purchasing division board of county commissioners … · rli no. r0918604r2 addendum no. 1 page 1...

RLI No. R0918604R2 Addendum No. 1

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Addendum Form #3

06/15/2011

PURCHASING DIVISION

BOARD OF COUNTY COMMISSIONERS

BROWARD COUNTY, FLORIDA

REQUEST FOR LETTERS OF INTEREST

RLI Name: Port Everglades Spangler Bypass Road, Phase 1

(Non-sheltered Market)

ADDENDUM NO. 1

DATE OF ADDENDUM: November 2, 2011

ATTENTION ALL POTENTIAL BIDDERS:

TO ALL PROSPECTIVE PROPOSERS, PLEASE NOTE THE FOLLOWING CHANGES AND

CLARIFICATIONS:

1. The RLI Due Date is changed to Monday, November 14, 2011 at 5:00 P.M.

2. Delete, on page 22, from question 5- Evaluation Criteria – Company Profile, Litigation History, “A Vendor is

also required to disclose to the County any and all case(s) that exist between the County and any of

the vendor's subcontractors/subconsultants proposed to work on this project.” This is not a requirement for this project.

3. On page 23, Question 1 of the Evaluation Criteria – Legal Criteria, Standard Agreement Language, there is a reference to a sample Agreement being attached to the pdf file as Attachment “D”, was not attached. Below is a link to the sample Agreement: http://www.broward.org/Purchasing/Documents/caf170.pdf

4. On page 26, Question 8 of the Evaluation Criteria – Legal Criteria, “…the certification form is referenced as

Scrutinized Companies List Certification and should be completed and submitted with your proposal...” is attached to this Addendum.

All other terms, conditions and specifications remain unchanged for RLI No. R0918604R2

NAME OF COMPANY: _________________________________________________

http://www.broward.org/Purchasing/Documents/caf170.pdf

RLI No. R0918604R2 Addendum No. 1

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Addendum Form #3

06/15/2011

SCRUTINIZED COMPANIES LIST CERTIFICATION

This certification form should be completed and submitted with your proposal but must be completed and submitted prior to award. The Vendor, by virtue of the signature below, certifies that:

a. The Vendor, owners, or principals are aware of the requirements of Section 287.135, Florida Statutes, regarding Companies on the Scrutinized Companies with Activities in Sudan List or on the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List; and

b. The Vendor, owners, or principals, are eligible to participate in this solicitation and not listed on either the Scrutinized Companies with Activities in Sudan List or on the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List; and

c. If awarded the Contract, the Vendor, owners, or principals will immediately notify the COUNTY in writing if any of its principals are placed on the Scrutinized Companies with Activities in Sudan List or on the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List.

_________________________________________ (Authorized Signature)

_________________________________________ (Print Name and Title) ____________________________________________ (Name of Firm)

STATE OF ___________________ COUNTY OF _________________ The foregoing instrument was acknowledged before me this day of ___________, 20___, by ____________________________ (name of person whose signature is being notarized) as ______________________________ (title) of ______________________ (name of corporation/entity), known to me to be the person described herein, or who produced _____________________________ (type of identification) as identification, and who did/did not take an oath. NOTARY PUBLIC: __________________________ State of ___________________ at Large (SEAL) (Signature) __________________________ My commission expires: _______________

(Print name)

Broward County Purchasing Division

115 S. Andrews Avenue, Room 212 Fort Lauderdale, FL 33301

(954) 357-6065 FAX (954) 357-8535

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Request for Letters of Interest (RLI) RLI Number: R0918604R2

RLI Name: Port Everglades Spangler Bypass Road, Phase 1

Procurement Authority

Unchecked boxes do not apply to this solicitation.

Pursuant to the Broward County Procurement Code, the Broward County Commission invites qualified firms to submit Letters of Interest for consideration to provide services on the following project:

Standard Request for Letters of Interest

Construction General Contractor: Two-Step Process - (Step 1) Issue RLI to Short list firms - (Step 2) Issue Invitation for Bids to Shortlisted firms to obtain bids

Establish Library of Firms for Services

Pursuant to the Broward County Procurement Code, the Broward County Commission invites qualified firms to submit Letters of Interest for consideration to provide Construction Manager at Risk Services on the following project.

Standard Construction Manager at Risk

Construction Manager at Risk (Modified): Two Step Process - (Step 1) Issue RLI to Short list firms (Step 2) Issue Invitation for Bids to Shortlisted firms to obtain bids

Pursuant to Florida Statutes, Chapter 287.055 (Consultants Competitive Negotiations Act), the Broward County Commission invites qualified firms to submit Letters of Interest for consideration to provide Professional Consulting Services on the following project.

Non-Continuing Contract: (Check only one box)

Professional services needed for a construction project where the construction costs exceed $ 325,000

Professional services needed for a planning or study activity where the fee for the professional services exceed $ 35,000

Continuing Contract :( Check only one box)

Professional services needed for projects in which construction costs do not to exceed $2 million

Professional services needed for study activities when the fee for such professional service does not exceed $ 200,000

Professional services needed for work of a specified nature

Design-Build: (Check only one box)



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Qualification - Based with a Guaranteed Maximum Price and a Guaranteed Completion Date

Two-Step process - (Step 1) Issue RLI to Short list firms - (Step 2) Issue Request for Proposals to Shortlisted firms to obtain proposals

The scope of services shall include:

Broward County is seeking to contract with a construction firm (licensed in the State of Florida) for construction of Spangler Bypass Road – Phase 1. Broward County will accept lump sum bids from the shortlisted firms. The purpose of the project is to carve out the Convention Center from the Port security requirements by relocating the Eisenhower Blvd. security checkpoint from SE 20 St. to Spangler Blvd. The project includes construction of secured and unsecured roadway sections, construction of a new security checkpoint and demolition of the existing checkpoint, relocation of Port security fiber optic network, security mesh (screen) for Northport parking garage, improvements to sally-port & relocation of dock access security gate. Specifically the scope of work shall include:

Security Checkpoint

A new security checkpoint shall be constructed on Eisenhower Boulevard just north of the intersection with Spangler Boulevard. The checkpoint will include but not be limited to the construction of a permanent canopy structure; installation of prefabricated security booths, installation of a prefabricated rest room facility and necessary water line, sanitary sewer and lift station; security gates; providing electrical power; and installation of security network and cameras.

Required as part of the checkpoint work will be relocation of the Dynamic Message Sign Structure (DMS) that is currently located at the existing checkpoint north of SE 20th Street. The new location shall be north of the existing checkpoint in the median. This work will include, but not be limited to, construction of a new drilled shaft foundation, underground conduits and fiber optics, removal and relocation of the existing sign structure and sign, reconnection to the DMS system including testing.

Upon completion of the new checkpoint and placement into service, the existing checkpoint on Eisenhower Boulevard north of SE 20th Street shall be demolished.

Roadway Construction

The existing Eisenhower Boulevard consists of a four-lane divided roadway. The contractor, as part of this project shall construct a barrier with attached fence in the existing median from the intersection of SE 20th Street to the checkpoint described above. The existing northbound lanes on Eisenhower Boulevard will be converted into a two-way section of “unsecured” roadway leading to the newly constructed checkpoint. The existing southbound lanes of Eisenhower Boulevard shall be converted into a two-way section of “secured” roadway which will provide access to the facilities within the Port west of Eisenhower Boulevard.



