BOARD OF COUNTY COMMISSIONERS, WALTON COUNTY, FLORIDA INVITATION TO BID FOR 2015 New Heavy Duty Dump Truck with Dump Body

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1 BOARD OF COUNTY COMMISSIONERS, WALTON COUNTY, FLORIDA INVITATION TO BID FOR 2015 New Heavy Duty Dump Truck with Dump Body ITB: The Board of County Commissioners, Walton County, Florida (the County ) will be accepting competitive sealed bids for the purchase of twelve (12) 2015 New Heavy Duty Tri Axle Dump Truck Chassis with 21 Yard Dump Body. ITB DEADLINE: February 23, 2015 no later than 3:00PM local time LATE BIDS RECEIVED AFTER THE AFOREMENTIONED DEADLINE DATE, EITHER BY MAIL OR OTHERWISE, WILL NOT BE CONSIDERED AND RETURNED UNOPENED. THE TIME OF RECEIPT WILL BE DETERMINED BY THE TIME RECEIVED IN THE PURCHASING AGENT S OFFICE. BIDS OFFERED ARE THE SOLE RESPONSIBILITY OF THE VENDOR FOR ASSURING THAT BIDS ARE RECEIVED IN THE PURCHASING OFFICE BY THE DESIGNATED DATE AND TIME. NO FAXED, ELECTRONIC, OR ORAL BIDS WILL BE ACCEPTED. To be considered, Bidder must submit an original and three (3) copies of the ITB in a sealed envelope or package, clearly marked with the Bidder s name, address, and the words 2015 NEW HEAVY DUTY DUMP TRUCK WITH DUMP BODY addressed to: Office of Central Purchasing 176 Montgomery Circle DeFuniak Springs, Florida

2 TABLE OF CONTENTS SECTION 1 INTRODUCTION 1.1 Scope SECTION 2 SCOPE OF SERVICES 2.1 Vehicle Scope. 2.2 Installation Warranty. 2.4 Manuals. 2.5 Miscellaneous. 2.6 Delivery Documentation. 2.7 Specification Exceptions SECTION 3 PROCUREMENT RULES AND INFORMATION 3.1 Contact Person 3.2 Calendar Events. 3.3 Evaluation Criteria Submission of Bid Bid Opening Insurance Requirements Cost of Preparing Bids Disposal of Bids 3.9 Bid Rules for Withdrawals Rejection of Bids Bid Conference Verbal Instructions 3.13 Sales and Use Tax 3.14 Public Entity Crimes Drug Free Workplace 3.16 Addendum Notices Representation Local Vendor Preference Protest 2

3 3.21 Bond 3.22 Black Out Period. SECTION 4 CONTENTS OF BID Forms 4.2 Contacts for Contract Administration. SECTION 5 AWARD OF BID 5.1 Identical Tie Bids. SECTION 6 TERMS AND CONDITIONS Termination of Contract 6.2 Terms ATTACHMENT 1 Questionnaire ATTACHMENT 2 Information Sheet. ATTACHMENT 3 Contact for Contract. ATTACHMENT 4 Fee Schedule ATTACHMENT 5 Public Entity Crimes. ATTACHMENT 6 - Drug Free Work Place Certification.. ATTACHMENT 6 Local Vendor Preference. 3

4 SECTION 1 SCOPE OF WORK 1.1 The County is looking to purchase twelve (12) 2015 New Heavy Duty Tri Axle 21 Yard Dump Truck with Dump Body. This specification is to set forth the specific requirements for a New Chassis and Dump Body for the Tri Axle Dump Truck This Tri Axle Dump Truck Chassis and Dump Body shall be the manufacturer s standard. It shall be equipped with the manufacturer s equipment and accessories which are included as standard in the advertised and published literature for the unit. No such item of equipment or accessories shall be removed or omitted for the reason that it was not specified in the bid. SECTION 2 SPECIFICATIONS 2.1 A. ENGINE No less than RPM and no less than 12.7L 6 cylinder wet sleeve Air intake single dry element Factory installed engine brake Full diagnostic capability Single vertical exhaust cab or frame mounted 12 volt system fuse/circuit breakers 160 amp alternator 19.0 cfm air compressor 13 gl. DEF tank with automatic regen system Davco 482 fuel/water separator with 2 engine mounted fuel filters Antifreeze-34 extended life coolant with Gates blue stripe hoses 1500 square inch radiator B. TRANSMISSION Eaton-Fuller 16210c Cast iron clutch housing Torque limiting clutch brake Eaton easy pedal advantage 15 ½ inches manually adjusted clutch Synthetic lube, magnetic plugs Painted shift leaver, solid linkage Water to oil transmission cooler in radiator and tank 4

