quote is in all respects fair and without collusion or fraud,

IT IS AGREED BY THE UNDERSIGNED VENDOR. THAT THE SIGNING AND DELIVERY OFTHE QUOTE REPRESENTS THE VENDOR'S ACCEPTANCE. OF THE TERMS AND CONDITIONSOF THE FORGOING SPECIFICATIONS AND PROVISIONS, AND IF AWARDED, THISCONTRACT WILL REPRESENT THE AGREEMENT BETWEEN THE VENDOR AND THEBOARD OF SUMTER COUNTY COMMISSIONERS

NAME OF FIRM: Harris-McBurney Company..,,\l,·t"'~ _.. - ......

~.. .. ...

, ,:>" [Si§lJ in ink in the s c...... ,.r.', .

t ':' :::. ,SIGKJED BY: / Gerry Gilbert..;; ., -. ..-

~<.:. ,-. JlTLE ....,'-Pr"""e'-'<.si""d""""-""-- _

'."., r

..... ADDRESS: 2120 North US Highway 301

CITY & STATE: --,T~a~m~p:::.:a::::...L..'....;F~L==--- _

33619

TELEPHONE: (813)626-7171

NO quotes will be withdrawn for a period of sixty (60) days subsequent to the opening of quotes,without the consent of the Board of Sumter County Commissioners,

NO QUOTE (Reason):


Sumter County Board of County Commissioners Page 270'40


STATEMENT OF PUBLIC ENTITY CRIMES

ITB # 011-0-2013/AT

This is a sworn statement under Section 287.133(3)(a), Florida Statutes, on public entity crimes and must

be signed in the presence of a notary public or other officer authorized to administer oaths.

1. This sworn statement is submitted with Bid, Proposal or Contract No. ITB # 011-0 -2013/AT

for Sumter county - county Road 470 Water Main Extension

2. This sworn statement is submitted by Harris-McBurney Company-------'----'--~------------

(Name of entity submitting sworn statement)whose business address is:

2120 North US Highway 301 Tampa, FL 33619

Its Federal Employer Identification Number (FEIN) is 38 - 2 2 7 8214 . (If theentity has no FEIN, include the Social Security Number of the individual signing this swornstatement: N/ A .)

3. I understand that a Public Entity Crime as defined in Paragraph 287.133(1)(g), Florida Statutes,is a violation ofany State or Federal law by a person with respect to and directly related to thetransaction of business with any public entity or with an agency or political subdivision ofanyother State or with the United States, including, but not limited to, any bid, proposal, reply orcontract for goods or services, any lease for real property, or any contract for the construction orrepair ofa public building or public work, involving antitrust, fraud, theft, bribery, collusion,racketeering, conspiracy, or material misrepresentation.

4. I wlderstand that convicted or conviction as defined in Paragraph 286.133(1 )(b), Florida Statutes,means a fmding ofguilt or a conviction ofa public entity crime, with or without an adjudicationof guilt, in any Federal or State trial court of record relating to charges brought by indictmentor information after July 1, 1989, as a result of a jury verdict, nonjury trial or entry of a plea ofguilty or nolo contendere.

5. I understand that an affiliate as defined in Paragraph 287.133 (1)(a), Florida Statutes, means:

(a) A predecessor or successor of a person convicted of a public entity or crime; or

(b) An entity under the control of a natural person who is active in the management of theentity and who has been convicted of a public entity crime. Affiliate includes thoseofficers, directors, executives, partners, shareholders, employees, members, and agentswho are active in the management of an affiliate. The ownership by one person of sharesconstituting a controlling interest in another person, or a pooling of equipment or incomeamong persons when not for fair market value under an arm's length agreement, shallbe a prima facie case that one person controls another person. A person who knowinglyenters into a joint venture with a person who has been convicted ofa public entity crime inFlorida during the preceding thirty-six (36) months shall be considered an affiliate.