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The work that will be required includes but is not limited to demolition of existing pavement; demolition of existing concrete; removal of existing curb and gutter; milling and resurfacing; new pavement; new curb and gutter; drainage; water and sewer construction; barrier wall and fencing; removal of existing lighting system and construction of new lighting; removal of the existing traffic signal at the Eisenhower/Spangler intersection; signing; striping; landscaping and irrigation; and relocation of the Port security fiber optic network.

Maintenance of Traffic (MOT)

The contractor shall maintain traffic at all times to Port Everglades, the Convention Center and Northport Parking Garage as well as all businesses within the area of the work. The contractor shall be aware that significant traffic is generated by the Port and the Convention Center and shall be required to have qualified experienced MOT personnel to ensure that traffic is not impeded. The bid documents will contain phased construction plans prepared by the Engineer of Record and the Contractor shall prepare their MOT to conform these plans.

Northport Parking Security Mesh

The contractor shall install a stainless steel security mesh (screen) on the east and south sides of the parking garage from the second floor parapet wall to approximately 6 feet above the roof deck level. The security mesh (screen) will also be installed on the stair structures located on the east and south faces of the garage. The work will include all hardware and attachments required to install the security mesh (screen). For purposes of comparison, a similar system was installed as part of the New World Symphony project in Miami Beach.

Improvements to sally port

The contractor will install a mechanical vehicle barrier in the east bound direction on SE 20th Street located just west of the existing sally port. The work will include but not be limited to the barrier; slab on grade; frame and anchors; electrical work; cameras; fiber optics and tie into existing Port security network.

Relocation of dock access gate (Gate 6)

An existing dock access gate (Gate 6) is located on the east side of Eisenhower north of the Spangler/Eisenhower intersection. The reconfiguration of Eisenhower Boulevard to a secure/unsecure roadway requires that the gate be relocated to the south of Spangler Boulevard. The work will include but not be limited to installation of prefabricated booths; water and sewer including installation of a lift station; fiber optics and tie into existing Port security network; gate arms; electrical and fencing.

Bid documents will contain Sensitive Security Information (SSI) and shortlisted firms must sign a Non-Disclosure Agreement (NDA) prior to receiving documents and will be responsible to obtain NDA’s from any individuals or subcontractors that receive bidding documents.



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Submittal Instructions


Only interested firms from the Sheltered Market may respond to this solicitation.

This solicitation is open to the general marketplace.

Interested firms may supply requested information in the “Evaluation Criteria” section by typing right into the document using Microsoft Word. Firms may also prepare responses and any requested ancillary forms using other means but following the same order as presented herein.

Submit ten (10) CDs, containing the following files:

CD or DVD discs included in the submittal must be finalized or closed so that no changes can be made to the contents of the discs. IT IS IMPORTANT THAT EACH CD BE LABELED WITH THE COMPANY NAME, RLI NUMBER AND TITLE, AND THEN PLACED IN AN INDIVIDUAL DISC ENVELOPE.

1. A single PDF file that contains your entire response with each page of the response in the order as presented in the RFP/RLI document, including any attachments.

2. Responses to the Evaluation Criteria questions are to be provided in the following formats:

a. Microsoft Word for any typed responses. b. Microsoft Excel for any spreadsheets

Submit four (4) total printed copies (hard copies) of your response.

It is the responsibility of each firm to assure that the information submitted in both its written response and CDs are consistent and accurate. If there is a discrepancy, the information provided in the written response shall govern. This is of particular importance in the implementation of the County's tiebreaker criteria. As set forth in Section 21.31.d of the Procurement Code, the tiebreaker criteria shall be applied based upon the information provided in the firm's response to the solicitation. Therefore, in order to receive credit for any tiebreaker criterion, complete and accurate information must be contained in the written submittal.

Send all requested materials to:

Broward County Purchasing Division 115 South Andrews Avenue, Room 212 Fort Lauderdale, FL 33301 RE: RLI Number: R0918604R2

The Purchasing Division must receive submittals no later than 5:00 pm on Monday, November 7, 2011. Purchasing will not accept electronically transmitted, late, or misdirected submittals.



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If fewer than three interested firms respond to this solicitation, the Director of Purchasing may extend the deadline for submittal by up to four (4) weeks. Submittals will only be opened following the final submittal due date. This is a Two-Step process. In response to this RLI, Step I consists of the submission of each firm (s) qualifications and the short listing of the most qualified firms. In Step II, the shortlisted firms will be provided an Invitation for Bid to respond. All firms responding to the RLI must include with their submission a bond or other surety identified below in the amount of Ten Thousand Dollars ($10,000), payable to the Board of County Commissioners, and condition upon and guaranteeing that if the firm is shortlisted in the Step I process, the firm will submit a bid in the Step II process. If the firm submits a bid, the bond shall be returned. Otherwise, the bond shall be forfeited to the Board of County Commissioners if the firm fails to provide a bid in response to the Step-Two process. The bond must be an original, no photocopies will be accepted. In lieu of the bond, the following will be acceptable: cash, money order, certified check, cashier's check, original irrevocable letter of credit, treasurer's check or bank draft of any national or state bank (United States). A personal check or a company check of a Bidder shall not be deemed a valid bond guaranty. The bond must be an original, no photocopies will be accepted. In lieu of the bond, the following will be acceptable: cash, money order, certified check, cashier's check, original irrevocable letter of credit, treasurer's check or bank draft of any national or state bank (United States). A personal check or a company check of a Bidder shall not be deemed a valid bond guaranty. Each bid (submitted in Step II) shall be accompanied by a bid guaranty in an amount equal to five percent (5%) of the bid amount. A Performance Bond and a Payment Bond each in an amount equal to one hundred percent (100%) of the Contract amount or an alternative form of security permitted by the Broward County Procurement Code must be submitted by the successful Bidder within fifteen (15) calendar days after notification of award. Qualifications of Surety

1. The Bond must be executed by a surety company of recognized standing, authorized to do business in the State of Florida and having been in business with a record of successful continuous operation for at least five (5) years.

2. In addition to the above minimum qualifications, the surety company must meet at least

one of the following additional qualifications: a. The surety company shall hold a current certificate of authority as acceptable surety

on federal bonds in accordance with the United States Department of Treasury Circular 570, Current Revisions. If the amount of the Bond exceeds the underwriting limitation set forth in the circular, in order to qualify, the net retention of the surety company shall not exceed the underwriting limitation in the circular and the excess risks must be protected by coinsurance, reinsurance, or other methods in accordance with Treasury Circular 297, revised September 1, 1978 (31 DFR Section 223.10, Section 233.111). Further, the surety company shall provide the County with evidence satisfactory to the County, that such excess risk has been protected in an acceptable manner.