5 C. FRONT AXLE 20,000 lb. front axle 20,000 lb. lead spring suspension with bronze bushings Front shocks, 16.5x6 brakes, cast iron drums with dust shields 50W synthetic front hub lube with vented caps D. REAR AXLE 46,000 lb. tandem rear axles with oil pump for differentials 4.89 gear ratio driver controlled differential lock on both differentials with buzzer and indicators Hendrickson or Chalmers rear spring suspension Rear shocks and transverse control rods 4 brake chambers 30/26 rear dust shields 16.5 x 7 q+ break shoes Frame mounted air dryer E. WHEELBASE AND FRAME Set forward axle design wheelbase /32 x 1/2 x 10-15/16 inch steel frame 1/4 C channel inter frame reinforcement. No less than RMB -3,217,200 Grade 8 threaded frame fasteners with heavy duty cross members 16 chrome steel bumper with tow hooks No less than 100 gallon round fuel tank F. TIRES AND WHEELS Front wheels aluminum disc 22.5 x Rear wheels steel disc 24.5 x 8.25 Front tires, Michelin XFE 425/65R ply radial Rear tires, Michelin XDN2 11R ply radial G. CAB INTERIOR AND EXTERIOR Steel cab with sun visor, air cab mounts with check valve 2 front finder extensions Left and right grab handles Stationary brit finish grille Dual air horns, chrome bullet lights, dual stainless heated mirrors All tinted glass, two piece windshield 5

6 Premium vinyl interior, floor mats Dash mounted ash tray, lighter and two 12 volt power receptacles Heater, defroster and air conditioner R134A Adjustable tilt and telescoping steering wheel Left and right sun visors High back air ride driver seat with dual arm rest and non-suspension passenger seat 3 point seat belt on each side DOT fire extinguisher and triangle kit included Low pressure light and buzzer, back up alarm, fuel gauge, temp gauge, oil temp gauge, transmission temp gauge, oil pressure gauge and volt meter. Power and ground for C.B. Tachometer with hour meter AM/FM radio with blue tooth, microphone and front USB port Cab, white (high gloss) H. DUMP BODY OxBodies, Inc. Stampede style, no exceptions Body: 16 Stampede Hoist Model: Frame Style: 2 x8 x 3/16 Rectangular Tubing, no cross-members Rear Style: Straight Front Exhaust Notch: No Side Height Front: 62 1/4 HardOx 450 minimum Side Height Rear: 62 1/4 HardOx 450 minimum Rear Height: 68 1/4 HardOx 450 minimum Floor Material: 1/4 HardOx 350 minimum Cabshield Style: Full Width Cabshield Projection: 42 Cabshield Width: 87 Tarp Style: Electric flip style tarp with spring assist and vinyl cover, controlled by console switch Tailgate Type: Hi-Lift Tailgate Sealed Tailgate: No Coal Chute: None Tailgate Operation: Air Tailgate Tailgate Bracing Style: 3 horizontal minimum 6