6. I wlderstand that a person as defmed in Paragraph 287.133(1)(e), Florida Statutes, means anynatural person or entity organized under the laws of any state or of the United States with the

Sumter County Board of County Commissioners Page 28 of 40

Sumter County C·470 Water Main Extension ITB # 011·0-20131AT

legal power to enter into a binding contract and which bids or applies to bid on contracts let by apublic entity, or which otherwise transacts or applies to transact business with a public entity.Person includes those officers, directors, executives, shareholders, partners, employees,members, and agents who are active in management of an entity.

7. Based on information and belief, the statement which I have marked below is true in relationto the entity submitting this sworn statement. (Please indicate which statement applies.)

A Neither the entity submitting this sworn statement, nor any officers, directors,executives, partners, shareholders, employees, members, or agents who are active in managementofthe entity, nor any affiliate ofthe entity have been charged with and convicted of a publicentity crime subsequent to July 1, 1989.

__ The entity submitting this sworn statement, or one or more ofthe officers, directors,executives, partners, shareholders, employees, members, or agents who are active in managementof the entity, or an affiliate of the entity have been charged with and convicted of a public entitycrime subsequent to July 1, 1989 AND (Please indicate which additional statement applies.)

___ There has been a proceeding concerning the conviction before a hearing officer oftheState ofFlorida, Division ofAdministrative Hearings. The fmal order entered by the hearingofficer did not place the person or affiliate on the convicted vendor list. (Please attach a copyof the fmal order.)

___ The person or affiliate was placed on the convicted vendor list. There has been asubsequent proceeding before a hearing officer ofthe State of Florida, Division ofAdministrative Hearings. The fmal order entered by the hearing officer determined that it wasin the public interest to remove the person or affiliate from the convicted vendor list. (Pleaseattach a copy of the fmal order.)

___ The person or affiliate has not been placed on the convicted vdescribe any action taken by or pending with the Department of ne

..............

Sworn to and subscribed before me this 24th

Personally Known _----*'X"-- _

OR produced identification _

day of May , 20~.

&~Notary Public - State of Florida

'.~~y ~~ ••..

'" ~1:- CHRISTINE J. RICHARDS'.... * MY COMMISSION #DO 994502'" ". EXPIRES: September 18, 2014;;;"~OFfCO~'V Bonded Thru Budget Notary Services

N/AType of identification produced

My commission expires September 18th. 2014

Christine J Richards(Printed, typed or stampedCommissioned name of notary public)



•• ~11l·]"'·..T.hh,.L-··"'IJI(IJ:l::t'.:J'lTIi~f"C1:Tll'I~litIl

STATE OF FLORIDA

DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATIONCONSTRUCTION INDUSTRY LICENSING BOARD SEQ# L12082302243• ...__ " ' .. d _;; t :~~. I

GILBERT, SHAWN RYANHARRIS-MCBURNEY COMPANY2120 US HIGHWAY 301 NTAMPA FL 33619'

AC#6296487

RICK SCOTT KEN LAWSONGOVERNOR SECRETARY

--,---,.--- . ._._DISE'.~AY_~§_~~_®ll3~Q~.~ LA'!Y..__. .__. , J

DISPLAY AS REQUIRED BY LAW

AC#712849

RICK SCOTTGOVERNOR

tIt: .'-........]••].::1::1••: ..1 iooT.'1lih .:B9,lI.U....

KEN LAWSONSECRETARY

I'it

II!I

_ ••••.•••• ~'-~"--"-"-'-.-.~•••__._._-.-•••• _ ••_-~--_., _ ••••_- --._~._•• - • __• __ ._•• __ ••- __ _ • ._,._••• ·M •••~__•••_ ••__ _.__ ._••• _ ••__••••_ •• __• ••M" .•••_._ ••_.__.. ._•• ••__

State ofFloridaDepartlnent ofState

I certify from the records ofthis office that HARRIS-MCBURNEY COMPANYis a Michigan corporation authorized to transact business in the State of Florida,qualified on February 4, 1980.

The document number of this corporation is 845147.