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b. The County will accept a surety bond from a company with a rating of B+ or better,

provided, however, that if any surety company appears on the watch list that is published quarterly by Intercom of the Office of the Florida Insurance Commissioner, the County shall review and either accept or reject the surety company based on the financial information available to the County.

c. A surety company that is rejected by the County may be substituted by the bidder or proposer with a surety company acceptable to the County.

d. The County will accept a Bond from a surety company which has twice the minimum

surplus and capital required by the Florida Insurance Code at the time the invitation bid is issued, if the surety company is otherwise in compliance with the provisions of the Florida Insurance Code, and if the surety company holds a currently valid Certificate of Authority issued by the United States Department of the Treasury under Section 9304 to 9308 of Title 31 of the United States Code.

e. The County will accept a surety bond from a company with a rating of B+ or better;

provided, however, that if the surety company appears on the 'Watch List' that is published quarterly by 'Focus’ of the Office of the Florida Insurance Commissioner, the County shall review and either accept or reject the surety company based on the financial information available to the County. A surety company that is rejected by the County may be substituted by the bidder or proposer with a surety company acceptable to the County.

For Additional Project Information Contact:

Claude M. Gentil, P.E. Phone: (954) 468-0141 Email: [email protected]

Selection Process

Review Responses

The Purchasing Division delivers the submittals to agency staff for summarization for the Selection Committee members. The Office of Economic and Small Business Development staff evaluates submittals to determine compliance with the Office of Economic and Small Business Development Program requirements, if applicable. Agency staff will prepare an analysis report which includes a matrix of responses submitted by the firms.

Staff will also identify any incomplete responses. The Director of Purchasing will review the information provided in the matrix and will make a recommendation to the Selection Committee as to each firm’s responsiveness to the requirements of the RLI. The final determination of responsiveness rests solely on the decision of the Selection Committee.



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Short Listing

The SC will meet to create a short list of the most qualified firms. The matrix and staff analysis report is a tool that the SC may use in its decision-making process. The County will not consider oral or written communications, prior to the conclusion of short-listing the firms, which may vary the terms of the submittals. The SC will post its recommendation of the short list of the most qualified firms for three days as a “Proposed Recommendation of Shortlisting”. Following this three-day period, if no objections to the proposed short list have been received in writing by the Director of Purchasing, a Final Recommendation of Shortlisting will be posted and presented to the Board for approval.

Cone of Silence

At the time of the Selection Committee appointment (which is typically prior to the advertisement of the solicitation document) in this RLI process, a Cone of Silence will be imposed. Section 1-266, Broward County Code of Ordinances as revised, provides that after Selection Committee appointment, potential vendors and their representatives are substantially restricted from communicating regarding this RLI with the County Administrator, Deputy and Assistants to the County Administrator and their respective support staff, or any person appointed to evaluate or recommend selection in this RLI process. For communication with County Commissioners and Commission staff, the Cone of Silence allows communication until the Shortlist Meeting of the Selection Committee. After the application of the Cone of Silence, inquiries regarding this RLI should be directed to the Director of Purchasing or designee. The Cone of Silence terminates when the County Commission or other awarding authority takes action which ends the solicitation.

Demonstrations

If this box is checked, then this project may lend itself to an additional step where short-listed firms demonstrate the nature of their offered solution. In those cases, staff, and sometimes members of the SC, may request a representative display or demonstration. If the SC decides that demonstrations are necessary, short-listed firms will receive a description of, and arrangements for, the desired demonstration.

Pricing


Price may be considered in the final evaluation and ranking of the short-listed firms. If the SC will consider price, staff will provide each short-listed firm with a pricing submittal instrument and instructions for its preparation and delivery.

Price will not be a factor in evaluating or ranking the interested firms.

County staff and the top ranked firm will negotiate fees for pre-construction services during the Negotiation Phase of this process. Generally, the Parties negotiate a Guaranteed Maximum Price (GMP) for construction services during the course of pre-construction services.



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Public Art and Design Program


Section 1-88, as amended, of the Broward County Code (of Ordinances) contains the requirements for the Broward County’s Public Art and Design Program. It is the intent of Broward County to functionally integrate art, when applicable, into capital projects and integrate artists’ design concepts into this improvement project. The bidder may be required to collaborate with the artist(s) on design development within the scope of this request. Artist(s) shall be selected by Broward County through an independent process. (For additional information contact Mary Becht at (954) 357-7456).

Insurance Requirements

OCIP Designated Project: this Project has been designated to be covered by Owner Controlled Insurance Program (OCIP). The COUNTY has arranged with Aon Risk Services, Inc., (the “OCIP Administrator”) for this project (“Project”) to be insured under its Owner Controlled Insurance Program (“OCIP”). The OCIP is more fully described in the Insurance Manual, provided at: http://www.broward.org/Purchasing/Documents/ocipmanual.pdf, The Safety and Loss Prevention Manual, provided at: http://www.broward.org/Purchasing/Documents/ocipsafetymanual.pdf,

Parties performing labor or services at the Project site are required to enroll in the OCIP, unless they are Excluded Parties (as defined in contract requirements language). The OCIP will provide to Enrolled Parties (as defined) Workers’ Compensation and Employer’s Liability insurance, Commercial General Liability insurance, Excess Liability insurance. Environmental Liability insurance and Builder’s Risk insurance, if applicable, in connection with the performance of this Project (“OCIP Coverages”). Insurance not provided under the OCIP will be vendor’s responsibility to secure and maintain.

OCIP Certification: Proposer should submit an Owner Controlled Insurance Program

Certification Form (Attachment 1-1) with RLI submittal, but must submit within five business days of County request. Vendor assumes full responsibility to read, understand, and comply with all of the County’s insurance requirements and OCIP requirements as explained in the contract documents, the OCIP Insurance Manual, and the OCIP Safety and Loss Prevention Manual.

OCIP Enrollment: within five business days of the County’s request, the recommended

vendor for award shall complete the OCIP enrollment forms (OCIP Insurance Manual, AON Form-3) and submit them to the OCIP Administrator. The contract award shall be contingent upon AON’s review and the County’s Risk Management Division’s approval of the forms.

NOTE: SEE ATTACHMENT “B” for further OCIP Designated Project information.

http://www.broward.org/Purchasing/Documents/ocipmanual.pdf

http://www.broward.org/Purchasing/Documents/ocipsafetymanual.pdf



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State and Local Preferences

If the solicitation involves a federally funded project where the fund requirements prohibit the use of state and/or local preferences, such preferences contained in the County's Local Preference Ordinance, Domestic Partnership Ordinance and Procurement Code will not be applied in the procurement process.

Posting of Solicitation and Proposed Contract Awards

The Broward County Purchasing Division's website is the official location for the County's posting of all solicitations and contract award results. It is the obligation of each vendor to monitor the website in order to obtain complete and timely information. The website is located at http://www.broward.org/Purchasing/Pages/SolicitationResult.aspx

Vendor Protest

Sections 21.118 and 21.119 of the Broward County Procurement Code set forth procedural requirements that apply if a vendor intends to protest a solicitation or proposed award of a contract and state in part the following:

(a) Any protest concerning the bid or other solicitation specifications or requirements must be made and received by the County within seven (7) business days from the posting of the solicitation or addendum on the Purchasing Division’s website. Such protest must be made in writing to the Director of Purchasing. Failure to timely protest bid specifications or requirements is a waiver of the ability to protest the specifications or requirements.