7 Side Top Rail: Diamond Mount Top Rail, 4 x4 x1/4 Square Tubing Dump Assist Vibrator: No Dump Apron : 3 Sch. #80 pipe with ¼ plate, 10 long Side Light Cutouts: Lower Front/Rear Clearance Cabshield Cutouts: 1 Set Stop Tall Turn Lights in Rear Post: 1 set Dirt Shedding Angle: Tailgate Board Holder Height: None Body Interior Width: 87 Cover Skirts with Alum: No Cab Height: Not Available Paint: Stock Color Side Boards: None Hydraulic Tank: Pyramid Flat Bottom Rear hinge with removable pin Hydraulic pump, PTO and cab controls as listed below Mud Flaps: 30 Backup Alarm Rigid, Non-Steer, Silent Drive Lift Axle, Mod AA1455UDA Four (4) 11R 22.5 White Steel Hub Piloted Rim/Tire Combo Body interior to have rolled 26 radium corners, front to rear. Step Brake method not accepted. Body interior to be 1/4" Hardox 450 minimum, no exceptions Body to be built to have a convertible High-Tilt Tailgate option to accept dual 3.5 pneumatic raising cylinders to be mounted inside rear post. Electric-over-hydraulic power not accepted. Diamond Mounted Top Rail, 4 x 4 x 1 /4 tubing. No weld on dirt shedders accepted. Hoist cylinder to have U-cup seals, spherical top bearing in pin-eye, 5.5 overlap stages, chromed bottom stage and pre-tested to 2750 PSI. Body frame to use 2 x8 x3/16 tubing longsillis without cross-members All pins at pivot points to be hardened (90,000 PSI tensile and 75,000 PSI yield minimum) and to have grease zerks. Upper tailgate pins to be 1-7/16 minimum, rear hinge pins to be 2-1/4 minimum. Cylinder pins to be 2-1/16 minimum Muncie PTO only Direct mounted, dowelled Pump/Valve Combination; 2000 PSI relief valve, three-line hook up 7

8 Console style controls with detent lever to pump, electric shift PTO. To have body up, PTO engage and tarp motion indicator lights All LED and-on lights All welded connections, loomed wiring harness 2.2 INSTALLATION Bidder will be required to install dump bodies, hoist and PTO to include all controls and hardware to make truck operational and ready to use. Bidder must furnish literature to verify that the units meet or exceed specifications. Bidder must also provide a list of make, model, and S/N on hoist, pump and cylinders with trucks when delivered. All hydraulic lines routed safely away from heat and moving parts. 2.3 WARRANTY Warranty must be at least 12 months on hoist, pumps, cylinders, tanks and the complete bodies including all welding, parts and labor. List manufacturer s standard warranty on cab chassis. Manufacturer s literature must be provided to verify that the unit meets or exceeds the specifications. 2.4 MANUALS Two sets each of master shop manual on engine and drive train and 2 sets each of operators and shop manuals to be delivered with each truck. 2.5 MISCELLANEOUS Dump Trucks shall be equipped with all standard equipment as specified by manufacturer for this model and shall comply with all EPA Emission Standards and all motor vehicles as established by the U.S. Department of Transportation regarding manufacturing of motor vehicles. Successful bidder shall be responsible for delivering vehicles that are properly services, cleaned and in first class operation condition; pre-delivery service at a minimum shall include the following: a. Complete lubrication b. Check all fluid levels to assure properly filled c. Adjustment of engine to proper operating condition d. Inflate tires to proper pressure e. Check to assure proper operation of all accessories, gauges, lights and mechanical features f. Front end alignment and wheels balanced 8

9 g. Cleaning of vehicles and removal of all necessary tags, stickers, etc. Do not remove window price sticker Vendor shall place order with manufacturer with seven (7) calendar days after receipt of a purchase order. Successful bidder must call at least 48 hours in advance of delivery to Office of Central Purchasing, Delivery of dump trucks to Walton County Board of County Commissioners does not constitute acceptance for the purpose of payment. Final acceptance and authorization of payment shall be given only after a thorough inspection indicates dump trucks meets contract specifications and conditions as listed. Should the delivered dump trucks differ in any respect from specifications, payment will be withheld until such time as the supplier takes necessary corrective action. Purchasing Department shall be notified of the deviation in writing within 10 days. If the proposed correction action is not acceptable to Walton County, the final acceptance of the dump trucks, in which case the dump trucks remains the property of the supplier and the County shall not be liable for payment for any portion thereof. 2.6 DELIVERY DOCUMENTATION Units shall be delivered with each of the following documents completed: a. State of Origin b. Owner s manual c. Warranty certifications d. Window price sticker (affixed) e. Application for Certificate of Title and/or Vehicle Registration f. Temporary tag g. Four (4) sets of keys for each vehicle 2.7 SPECIFICATION EXCEPTIONS Bidders shall clearly list any change in the manufacturer s specifications that conflict with the bid specifications. Bidder must also explain any deviation from the bid specification in writing. Failure to comply with this provision may result in bid being found non-responsive. The County reserves the right to add to or delete any item from this bid or resulting contract when deemed to be in the County s best interest. 9