I further certify that said corporation has paid all fees due this office throughDecember 31, 2013, that its most recent annual report/uniform business reportwas filed on January 23, 2013, and its status is active.

I further certify that said corporation has not filed a Certificate of Withdrawal.

Given under my hand and theGreat Seal ofthe State ofFloridilat Tallahassee, the Capital, this isthe Twenty third day ofJanuary,2013

~D~Secretary ofState

Autbentication ill: CC5048102487

I To authenticate this certificate,visit the foUowiDg site,enter thisID, and then follow the instructions displayed.

https://efile.sunbiz.orgicertauthver.html

DRUG-FREE WORKPLACE

J<tcttlfi(QtE:""'il~jf'"(tiimpliaRCC",HARRIS MCBURNEY COMPANY

HAS SUCCESSFULLY I'MPLEMENTED A FULLY COMPLYING

&''i'kt, meeting sta.ndards established by the S.tate of Florida for the ~ainte.n~nce of~r",

'~~ comprehensive drug abuse and alcohol misuse deterrence, education, training and :,.," assistance programs which comply with applicable Federal and State laws, including :~i

~,.Florida Statutes, Chapter 440 Workers' Compensation, Section 440.101 - .102 and :'f,.01 l

"Chapter 59A-24 Drug-Free Workplace Standards. Compliance may be verified by~!

J contacting Alcohol &Substance Abuse Prevention Programs, Inc. at (800) 329-6334. :

JANUARY 2014

CERTIFIED THROUGH

_ ~ __ ====TM

--~ -- =-.... ~ ... ::r ................e = '-.. .=......e e =.---- - ............ ~- ---,-= -e..--==.....=' ..... ===,....-- ---Alcohol & Substance Abuse Prevention Programs, Inc.USCIS Office Plaza5635 Hoover Blvd.Tampa, FL 33634

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Filing Information

Document Number 845147FEIIEIN Number 382278214

Date Filed 02104/1980

State MIStatus ACTIVELast Event REINSTATEMENT

Event Date Filed 10/27/2003

Event Effective Date NONE

Principal Address2120 US HWY 301 NTAMPA FL 33619

Changed 10/27/2003

Mailing AddressPOBOX 3430BRANDON FL 33509 US

Changed 10/2712003

Registered Agent Name & AddressCORPORATION SERVICE COMPANY1201 HAYS STREETTALLAHASSEE FL 32301-2525 US

Name Changed: 12127/2011

Address Changed: 12/27/2011

OfficerlDirector DetailName & Address

Title T

MOATS, TERRY S

httrl'! 1<:.\ Inhi7 I"'\rn I<:.r-rintc:: /r-l"'\rrlAt p)(p2nr-ti(')n=nFTFIl ;1..inn r!(')l: nl JmhAr=R4,t; 147P>.inn loam... 2/6/20 1~

www.sunbiz.org - Department of State

12603 BROOKER TRACE LANEIVALRICO FL 33596

ITitle CD

GILBERT, LINDA K3416 WEST MULLEN AVENUETAMPA FL 33609

Title P

GILBERT, GERRY L3416 WEST MULLEN AVENUETAMPA FL 33609

Title S

RICHARDS. CHRISTINE1436 TIVERTON DRIVEBRANDON Fl 33511

IAnnual Reports

Report Year Filed Date2010 02/19/2010

2011 01/07/20112012 01/0612012

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AE~RD® CERTIFICATE OF LIABILITY INSURANCE I DATE (MMlDDIYYYY)

5/23/2013

THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THISCERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIESBELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZEDREPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.

IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject tothe terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to thecertificate holder in lieu of such endorsement/51.