(b) Any protest concerning a solicitation or proposed award above the award authority of the Director of Purchasing, after the bid opening, shall be submitted in writing and received by the County within five (5) business days from the posting of the recommendation of award on the Purchasing Division's website.

(c) Any actual or prospective bidder or offeror who has a substantial interest in and is aggrieved in connection with the proposed award of a contract which does not exceed the amount of the award authority of the Director of Purchasing, may protest to the Director of Purchasing. The protest shall be submitted in writing and received within three (3) business days from the posting of the recommendation of award on the Purchasing Division's website.

(d) For purposes of this section, a business day is defined as Monday through Friday between 8:30 a.m. and 5:00 p.m. Failure to timely file a protest within the time prescribed for a solicitation or proposed contract award shall be a waiver of the vendor's right to protest.

(e) Protests arising from the decisions and votes of a Selection Committee or Evaluation Committee shall be limited to protests based upon the alleged deviations from established Committee procedures set forth in the Broward County Procurement Code and existing written Guidelines. Any allegations of misconduct or misrepresentation on the part of a competing vendor shall not be considered a protest.

http://www.broward.org/Purchasing/Pages/SolicitationResult.aspx



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(f) As a condition of initiating any RLI protest, the protestor shall present the Director of Purchasing a nonrefundable filing fee in accordance with the table below.

Estimated Contract Amount Filing Fee

$30,000 - $250,000 $ 500

$250,001 - $500,000 $1,000

$500,001 - $5 million $3,000

Over $5 million $5,000

If no contract bid amount was submitted, the estimated contract amount shall be the County’s estimated contract price for the project. The County may accept cash, money order, certified check, or cashier’s check, payable to Broward County Board of Commissioners.

Rejection of Responses

The Selection Committee may recommend to the Director of Purchasing the rejection of all responses to this solicitation.

Public Records and Exemptions

Upon receipt, all response submittals become "public records" and shall be subject to public disclosure consistent with Chapter 119, Florida Statutes. Any firm that intends to assert any materials to be exempted from public disclosure under Chapter 119, Florida Statutes must submit the document(s) in a separate bound document labeled "Name of Firm, Attachment to Proposal Package, RLI# - Confidential Matter". The firm must identify the specific statute that authorizes the exemption from the Public Records Law.

Failure to provide this information at the time of submittal may result in a recommendation by the Director of Purchasing that the response is non-

responsive.

Any claim of confidentiality on materials that the firm asserts to be exempt and placed elsewhere in the submittal will be considered waived by the firm upon submission, effective after opening.

Please be aware that submitting confidential material may impact full discussion of your submittal by the Selection/Evaluation Committee because the Selection/Evaluation Committee will be unable to talk about the details of the confidential material(s) at the public Selection/Evaluation Committee meeting. Please note that the financial statement exemption provided for in Section 119.071(1) c, Florida Statutes only applies to submittals in response to a solicitation for a "public works" project.



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Copyrighted Materials

Copyrighted material will be accepted as part of a submittal only if accompanied by a waiver that will allow the County to make paper and electronic copies necessary for the use of County staff and agents. It is noted that copyrighted material is not exempt from the Public Records Law, Chapter 119, Florida Statutes. Therefore, such material will be subject to viewing by the public, but copies of the material will not be provided to the public.

***NOTICE TO PROPOSERS***

Proposers are invited to pay strict attention to the following requirements of this RLI. The information being requested in this section is going to be used by the Selection Committee during the selection/evaluation process and further consideration for contract award. Please be aware that proposers have a continuing obligation to provide the County with any material changes to the information being requested in this RLI. A. Definition of a Responsive Bidder: In accordance with Broward County Procurement Code Section 21.8.b.66, a Responsive Bidder means a person who has submitted a bid which conforms in all material respects to a solicitation. A bid or proposal of a Responsive Bidder must be submitted on the required forms, which contain all required information, signatures, notarizations, insurance, bonding, security, or other mandated requirements required by the bid documents to be submitted at the time of bid opening.

Responsiveness Criteria

Failure to provide the information required below, at the time of submittal opening may result in a recommendation of non-responsive by the Director of Purchasing. The Selection Committee will determine whether the firm is responsive to the requirements specified herein. The County reserves the right to waive minor technicalities or irregularities as is in the best interest of the County in accordance with Section 21.30.f.1(c) of the Broward County Procurement Code.

1. Office of Economic and Small Business Development Program – (See Office

of Economic and Small Business Development Program requirements below).

Office of Economic and Small Business Development Program Requirements The Broward County Business Opportunity Act of 2004 and the County Business Enterprise (CBE) Act of 2009 establish the County’s policies for participation by small business enterprises, county business enterprises, and federal disadvantaged business enterprises in all County contracts and in other selected activities.



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In accordance with the Acts, participation for this contract is as follows:

Business Enterprise Category % of Participation Goal

County Business Enterprise (CBE) 25%

Overall Goal 25%

SPECIALTIES NAICS: 238910, 561730, 238120, 237310 NIGP: 90976, 98852, 91479, 91327 The County uses the interested firm’s submittal to this section of the RLI to determine the firm’s “responsiveness.” The County only considers “responsive” submittals for short-listing. To be considered responsive requires the following actions.

Submit the forms and documentation detailed below and attached to this RLI. Copies of each form are available on the Internet at: www.broward.org/smallbusiness/compliance. If the firm does not have access to the Internet, contact the Project Manager to receive copies by mail or fax. To be considered responsive requires the following action.

Step 1: In the initial response to this RLI, submit a Contractor Assurance Statement on company letterhead, signed by the owner or authorized company representative, affirming that company will comply with the County’s non-discrimination policy, acknowledge the percentage goal established on the project and, agree to engage in good faith effort solicitation of approved Broward County Small Business Development Program firms to achieve the project goals stated above. Step 2: Short listed firms will be required to submit the CBE Plan by completing the following

forms (attached) and submitting them as part of the bid package in Step Two:

Form Content

Schedule of Participation

List each of the proposed Broward County-certified subcontractors or subconsultants, the type of work each firm will perform, and the projected subcontract dollar amount and/or percentage of professional fees to be awarded, if selected.

Letters of Intent

For each participating firm, indicate the agreed subcontract amount executed with the responding firm’s signature and countersigned by the proposed subcontractor or subconsultant listed on the Schedule of Participation form.

Unavailability Report

For any instances where the specific goals were not achieved, list the subcontractors or subconsultants formally contacted and the reason unavailable to perform or whose bid was not considered.

http://www.broward.org/econdev/SmallBusiness/Pages/compliance.aspx



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If the Responder is unable to engage sufficient firms to achieve the participation goals established for this RLI, the responder can demonstrate through accompanying documentation that it made a good-faith effort to meet the goal. The County will evaluate the weight of the evidence to determine if the Responder’s effort was made in good faith. A pro-forma submittal will be considered non-responsive. Evidence of good-faith effort on the part of the Responder should minimally include successful completion and submission of the following requirements:

Soliciting through activities such as attendance at pre-bid meetings, advertising, or written notices, the interest of certified CBEs (or CBEs eligible for certification) that have the ability and capacity to perform the contract work.