10 SECTION 3 - PROCUREMENT RULES AND INFORMATION 3.1 Contact Person: Glyndol Johnson or Kim Jones Purchasing Agent Purchasing Assistant 176 Montgomery Circle DeFuniak Springs, Florida Fax: johglyndol@co.walton.fl.us All technical questions regarding this Request should be directed in writing; preferably by to the Purchasing Agent. Questions shall be submitted no later than 12:00 Noon (local time) on February 11, Questions submitted after that date and time will not be answered. If applicable, answers citing the question asked but not identifying the questioner will be distributed to all known prospective vendors. Failure to submit requests in writing by the specified time shall not be grounds for a protest. Note: Written requirements in the Request or its amendments are binding, but any oral communications between you and us are not. 3.2 CALENDAR EVENTS: DATE/TIME February 11, 2015 no later than 12:00 Noon February 23, 2015 no later than 3:00 P.M. ACTION Last day for questions Closing of bid 3.4 SUBMISSION OF BID: Each bid shall be prepared simply and economically, providing a straightforward, concise delineation of the bid s capabilities to satisfy the requirements of this Invitation to Bid. Fancy bindings, colored displays and promotional material are not desired. Emphasis in each bid must be on completeness and clarity of content. In order to expedite the evaluation of bids, it is essential that proposers follow the format and instructions herein. 10

11 3.5 BID OPENING: Bids will be accepted until the 23rd day of February, 2015 By 3:00 PM local time and will open immediately thereafter. Bids are due at the time and date specified. Bids received late will not be considered and will be marked as LATE. Any person with a qualified disability requiring special accommodations at the bid opening should contact Purchasing at at least five (5) working days prior to the event. 3.6 INSURANCE REQUIREMENTS: VENDOR shall purchase and maintain through the Contract period workers compensation, comprehensive general liability (occurrence form), comprehensive automobile liability, builder s risk, and other insurance as is appropriate for the Project being performed hereunder by VENDOR, its employees, subcontractors or agents. The amounts and types of workers compensation, comprehensive general liability (occurrence form), and comprehensive automobile liability insurance shall conform to the following minimum requirements: 1. Worker's Compensation Coverage must apply for all employees and statutory limits in compliance with the applicable state and federal laws. In addition, the policy must include the following: a. Employer's Liability with a minimum limit per accident in accordance with statutory requirements. b. Notice of Cancellation and/or Restriction. The endorsed to provide the COUNTY with thirty (30) days written notice of cancellation and/or restriction. 2. Comprehensive General Liability Coverage must include: a. $1,000,000 combined limit per occurrence for bodily injury, personal injury and property damage. If contract is less than $100,000.00, then general liability insurance requirement is $300, b. Contractual coverage applicable to this specific contract, including any hold harmless and/or indemnification agreement. c. Notice of Cancellation and/or Restriction. The policy must be endorsed to provide the COUNTY with thirty (30) days written notice of cancellation and/or restriction. 11