PRODUCER ~2~~~CT n;:,rrpn ScottWallace, Welch & Willingham rA~gNJo Exl\:727-522-7777 I FAX

IA/C N01:727-521-2902P.O. Box 33020

~D~~~ss:certificateSfa)W3ins. comSt. Petersburg FL 33733INSURER(S) AFFORDING COVERAGE NAIC#

INSURER A : Mutual Ins Co ?::\::\ooINSURED HARMC-1 INSURER B :Federal Insurance Comoanv /0281

Harris McBurney Company INSURER C:L1ovd's LondonGerry Gilbert INSURER D:Torus National Ins. C:o2120 N US Hwy 301

INSURER E:Amerisure Ins. Co. 1~4RRTampa FL 33619INSURER F:

COVERAGES CERTIFICATE NUMBER: 1555653119 REVISION NUMBER:

THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIODINDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THISCERTIFICATE 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.

INSR ADDL SUBR1~~~gYv~ 1~~L~gYv~LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER LIMITS

A GENERAL LIABILITY GL20250960702 11/1/2012 11112013 EACH OCCURRENCE $1,000,000-~~~~)S~SYEa~~~;;'nce\X COMMERCIAL GENERAL LIABILITY $100,000

=U CLAIMS-MADE ~ OCCUR MED EXP (Anyone person) $5,000

PERSONAL & ADV INJURY $1,000,000-

- GENERAL AGGREGATE $2,000,000

GEN'L AGGRE~E LIMIT APFlS PER: PRODUCTS - COMP/OP AGG $2,000,000

n POLICY X ~b'P,: LOC $

A AUTOMOBILE LIABILITY CA20148961001 11/1/2012 11112013 Ea accident. LOIV"

52 000 000f--

BODILY INJURY (Per person) $X ANY AUTOf---- ALL OWNED ~ SCHEDULED

AUTOS AUTOSBODILY INJURY (Per acadent) $

- f---- NON-OWNED Fte~~~Jd~~gAMAGE $- HIRED AUTOS

f---- AUTOS$

D X UMBRELLA L1ABHOCCUR

21912C120AL1 11/1/2012 11112013 EACH OCCURRENCE $6,000,000-

EXCESS L1AB CLAIMS-MADE AGGREGATE $6,000,000

DED IX IRETENTION $0 $

E WORKERS COMPENSATION ~C201489710 11/1/2012 11112013 X IT~~$T iiI,Ys I IOJ,tI-AND EMPLOYERS' LIABILITY YINANY PROPRIETOR/PARTNER/EXECUTIVE~ E.L. EACH ACCIDENT $1,000,000OFFICER/MEMBER EXCLUDED? N/A

E.L. DISEASE - EA EMPLOYEE(Mandatory In NH) $1,000,000If yes, describe under E.L. DISEASE - POLICY LIMIT $1,000,000DESCRIPTION OF OPERATIONS below

B Inland Marine- Rented Equipment ~~i~~ri1311011/19/2013 11912014 Max Limit $150,000 Deduct $1,000

C Professional Liab- Claims Made ~/8/2012 ~/8/2013 Limit $1 ,000,000 Deduct $10,000

DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required)

ITB # 011-0-2013/ATSumter CountyC-470 Water Main Extension . ..... d 'thSumter County Board of County Commissioners is Additional Insured with resp~ct to General Llablhty If reqUired by written contract an WIrespect to Umbrella policy subject to its underlying terms and conditions. A Waiver of Subrogation In favor of Sumter County Board ofCounty Commissioners applies to General Llablhty If reqUired by written contract.

CANCELLATION

© 19882010 ACORD CORPORATION. All rights es

The ACORD name and logo are registered marks of ACORDACORD 25 (2010/05)

CERTIFICATE HOLDER

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN

Sumter County Board of County Commissioners ACCORDANCE WITH THE POLICY PROVISIONS.

Attn: Financial Services Department7375 Powell Rd. Suite 206 AUTHORIZED REPRESENTATIVEWildwood FL 34785 fjh-jt/

I !j

- r erved.

, '--. -----_.- ----

Policy #GL202509S0802 eff.11/1/2012

------- -.' ---._...- .._--------- ... ' .. --------

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CONTRACTOR'S BLANKET ADDITIONAL INSURED ENDORSEMENT

This endorsement modifies insurance prOVided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE FORM

All of the terms. provisions, exclusions, and limitations of the coverage form apply except as specifically statedbelow.