The bidder must solicit this interest in a timely manner to allow the CBEs to respond to the solicitation. The bidder must take appropriate steps to follow up initial solicitations of CBE firms.

Identifying the portions of the contract that could reasonably be performed by a CBE in order to increase the likelihood that the CBE goals will be achieved. This may include, where appropriate and commercially practicable, separating contract work items into segments more appropriate for participation by CBEs.

Providing each interested CBE with adequate information about the plans, specifications, and requirements of the contract in a timely manner.

Negotiating in good faith with each interested CBE. Evidence of such negotiation includes the names, addresses, and telephone numbers of CBEs that were considered; a description of the information provided regarding the plans and specifications for the work selected for subcontracting; and evidence as to why an agreement could not be reached with an interested CBE to perform the work. The fact that there may be some additional costs involved in subcontracting with CBEs is not in itself sufficient reason for a bidder's failure to meet the contract CBE goal, as long as such additional costs are reasonable. The determination of whether additional costs are reasonable shall be made jointly by the Purchasing Director (or designee) and the Program Director (or designee), with any disagreement resolved by the County Administrator or designee.

Rejecting a CBE as being unqualified for participation only after diligently investigating the CBE's capabilities and documenting the sound reasons justifying such rejection (with such documentation to be provided to the Program Director).

The County may take into account the response of other bidders in meeting the contract goal. For example, when the apparent successful bidder fails to meet the contract goal, but others meet it, it is proper to question whether, with additional reasonable efforts, the apparent successful bidder could have met the goal. If the apparent successful bidder fails to meet the goal, but meets or exceeds the average CBE participation obtained by other bidders, this may be viewed, in conjunction with other factors, as evidence of the apparent successful bidder having made a good faith effort.



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For additional guidance on what information or documentation is deemed acceptable for satisfying the good faith efforts requirements, please contact Office of Economic and Small Business Development at 954-357-6400.

Responsiveness Criteria (continued)

2. Bond Requirements - All firms responding to the RLI must include with their

submission a bond or other surety, identified below, in the amount of Ten Thousand Dollars ($10,000), payable to the Board of County Commissioners, and condition upon and guaranteeing that if the firm is shortlisted in the Step I process, the firm will submit a bid in the Step II process. If the firm submits a bid, the bond shall be returned. Otherwise, the bond shall be forfeited to the Board of County Commissioners if the firm fails to provide a bid in response to the Step-Two process. The bond must be an original, no photocopies will be accepted. In lieu of the bond, the following will be acceptable: cash, money order, certified check, cashier's check, original irrevocable letter of credit, treasurer's check or bank draft of any national or state bank (United States). A personal check or a company check of a Bidder shall not be deemed a valid bond guaranty.

JOINT VENTURE ENTERPRISES

Unchecked boxes do not apply to this solicitation

Construction Licensing

A Joint Venture is required to provide evidence with its response that the Joint Venture, or at least one of the Joint Venture partners, holds the specified Construction License issued either by the State of Florida or Broward County. If not with its response, the Joint Venture is required to provide evidence prior to contract execution that the Joint Venture holds the specified Construction License issued either by the State of Florida or Broward County. A Joint Venture is also required to provide with its response a Statement of Authority indicating that the individual submitting the Joint Venture’s proposal has the legal authority to bind the Joint Venture. Failure to provide any of this information to the County at the required time may be cause for the response to the solicitation to be deemed non-responsive.

Florida Registration

A Joint Venture is required to provide evidence with its response that the Joint Venture, or at least one of the Joint Venture partners, holds a Certificate of Authority or Certificate of Status from the Florida Department of State, Division of Corporations to transact business in Florida. If not with its response, the Joint Venture is required to provide evidence prior to contract execution that the Joint Venture is registered by the State of Florida and is allowed to transact



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business in Florida. Failure to provide any of this information to the County at the required time may be cause for the response to the solicitation to be deemed non-responsive.

B. Definition of Responsible Bidder: In accordance with Broward County Procurement Code Section 21.8.b.65, a Responsible Bidder or Offeror means an offeror who has the capability in all respects to perform the contract requirements, and the integrity and reliability which will assure good faith performance.

Responsibility Criteria

The Selection Committee will recommend to the awarding authority a determination of a firm’s responsibility. At any time prior to award, the awarding authority may find that an offeror is not responsible to receive a particular award. The following criteria shall be evaluated in making a determination of responsibility:

1. Financial Information - Although the review of a vendor's financial information is an

issue of responsibility, the failure to either provide the financial documentation or correctly assert a confidentiality claim pursuant the Florida Public Records Law and the solicitation requirements as stated in the Evaluation Criteria and Public Record and Exemptions sections may result in a recommendation of non-responsive by the Director of Purchasing.

2. Litigation History - Although the review of a vendor's litigation history is an issue of

responsibility, the failure to provide litigation history as required in the Evaluation Criteria may result in a recommendation of non-responsive by the Director of Purchasing.

3. The licensing requirement for the above referenced project contractor or

subcontractor must possess one (1) of the following licenses and State Registration (if applicable), and provide such to County is as follows:

STATE: CERTIFIED GENERAL CONTRACTOR; OR

BROWARD

COUNTY: GENERAL BUILDING CONTRACTOR---Class “A” (Must be registered with the State)

Please note that all work not within the scope of the above contractor should be completed by a licensed subcontractor. All contractors must have current liability insurance and workers compensation, or proof of exemption from workers compensation.

Additionally, the awarding authority may consider the following factors, without limitation: debarment or removal from the authorized vendors list or a final decree, declaration or order by



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a court or administrative hearing officer or tribunal of competent jurisdiction that the offeror has breached or failed to perform a contract, claims history of the offeror, performance history on a County contract(s), an unresolved concern, or any other cause under this code and Florida law for evaluating the responsibility of an offeror.

Right of Appeal

Pursuant to Section 21.83 of the Broward County Procurement Code, any vendor that has a substantial interest in the matter and is dissatisfied or aggrieved in connection with the Selection Committee's determination of responsiveness may appeal the determination pursuant to Section 21.120 of the Code. The appeal must be in writing and sent to the Director of Purchasing within ten (10) calendar days of the determination by the Selection Committee to be deemed timely. As required by Section 21.120, the appeal must be accompanied by an appeal bond by a person having standing to protest and must comply with all other requirements of this section. The institution and filing of an appeal is an administrative remedy to be employed prior to the institution and filing of any civil action against the County concerning the subject matter of the appeal.

Projected Schedule:

Open Date: November 7, 2011 Short list Date: December 19, 2011



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Evaluation Criteria

With regard to the Evaluation criteria, each firm has a continuing obligation to provide the County with any material changes to the information requested. The County reserves the right to obtain additional information from interested firms.

Evaluation Criteria –

Project-Specific Criteria

Provide answers below. If you are submitting a response as a joint venture, you must respond to each question for each entity forming the joint venture. When an entire response cannot be entered, a summary, followed with a page number reference where a complete response can be found is acceptable.