12 3. Comprehensive Automobile Liability Coverage must be afforded on a form no more restricted than the latest edition of the Comprehensive Automobile Liability Policy filed by the Insurance Services Office and must include: a. $300,000 combined single limit per accident for bodily injury and property damage. b. Owned Vehicles. c. Hired and Non-Owned Vehicles. d. Employee Non-Ownership. e. Notice of Cancellation and/or Restriction. The policy must be endorsed to provide the COUNTY with thirty (30) days written notice of cancellation and/or restriction. 3.7 COST OF PREPARING BIDS: The County is not liable for any costs incurred by the bidder in responding to this ITB, including those for oral presentations. 3.8 DISPOSAL OF BID: All bids become the property of the County and will be a matter of record. The County shall have the right to use all ideas, or adaptations of those ideas, contained in any bid received in response to this ITB. Selection or rejection of this bid will not affect this right. Any submitted proposal shall remain a valid bid for thirty (30) days after the submission date. 3.9 BID RULES FOR WITHDRAWAL: A bid may not be withdrawn for a period of thirty (30) calendar days after the date of the ITB opening. Bids may be modified or withdrawn by an appropriate document duly executed (in the manner that a Bid must be executed) and delivered to the place were bids are to be submitted at any time prior to the opening of the Bids REJECTION OF BID: The County reserves the right to accept or reject any all bids as may be deemed necessary by the County to be in its best interest. The County further reserves the right to waive any and all informalities, and reserves the right to reject all nonconforming, unresponsive, unbalanced or conditional Proposals. The County reserves the right to 12

13 reject the Proposal of any Proposer if the County believes that it would not be in the best interest of the Project to make an award to that Proposer, because the Proposal is not responsive or responsible, or the Proposer is unqualified or of doubtful financial ability or fails to meet any other pertinent standard or criteria established by the County. The County also reserves the right to enter into contract negotiations with a qualified, responsible, and responsive Proposer who submits the highest ranked proposal. If the County and the highest ranked Proposer cannot negotiate a successful contract the County may terminate such negotiations and begin negotiations with the qualified, responsible, and responsive Proposer who submits the next highest ranked proposal. No Proposer shall have any rights against the County arising from such negotiations. Discrepancies in the multiplication of units of work and unit prices will be resolved in favor of the unit prices. Discrepancies between the indicated sum of any column of figures and the correct sum thereof will be resolved in favor of the correct sum. Where numeric data is given both in Arabic numerals and in written language, and where there exists a discrepancy between an Arabic numeral and written language, the written language shall be presumed to be correct and the Arabic numeral presumed incorrect. The County reserves the right to delete any Proposal items and the total Proposal shall be determined as the sum of the Proposal items awarded. In evaluating Proposals, the County will consider the qualifications of the proposers, whether or not the Proposals comply with the prescribed requirements, time of completion and other data, as may be requested in the Proposal form or prior to the Notice of Award. The County may conduct such investigations as the County deems necessary to assist in the evaluation of any Proposal and to establish the responsibility, qualifications and financial ability of Proposers, proposed Subcontractors, Suppliers and other persons and organizations to perform and complete the Project in accordance with the Contract Documents to the County s satisfaction within the prescribed time. The County may consider the operating costs, maintenance requirements, performance data and guarantees of major items of materials and equipment proposed for incorporation in the Project when such data is required to be submitted prior to Notice of Award. If the contract is to be awarded, it will be awarded to the responsible and responsive Proposer submitting the best proposal whose evaluation by the County indicates to the County that the award will be in the best interest of the Project BID CONFERENCE: There will not be a pre-bid conference. 13

14 3.12 VERBAL INSTRUCTIONS: No negotiations, decisions, or actions shall be initiated or executed by the bidder as a result of any discussion with any county employee. Only those communications from proposers, which are signed, and in writing will be recognized by the County, as duly authorized expressions on behalf of the bidder. Oral and other interpretations or clarifications will be without legal effect. Any and all communication with County Commissioners or county staff other than the Office of Central Purchasing is prohibited during the time of the bid until awarded SALES AND USE TAX: The BIDDER agrees that any and all applicable federal, state and local sales and use taxes that are incurred by the BIDDER are included in the stated bid price for the Project. The County is tax exempt from federal excise and state sales tax PUBLIC ENTITY CRIMES: The BIDER must sign and complete a Public Entity Crime Sworn Statement as defined under Section (3) (a), F.S. A person or affiliate who has been placed on the convicted vendor list following a conviction of a public entity crime may not submit a proposal on a contract to provide any goods or services to a public entity, may not submit a proposal on a contract with a public entity for the construction or repair of a public building or public work, may not submit proposals on leases of real property to a public entity, may not be awarded or perform work as a consultant, supplier, or subcontractor, under a contract with any public entity, and may not transact business with any public entity in excess of the threshold amount provided in Section , for Category Two for a period of 36 months from the date of being placed on the convicted vendor list DRUG FREE WORKPLACE: The BIDDER must complete the County s Drug Free Workplace Certification form, attached and made a part of the bid. According to Walton County policy, preference shall be given to businesses with drug-free work place programs. Whenever two or more bids, which are equal with respect price, quality, and service, are received by the state or by any political subdivision for the procurement of commodities or contractual services, a proposal received from a business that certified that it has implemented a drug-free work place program shall be given preference in the award process. Established procedures for processing tie proposals will be followed if none of the tied vendors have a drug-free work place program ADDENDUM: The County may issue Addendums to modify the bid as deemed appropriate. 14