SECTION II - WHO IS AN INSURED is amended to include as an insured any person or organization. called anadditional'insured in this endorsement:

1. Whom you are required to add as an additional insured on this policy under a written contract or agreementrelating to your business: or

2. Who is named as an additional insured under this policy on a certificate of insurance.

However, the written contract. agreement or certificate of insurance must require additional insured status for a timeperiod during the term of this policy and be executed prior to the "bodily injury". "property damage". "personal injury".or "advertising injury" giving rise to a claim under this policy.

If. however, "your work" was commenced under a letter of intent or work order, subject to a subsequent reduction towriting within 30 days from such commencement and with customers whose customary contracts require they benamed as additional insureds. we will provide additional insured status as spl;!ofied in this endorsement.

3. If the additional insured is:

(a) An individual. their spouse is also an additional insured.

(b) A partnership or joint venture. members. partners. and their spouses are also additional insureds.

(c) A limited liability company. members and managers are also additional insureds.

(d) An organization other than a partnership. joint venture or limited liability company. executive officers anddirectors of the organization are also additional insureds. Stockholders are also additional insureds, butonly with respect to their liability as stockholders.

(e) A trust. you are an insured. Your trustees are also insureds. but only with respect to their duties astrustees.

The insurance provided to the additional insured is limited as follows:

1. That person or organization is only an additional insured with respect to liability arising out of:

(a) Premises you own, rent, lease. or occupy. or

(b) Your ongoing operations performed for that additional insured. unless the written contract or agreement orthe certificate of insurance requires ''your work" coverage (or wording to the same effect) in which case thecoverage provided shall extend to "your work" for that additional insured.

Premises, as respects this provision, shall include common or public areas about such premises if so requiredin the written contract or agreement.

Ongoing operations. as respects this provision. does not apply to "bodily injury" or "property damage" occurringafter:

(1) All work including materials. parts or equipment furnished in connection with suc:~.work.on the project (ot~erthen service. maintenance or repairs) to be performed by or on behalf of the addltionallnsured(s) at the siteof the covered operations has been completed: or

Includes copyrighted material of Insurance Services Office. Inc.. with 'its permission.Copyright Insurance Services Office. Inc.• 2003

CG 70 48 03 04 Page 1 of 2

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(2) That portion of "your wOrk" out of which the injury or damage arises has been put to its intended use byany person or organization other than another contractor or subcontractor engaged in performingoperations for a principal as a part of the same project.

2. The limits of insurance applicable to the additional insured are the least of those specified in the writtencontract or agreement, or in the certificate of insurance or in the Declarations for this policy. If you also carryan Umbrella policy, and the written contract or agreement or certificate of insurance requires that the additionalinsured status also apply to such Umbrella policy. the limits of insurance applicable to the additional insuredunder this policy shall be those specified in the Declarations of this policy. The limits of insurance applicable tothe additional insured are inclusive of and not in addition to the limits of insurance shown in the Declarations.

3. The additional insured status provided by this endorsement does not extend beyond the expiration ortermination of a premises lease or rental agreement nor beyond the term of this policy.

4. Any person or organization who is an insured under the terms of this enqorsement and who is also an insuredunder the terms of the GENERAL LIABILITY EXTENSION ENDORSEMENT. if attached to this policy, shallhave the benefit of the terms of this endorsement if the terms of this endorsement are broader.

5. If a written contract or agreement or a certificate of insurance as outlined above requires that additional insuredstatus be provided by the use of CG 20 10 11 85. then the terms of that endorsement. which are shown below,are incorporated into this ,endorsement as respects such additional insured, to the extent that such terms donot restrict coverage otherwise provided by this endorsement .

ADDITIONAL INSURED· OWNERS. LESSEES OR, CONTRACTORS (FORM B)

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART.