1. Identify the office that will be responsible for this project.

2. Describe current similar projects and estimated date of completion.

3. Within the past five (5) years, describe your experience on all aspects of similar projects and indicate the dollar value and if they were completed on time, satisfactory, and within the awarded contract amount. Include a brief description of the work and Include contact information (name, address, telephone number and email address) for references for all cited projects.

4. List all projects, including project numbers, which have been completed or are active with Broward County within the past five (5) years. Include contact information (name, address, telephone number and email address) for references for all cited projects.

5. Identify key personnel and their experience that will be assigned to this project. Include a listing of proposed sub-



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contractors and their experience with similar projects and their resumes.

6. Project includes work that is located in close proximity to petroleum lines. Provide evidence of key personnel or sub-contractor experience working under similar conditions.

7. Provide evidence of familiarity of Port security regulations and of experience working in secure environments (e.g. Ports, airports etc.)

8. Identify the entity (either prime or subcontractor) that will be responsible for installation of the Northport Garage Security mesh (screen) and provide evidence of experience of installing security mesh on existing buildings.

9. Identify the entity (either prime or subcontractor) that will be responsible for installation of the sally port mechanical vehicle barrier and provide evidence of experience.

10. Identify the entity (either prime or subcontractor) that will be responsible for relocation of the DMS sign and provide evidence of experience.

11. Identify the entity (either prime or subcontractor) that will be responsible for construction of the new security checkpoint and relocation of the dock access gate and provide evidence of experience constructing similar facilities.

12. Identify the entity (either prime or subcontractor) that will be responsible for installation of fiber optics and other security items and provide evidence of experience.

13. Provide a list of roadway construction projects completed by the contractor in industrialized areas requiring maintenance of traffic for heavy traffic.



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Company Profile


1. Supply legal firm name, headquarters address, local office addresses, state of incorporation, and key firm contact names with their phone numbers and e-mail addresses.

2. Supply the interested firm’s federal ID number and Dun and Bradstreet number.

3. Is the interested firm legally authorized, pursuant to the requirements of the Florida Statutes, to do business in the State of Florida?

4. All firms are required to provide Broward County the firm's financial statements at the time of submittal in order to demonstrate the firm's financial capabilities. Failure to provide this information at the time of submittal may result in a recommendation by the Director of Purchasing that the response is non-responsive. Each firm shall submit its most recent two (2) years of financial statements for review. The financial statements are not required to be audited financial statements. With respect to the number of years of financial statements required by this RLI, the firm must fully disclose the information for all years available; provided, however, that if the firm has been in business for less than the required number of years, then the firm must disclose for all years of the required period that the firm has been in business, including any partial year-to-date financial statements. The County may consider the unavailability of the most recent year’s financial statements and



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whether the firm acted in good faith in disclosing the financial documents in its evaluation. Any claim of confidentiality on financial statements should be asserted at the time of submittal. (see below) *****ONLY “IF” claiming Confidentiality***** The financial statements should be submitted in a separate bound document labeled "Name of Firm, Attachment to Proposal Package, RLI# - Confidential Matter". The firm must identify the specific statute that authorizes the exemption from the Public Records Law. Failure to provide this information at the time of submittal may result in a recommendation by the Director of Purchasing that the response is non-responsive. Please note that the financial statement exemption provided for in Section 119.071(1) c, Florida Statutes only applies to submittals in response to a solicitation for a "public works" project.

5. Litigation History Requirement:

The County will consider a vendor's litigation history information in its review and determination of responsibility. All vendors are required to disclose to the County all "material" cases pending, filed or resolved in the three (3) year period ending with the solicitation response due date, whether such cases were brought by or against the vendor, any parent or subsidiary of the vendor, or any predecessor organization. If the vendor is a joint venture, the information provided should encompass the joint venture (if it is not newly-formed for purposes of responding to the solicitation) and each of the entities forming the joint venture. For purpose of this disclosure requirement, a “case” includes lawsuits, administrative hearings and arbitrations. A case is considered to be "material" if it relates, in whole or in part, to any of the following: 1. A similar type of work that the vendor is seeking to perform for the County under the



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current solicitation; 2. An allegation of negligence, error or omissions, or malpractice against the vendor or any of its principals or agents who would be performing work under the current solicitation; 3. A vendor's default, termination, suspension, failure to perform, or improper performance in connection with any contract; 4. The financial condition of the vendor, including any bankruptcy petition (voluntary and involuntary) or receivership; or 5. A criminal proceeding or hearing concerning business-related offenses in which the vendor or its principals (including officers) were/are defendants. Notwithstanding the descriptions listed in paragraphs 1 – 5 above, a case is not considered to be "material" if the claims raised in the case involve only garnishment, auto negligence, personal injury, workers' compensation, foreclosure or a proof of claim filed by the vendor. For each material case, the vendor is required to provide all information identified in the form attached as Attachment "A". A Vendor is also required to disclose to the County any and all case(s) that exist between the County and any of the vendor's subcontractors/subconsultants proposed to work on this project. Failure to disclose any material case, or to provide all requested information in connection with each such case, may result in the vendor being deemed non-responsive. Prior to making such determination, the vendor will have the ability to clarify the submittal and to explain why an undisclosed case is not material.

6. Has the interested firm, its principals, officers, or predecessor organization(s) been debarred or suspended from bidding by any government during the last three (3) years? If yes, provide details.



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7. Has your company ever failed to complete any work awarded to you? If so, where and why?

8. Has your company ever been terminated from a contract? If so, where and why?

9. Insurance Requirements: Attached is a sample Certificate of Insurance. It reflects the insurance requirements deemed necessary for this project. It is not necessary to have this level of insurance in effect at the time of submittal but it is necessary to submit certificates indicating that the firm currently carries the insurance or to submit a letter from the carrier indicating upgrade availability.

10. Insurance Requirements: Attached is a sample Certificate of Insurance. It reflects the insurance requirements deemed necessary for this project. It is not necessary to have this level of insurance in effect at the time of submittal but it is necessary to submit certificates indicating that the firm currently carries the insurance or to submit a letter from the carrier indicating upgrade availability.


Legal Requirements


1. Standard Agreement Language: Identify any standard terms and conditions with which the interested firm cannot agree.

The standard terms and conditions for the resulting contract can be found in the attached sample Agreement, ATTACHMENT “D” in the pdf file.

YES (Agree)

NO

If no, you need to specifically identify the terms and conditions with which you are taking exception



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2. Cone of Silence: This County’s ordinance prohibits certain communications among vendors, county staff, and selection committee members. Identify any violations of this ordinance by any members of the responding firm or its joint venturers. The firm(s) submitting is expected to sign and notarize the Cone of Silence Certification included in this solicitation.

3. Public Entity Crimes Statement: A person or affiliate who has been placed on the convicted vendor list following a conviction for a public entity crime may not submit an offer to perform work as a consultant or contract with a public entity, and may not transact business with Broward County for a period of 36 months from the date of being placed on the convicted vendor list. Submit a statement fully describing any violations of this statute by members of the interested firm or its joint venturers.