15 Addendums and clarification to this ITB along with and Addendum Acknowledgement Form will be mailed to all vendors receiving this ITB. The Addendum Acknowledgement Form, which is included with each mail out, shall be signed by an authorized company representative, dated, and returned with proposal. Attached is a sample of the Addendum Acknowledge Form NOTICES: Any notices to be given under this ITB shall be given by United States Mail, addressed to BIDDER at its address stated herein, and to the COUNTY at its address stated herein. Additional notice may also be given by facsimile in which case it shall be deemed that notice was provided on the date said facsimile was received. The party providing notice by facsimile shall confirm that the facsimile was received by the other party REPRESENTATION: The BIDDER represents to the COUNTY that: A. The BIDDER is properly certified and licensed; is solvent financially; is experienced in and competent to complete the Project. B. The BIDDER is familiar with all Federal, State, Local or other regulatory laws, ordinances and regulations, which in any manner whatsoever may affect the Project LOCAL VENDOR PREFERENCE: Award of the contract for this project shall be subject to local preference in accordance with the Walton County Purchasing Policies and Procedures (PP017). Application for Local Preference is attached to this Invitation to Bid PROTEST: Any person or entity whose bid is rejected, in whole or in part, or who submits a bid but is not awarded the contract, may protest such decision. Written notice of intent to file a protest must be submitted with the Purchasing Agent or Finance Director within twentyfour (24) hours after the Board s declaration of its intention with regard to an award. Written protest must be submitted to the Purchasing Agent or Finance Director within ten (10) calendar days after filing written notice of intent BOND: All bids shall be accompanied by a bid security in an amount of ONE THOUSAND AND 00/100THS DOLLARS ($1,000.00) made payable to Board of County Commissioners, Walton County, and in the form of a certified bank check or bid bond, issued by a surety 15

16 authorized to conduct business in the State of Florida and having an A.M. Best rating of V-A or better and who is listed on the United States Treasury Department s T-list as acceptable to issue bonds for the applicable dollar amount. The bid security of the Successful Proposer will be retained until such Proposer has executed the Contract, and has furnished the required Certificates of Insurance. If the Successful Proposer fails to execute and deliver the Contract, or furnish Certificate of Insurance, within five (5) business days after the Notice of Award, the County may annul the Notice of Award and the bid security of that bidder will be forfeited. The bid security of other bidder may be retained by the County until ten (10) calendar days after the Notice of Award, whereupon bid security furnished by such bidders will be returned. Failure to submit an appropriate bid security shall result in the bid being declared unresponsive BLACK OUT PERIOD: The period between the time the bids/proposals for invitations for bid or the request for proposal, or qualifications or information or requests for letters of interest, or the invitation to negotiate, as applicable, are received at the Walton County Office of Central Purchasing and the time the Board awards the contract and any resulting bid protest is resolved or the solicitation is otherwise cancelled. SECTION 4 CONTENTS OF PROPOSAL This section contains instructions regarding the format of the ITB that are to be submitted. 4.1 FORMS: It is MANDATORY that vendor s return the Invitation cover sheet with their bid. A representative who is authorized to contractually bind the vendor shall sign the bid. It is MANDATORY that vendors return the Drug-Free Workplace Certification Form, Questionnaire Form, along with the Public Entity Crime Form. 4.2 CONTACTS FOR CONTRACT ADMINISTRATION: Bidders shall return the Contact for Contract Administration Form. This shall be the company representative for the day-to-day activities of the contract. 16