SCHEDULE

Name of Person or Organization: Blanket Where Required by Written Contract,Agreemen~, or Certificate of Insurance that the terms of CG 20 10 11 85 apply

(If no entry appears above~ information required to complete this endorsement will beshown in the Declarations as applicable to this endorsement.)

WHO IS AN INSURED (Section II) is amended to include as an insured the'person ororganization shown in the SChedule. but only with respect to liability arising out of"your work" for that insured by or for you.

'Copyright, Insurance Services Office, Inc., 1984

CG 20 10"85

The insurance provided to the additional insured does not apply to "bodily injury", "property damage". "personalinjury", or "advertising injury" arising out of an ~rchitect's. engineer's. or surveyors rendering of or failure to renderany professional services including but not limited to:

,. The preparing, approving, or failing to prepare or approve maps. drawings. opinions, reports. surveys. changeorders, design specifications; and

2. Supervisory, inspection, or engineering services.

Any coverage provided in this endorsement is excess over any other valid and col!ectible insuran~e availableto the additional insured whether primary. excess, contingent. or on any other baSIS Unless the written contract,agreement. or certificate of insurance requires t~at this insura~ce be primary. !~ whic.h case this insurance willbe primary without contri~ution from such other Insurance available to the additional msured.

Includes copyrighted material of Insurance Services Office, Inc., with its permission.Copyright Insurance Services Office, Inc. 2003

Page 2 of 2 CG 70 48 03 04

I President

Board of Sumter County Commissioners7375 Powell Road

Wildwood, FL 34785PHONE: (352) 689-4435 FAX: (352) 689-4436

E-mail: [email protected]

Addendum #1 for ITB 011-o-2013/AT Sumter County C-470 Water Main Extension

Date: April 24, 2013

A. Notice to Contractors: Whenever a conflict appears between this addendum and theinitial solicitation, or plans, this addendum shall prevail, and as such shall constitute abinding portion of the contract documents. All provisions of the original specificationsshall remain in force, except as specifically modified or changed herein.

B. Additions, Deletions, and/or Clarifications: This addendum forms a part of the ContractDocuments and modified the original Quote Documents as noted below and supersedesall contrary information and requirements. Contractors shall acknowledge receipt of thisAddendum.

The specifications for the above project are amended in the following particulars. All provisionsof the original drawings and specifications shall remain in force, except as specifically modified orchanged herein.

This Addendum consists of (1) text pages.

ADDITION:Part 6, Exhibit A, Drawings and Specifications of the bid document does not include the FDEPPermit and FOOT Permit.

This addendum will add the FDEP permit and FOOT permit to Exhibit A. Both permits areuploaded to Demand Star as separate attachments.

I President


Board of Sumter County Commissioners7375 Powell Road

Wildwood, FL 34785PHONE: (352) 689-4435 FAX: (352) 689-4436

E-mail: [email protected]

Addendum #2 for ITB 011-o-2013/AT Sumter County C-470 Water Main Extension

Date: May 14, 2013

A. Notice to Contractors: Whenever a conflict appears between this addendum and theinitial solicitation, or plans, this addendum shall prevail, and as such shall constitute abinding portion of the contract documents. All provisions of the original specificationsshall remain in force, except as specifically modified or changed herein.

B. Additions, Deletions, and/or Clarifications: This addendum forms a part of the ContractDocuments and modified the original Quote Documents as noted below and supersedesall contrary information and requirements. Contractors shall acknowledge receipt of thisAddendum.

The specifications for the above project are amended in the following particulars. All provisionsof the original drawings and specifications shall remain in force, except as specifically modified orchanged herein.

This Addendum consists of (1) text pages to include revisions and additions to the following:

1. Revised locate wire thickness to #8 gauge - Sheets C1.1 & C3.2.2. Revised "Summary of Estimated Quantities" table on Sheet C1.2.3. Added 6" gate valve future connections - Sheets C2.9 & C2.10.

The plan sheets and revised Exhibit C - Summary of Pay Items are both attached separately.

End of Addendum 2