4. No Contingency Fees: By responding to this solicitation, each firm warrants that it has not and will not pay a contingency fee to any company or person, other than a bona fide employee working solely for the firm, to secure an agreement pursuant to this solicitation. For Breach or violation of this provision, County shall have the right to reject the firm’s response or terminate any agreement awarded without liability at its discretion, or to deduct from the agreement price or otherwise recover the full amount of such fee, commission, percentage, gift, or consideration.

Submit an attesting statement warranting that the Responder has not and will not pay a contingency fee to any company or person, other than a bona fide employee working solely for the firm, to secure an agreement pursuant to this solicitation.

5. If this box is checked, then the provisions of the Broward County Living Wage Ordinance 2008-45, as amended, (“Living Wage Ordinance”) will apply to this agreement. in



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accordance with the living wage ordinance, certain employers who do business with the county shall pay a living wage to its employees who work on service contracts providing covered services identified under the living wage ordinance.

(If living wage applies, check this statement and include the living wage attachment to the RLI solicitation)

6. DRUG FREE WORKPLACE: 1. Do you have a drug free workplace policy? 2. If so, please provide a copy of your drug free workplace policy in your proposal. 3. Does your drug free workplace policy comply with Section 287.087 of the Florida Statutes? 4. If your drug free workplace policy complies with Section 287.087 of the Florida Statutes, please complete the attached Drug Free Workplace Policy Certification Form. 5. If your drug free workplace policy does not comply with Section 287.087of the Florida Statutes, does it comply with the drug free workplace requirements pursuant to Section 21.31.a.2 of the Broward County Procurement Code? 6. If so, please complete the attached Drug Free Workplace Policy Certification Form. 7. If your drug free workplace policy does not comply with Section 21.31.a.2 of the Broward County Procurement Code, are you willing to comply with the requirements Section 21.31.a.2 of the Broward County Procurement Code? 8. If so, please complete the attached Drug Free Workplace Policy Certification Form. Failure to provide a notarized Certification Form in your proposal indicating your compliance or willingness to comply with Broward County's Drug Free Workplace requirements as stated in Section 21.31.a.2 of the Broward County Procurement Code may result in your firm being ineligible to be awarded a contract pursuant to Broward County's Drug Free Workplace Ordinance and Procurement Code.



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7. Non-Collusion Statement: By responding to this solicitation, the vendor certifies that this offer is made independently and free from collusion. Vendor shall disclose on the attached Non-Collusion Statement Form to their best knowledge, any Broward County officer or employee, or any relative of any such officer or employee as defined in Section 112.3135(1) (c), Florida Statutes (1989), who is an officer or director of, or had a material interest in, the vendor’s business, who is in a position to influence this procurement. Any Broward County officer or employee who has any input into the writing of specifications or requirements, solicitation of offers, decision to award, evaluation of offers, or any other activity pertinent to this procurement is presumed, for purposes hereof, a person has a material interest if they directly or indirectly own more than 5 percent of the total assets or capital stock of any business entity, or if they otherwise stand to personally gain if the contract is awarded to this vendor. Failure of a vendor to disclose any relationship described herein shall be reason for debarment in accordance with the provisions of the Broward County Procurement Code.

8. Scrutinized Companies List Certification: Any company, principals, or owners on the Scrutinized Companies with Activities in Sudan List or on the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List is prohibited from submitting a bid, proposal or response to a Broward County solicitation for goods or services in an amount equal to or greater than $1 million. Therefore, if applicable, each company submitting a bid, proposal or response to a solicitation must certify to the County that it is not on either list at the time of submitting a bid, proposal or response. The certification form is referenced as Scrutinized Companies List Certification and should be completed and submitted with your proposal but must be completed and submitted prior to award.



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Tiebreaker Criteria


LOCATION in BROWARD COUNTY

1. Is your firm located in Broward County? 2. Does your firm have a valid current Broward County Local Business Tax Receipt? 3. Has your firm (a) been in existence for at least six (6) months prior to the proposal opening (b) providing services on a day to day basis (c) at a business address physically located within the limits of Broward County (d) in an area zoned for such business and (e) the services provided from this location are substantial component of the services offered in the firm's proposal? If so, please provide the interested firm's business address in Broward County, telephone number(s), email address, evidence of the Broward County Local Business Tax Receipt and complete the attached Local Vendor Certification Form). Failure to provide a valid Broward County Local Business Tax Receipt and a notarized Certification Form in your proposal shall prevent your firm from receiving credit under Broward County's tiebreaker criteria of Section 21.31.d of the Broward County Procurement Code and, if applicable, shall prevent your firm from receiving any preference(s) allowed under Broward County's Local Preference Ordinance.



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DOMESTIC PARTNER BENEFIT

1. Do you have a domestic partnership benefit program? 2. If so, please provide a copy of your domestic partnership benefit program in your proposal and complete the attached Domestic Partnership Benefit Certification Form (Tiebreaker Criteria Form 2). Failure to provide a notarized Certification Form indicating in your proposal shall prevent your firm from receiving credit for having such a program under Broward County's tiebreaker criteria of Section 21.31.d of the Broward County Procurement Code. 3. Does your domestic partnership benefit program provide benefits which are the same or substantially equivalent to those benefits offered to other employees in compliance with the Broward County Domestic Partnership Act of 1999, Broward County Ordinance # 1999-03, as amended? 4. If so, please complete the attached Domestic Partnership Benefit Certification Form. Failure to provide a notarized Certification Form in your proposal indicating that the company provides domestic partnership benefits which are the same or substantially equivalent to the requirements of the Broward County Domestic Partnership Act of 1999, Broward County Ordinance # 1999-03, as amended, shall prevent your firm from receiving any preference(s) allowed under the Act if applicable to this solicitation.

VOLUME OF WORK OVER FIVE YEARS Vendor that has the lowest dollar volume of work previously awarded by the County over a five (5) year period from the date of the submittal. If applicable complete the attached Tiebreaker Criteria Form. (report only amounts awarded as a Prime Vendor)

$



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Vendor’s List (Non-Certified Subcontractors and Suppliers Information)

THIS FORM SHOULD BE SUBMITTED WITH THE RLI/RFP; HOWEVER, IT MUST BE SUBMITTED WITHIN 5 CALENDAR DAYS OF COUNTY’S REQUEST.

Provide this information for any sub vendor(s) who will provide a service to the County for this solicitation. This includes major suppliers as well.

1. Firm’s Name:_____________________________________________________________________

2. Firm’s Address:___________________________________________________________________

3. Firm’s Telephone Number: _________________________Firm’s Email

Address:_________________

4. Contact Name and Position:__________________________________________________________

5. Alternate Contact Name and Position:__________________________________________________

6. Alternate Contact Telephone Number: _________________Email Address:___________________

7. Bid/Proposal Number: ______________________________Contracted Amount:_______________

8. Type of Work/Supplies Bid: __________________________Award Date:_____________________

1. Firm’s Name:_____________________________________________________________________

2. Firm’s Address:___________________________________________________________________

3. Firm’s Telephone Number: _________________________Firm’s Email

Address:_________________

4. Contact Name and Position:__________________________________________________________

5. Alternate Contact Name and Position:__________________________________________________

6. Alternate Contact Telephone Number: _________________Email Address:___________________

7. Bid/Proposal Number: ______________________________Contracted Amount:_______________

8. Type of Work/Supplies Bid: __________________________Award Date:_____________________

I certify that the information submitted in this report is in fact true and correct to the best of my knowledge

Signature

Title

Date

Note: the information provided herein is subject to verification by the Purchasing Division. Use additional sheets for more subcontractors or suppliers as necessary.