17 SECTION 5 - AWARD OF BID The Board will award this ITB to the responsive BIDDER with the best cumulative price and meets the County s needs. In the event the best cumulative proposer is found to be non-responsive, the County may proceed to the next best cumulative responsive proposer and continue the award process. 5.1 IDENTICAL TIE BIDS: In the event of a tie between identical proposals from this Invitation to Bid, the Board shall decide the final determination of the award. SECTION 6 TERMS AND CONDITIONS: 6.1 TERMINATION OF CONTRACT: The County may terminate this Agreement at any time with or without cause, or with or without prior notice when it is in the best interest of the County. 17

18 Information Sheet For Transactions and Conveyances Corporate Identification The following information will be provided to the Walton County Legal Services for incorporation in legal documents. It is, therefore, vital all information is accurate and complete. Please be certain all spelling, capitalization, etc. is exactly as registered with the state of federal government, (Please circle one) Is this a Florida Corporation: Yes or No If not a Florida Corporation, In what state was it created: Name as spelled in that State: What Kind of corporation is it: For Profit or Not for Profit Is it in good standing: Yes or No Authorized to transact business In Florida: Yes or No State of Florida Department of State of Certificate of Authority Document No: Does it use a registered fictitious name: Yes or No Name of Officers: President: Vice President: Director: Other: Secretary: Treasurer: Director: Other: Name of Corporation (As used in Florida): (spelled exactly as it is registered with the state or federal government) Corporate Address: Post Office Box: City, State, Zip Street Address: City, State, Zip: (Please provide post office box and street address for mail and/or express delivery; also for recorded instruments involving land) Federal Identification Number: (For all instruments to be recorded, taxpayer s identification is needed) Name of individual who will sign the instrument on behalf of the company: (Upon Certification of Award, Contract shall be signed by the President or Vice-President. Any other officer shall have permission to sign via a resolution approved by the Board of Directors on behalf of the company. Awarded contractor shall submit a copy of the resolution together with the executed contract to the Office of Purchasing) (Spelled exactly as it would appear on the instrument) Title of the individual named above who will sign on behalf of the company: 18

19 CONTACT FOR CONTRACT ADMINISTRATION Designate one person authorized to conduct contract administration. NAME: TITLE: COMPANY NAME: ADDRESS: TELEPHONE NUMBER: FAX NUMBER: SIGNATURE: 19

20 FEE SCHEDULE FIRM: ADDRESS: TELEPHONE NUMBER: FAX NUMBER: SIGNATURE: ADDRESS: PRICE PER DUMP TRUCK: TIME FRAME TO DELIVER: 20

21 PUBLIC ENTITY CRIMES Sworn Statement Under Section (3) (a), Florida Statutes, on Public Entity Crimes This form must be signed in the presence of a Notary Public or other officer authorized to administer oaths: This sworn statement is submitted to The Board of County Commissioners, Walton County, Florida by (print individual s name and title) for (print name of entity submitting sworn statement) Whose business address is and (if applicable) its Federal Employer Identification Number (FEIN) is ; (if the entity has no FEIN, include the Social Security Number of individual signing this sworn statement: ). I understand that a public entity crime as defined in Paragraph (l ((g), Florida Statutes, means a violation of any state or Federal law by a person with respect to an directly related to the transaction of business with any public entity or with an agency or political; subdivision of any other state or of the United States, including, but not limited to, any bid or contract for good or services to be provided to any public entity or an agency or political subdivision of any other state or of the United States and involving antitrust, fraud, theft, bribery, collusion, racketeering, Conspiracy, or material misrepresentation. I understand that convicted or conviction as defined in Paragraph (l)(b), Florida Statutes, means a finding of guilt or 21

22 a conviction of a public entity crime, with or without adjudicationfebruary 27, 2014 no later than 12:00Noon Last day for questions March 6, 2014 no later than 3:00PM Closing of bid 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. I understand that an affiliate as defined in Paragraph (l)(a) Florida Statutes, means: A predecessor or successor of a person convicted of a public crime; or; an entity under 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 36 months shall be considered an affiliate. I understand that person as defined in Paragraph (l)(e), Florida Statutes, means any natural person or entity organized under the laws of any state or have the United Sates with the legal power to enter into 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 pubic entity. The term person includes those officers, directors, executives, partners, \ shareholders, employees, members, and agents who are active in management of an entity. Based on information and belief, the statement which I have marked below is true in relation to the entity submitting this sworn statement. [Indicate which statement applies.] Neither the entity submitting this sworn statement, nor any of its 22

23 officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, nor any affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, The entity submitting this sworn statement, or one or more of its 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, The entity submitting this sworn statement, or one or more of its 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, However, there has been a subsequent proceeding before a Hearing Officer of the State of Florida, Division of Administration Hearings and the Final Order entered by the Hearing Officer determined that it was not in the public interest to place the entity Submitting this sworn statement on the convicted vendor list. [Attach a copy of the final order.] I understand that the submission of this form to the contracting officer for the Public Entity identified in Paragraph ONE (#1) above is for that Public Entity only, and that this form is valid through December 31 of the calendar year in which it is filed. I also understand that I am required to inform the Public Entity prior to entering into a contract in excess of the threshold amount provided in Section , Florida Statutes, for category two of any change in the information contained in this form. Name of Bidder By: Title: 23

24 STATE OF COUNTY OF Sworn to and subscribed before me this day of, Personally known to me, or produced the following identification as proof of identity.. My Commission Expires: Notary Public Printed Notary Name Commission Expires: 24

25 DRUG FREE WORKPLACE CERTIFICATION (This form must be completed and attached to proposal) Identical tie bids: preference shall be given to businesses with drug-free work place programs. Whenever two or more bids which are equal with respect price, quality, and service are received by the state or by any political subdivision for the procurement of commodities or contractual services, a bid received from a business that certified that it has implemented a drug-free work place program shall be given preference in the award process. Established procedures for processing tie bids will be followed in none of the tied vendors have a drug-free work place program. In order to have a drug-free work place program, a business shall: 1. Publish a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the work place specifying the actions that will be taken against employees for violations of such prohibition. 2. Inform employees about the dangers of drug abuse in the work place, the business s policy of maintaining a drug-free work place, available drug counseling, rehabilitation providing employee assistance programs, and the penalties that may be imposed upon employees for drug abuse violations. 3. Give each employee engaged in providing the commodities of contractual services that are under bid a copy of the statement specified in paragraph #1. 4. In the statement specified in paragraph #1, notify the employees that, as a condition of working on the commodities or contractual services that are under bid, the employee will abide by the terms of the statement and will notify the employer of any conviction of or pleas of guilty or no contest to, and violation of Chapter 893 or of any controlled substance law of the United States or any state, for a violation occurring in the work place no later than five (5) days after such conviction. 5. Impose a sanction on, or require the satisfactory participation in a drug abuse assistance or rehabilitation program if such is available in the employee s community, by any employee who is so convicted. 6. Make a good faith effort to continue to maintain a drug-free work place through implementation of this section. As the person authorized to sign this statement, I certify that this firm complies fully with the above requirements. Company Name Authorized Signature 25

26 Federal I.D. Number or SSN Printed Name WALTON COUNTY LOCAL PREFERENCE APPLICATION PROJECT NAME: Dump Truck ITB NO: Name of Business: Address: City, State: Zip code: I hereby certify under penalty of perjury that my business qualifies as a local vendor/contractor in accordance with Walton County Purchasing Policies and Procedures, Procedure No: PP017. My business maintains its principal place of business within Walton County; OR My business has maintained a permanent place or places of business within Walton County and has employed people who live in Walton County on a regular and continuing basis for at least six (6) months prior to the advertising of this Request for Proposal Signature Date: 26