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SAMPLE FORM FOR CONTRACTOR ASSURANCE STATEMENT

CBE PROGRAM ACKNOWLEDGEMENT

To be considered responsive with the CBE requirements, the following actions are required for the Step 1 process:

(Company Letterhead)

CONTRACTOR ASSURANCE STATEMENT PROJECT DESCRIPTION __________________________________________________________

I, ___________________________________, (Authorized Official/Agent) on behalf of the ____________________________________ (Contractor) hereby agree to comply with the County Business Enterprise (CBE) requirements of the RLI between Broward County and (your company) for ____________ Project. 1. Affirm that your company will comply with the County’s non-discrimination policy by providing

a non-discrimination Statement and; 2. Acknowledge the CBE percentage goal established on the project and; 3. Agree to engage in good faith effort solicitation of approved Broward County Small Business

Development Program firms to achieve the project goals as indicated in the RLI document. _______________________________________ Authorized Agent of Contractor ________________________________________ Printed Name & Title ________________________________________ Telephone Number/Fax Number Date: _______________

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Tiebreaker Criteria (or Local Preference if applicable)

Local Vendor Certification THE UNDERSIGNED VENDOR HEREBY CERTIFIES THAT:

1. _____ THE VENDOR IS A LOCAL VENDOR IN BROWARD COUNTY AND HAS A VALID BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT WHICH IS ATTACHED TO THIS CERTIFICATION

AND 2. _____ THE VENDOR IS A LOCAL VENDOR IN BROWARD COUNTY AND:

(a) Has been in existence for at least six (6) months prior to the proposal opening; (b) Provides services on a day to day basis at a business address physically located within the limits of Broward County and in an area zoned for such business; and

(c) The services provided from this location are a substantial component of the services offered in the vendor's proposal.

AND/OR 3. _____ THE VENDOR IS A LOCAL VENDOR IN BROWARD OR MIAMI-DADE COUNTY AND HAS A VALID CORRESPONDING COUNTY

LOCAL BUSINESS TAX RECEIPT WHICH IS ATTACHED TO THIS CERTIFICATION AND:

(a) Has been in existence for at least ONE YEAR prior to the proposal opening; (b) Provides services on a day to day basis at a business address physically located within the limits of Broward County and in an area zoned for such business; and

(c) The services provided from this location are a substantial component of the services offered in the vendor's proposal.

______________________________________ (VENDOR SIGNATURE)

______________________________________ (PRINT VENDOR NAME) STATE OF __________________ COUNTY OF ________________ The foregoing instrument was acknowledged before me this ____day of ________________, 20___, by _________________________________________________ as _________________________ of (Name of person who's signature is being notarized) (Title) ____________________________________________ known to me to be the person described herein, or who produced (Name of Corporation/Company) ____________________________________________ as identification, and who did/did not take an oath. (Type of Identification) NOTARY PUBLIC: ________________________________ (Signature) ________________________________ My commission expires: _______________________ (Print Name)

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Tiebreaker Criteria Domestic Partnership Benefit Certification

THE UNDERSIGNED VENDOR HEREBY CERTIFIES THAT: 1. _____ THE VENDOR HAS A DOMESTIC PARTNERSHIP PROGRAM AND THE DOMESTIC PARTNERSHIP BENEFITS ARE AS IDENTIFIED

IN THE COMPANY POLICY ATTACHED TO THIS CERTIFICATION. AND/OR

2. _____THE VENDOR HAS A DOMESTIC PARTNERSHIP PROGRAM THAT IS IN COMPLIANCE WITH THE BROWARD COUNTY DOMESTIC

PARTNERSHIP ACT OF 1999, BROWARD COUNTY ORDINANCE # 1999-03, AS AMENDED, AND OUTLINED AS FOLLOWS: A. VENDOR'S EMPLOYEE BENEFITS PROGRAM INCLUDES THE FOLLOWING MINIMUM STANDARDS:

1. Any vendor's employee who is a party to a domestic partnership relationship is entitled to elect insurance coverage for his or her domestic partner or a dependent of such domestic partner on the same basis in which any other vendor's employee may elect insurance coverage for his or her spouse or dependents. A vendor's employee's right to elect insurance coverage for his or her domestic partner, or the partner's dependent, extends to all forms of insurance provided by the vendor to the spouses and dependents of vendor's employees.

2. Any vendor's employee who is a party to a domestic partnership relationship is entitled to use all forms of leave provided by the vendor including, but not limited to sick leave and annual leave to care for his or her domestic partner or the dependent of the domestic partner as applicable.

3. All other benefits available to the spouses and dependents of vendor's employees are made available on the same basis to the domestic partner, or dependent of such domestic partner, of a vendor's employee who is party to a domestic partnership relationship.

4. It is within the vendor's discretion as to what benefits are provided to its employees and whether vendor's employees who are party to a domestic partnership relationship must be registered in accordance with Broward County Ordinance No. 1999-03, as amended, in order to be eligible for access to employee benefits.

B. VENDOR'S DOMESTIC PARTNERSHIP EILIGIBILITY CRITERIA ARE SUBSTANTIALLY EQUIVALENT TO THE FOLLOWING:

1. Each domestic partner is at least 18 years old and competent to contract. 2. Neither domestic partner is married nor a partner to another domestic partnership relationship. 3. The domestic partners are not related by blood. 4. Consent of either domestic partner to the domestic partnership relationship has not been obtained by force, duress, or fraud. 5. Each domestic partner agrees to be jointly responsible for each other's basic food and shelter.

__________________________________ (VENDOR SIGNATURE)

__________________________________ (PRINT VENDOR NAME)

STATE OF __________________ COUNTY OF ________________ The foregoing instrument was acknowledged before me this ____day of ________________, 20___, by _________________________________________________ as _________________________ of (Name of person who's signature is being notarized) (Title) ____________________________________________ known to me to be the person described herein, or who produced (Name of Corporation/Company) ____________________________________________ as identification, and who did/did not take an oath. (Type of Identification) NOTARY PUBLIC: ________________________________ (Signature) ________________________________ (Print Name) My commission expires: _______________________

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Tiebreaker Criteria BROWARD COUNTY PROJECTS AWARDED

(Volume of work awarded, as Prime vendor only, over the past five years)

Item No.

Project Title Solicitation Contract Number RLI RFP Bid or Quote

Broward County Department Division Area work performed

Awarded Amount

Date Awarded

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

18.

19.

20.

Grand Total $

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Drug Free Workplace Policy Certification

THE UNDERSIGNED VENDOR HEREBY CERTIFIES THAT: 1. _____ THE VENDOR HAS A DRUG FREE WORKPLACE POLICY AS IDENTIFIED IN THE COMPANY POLICY ATTACHED TO THIS CERTIFICATION.

AND/OR

2. _____ THE VENDOR HAS A DRUG FREE WORKPLACE POLICY THAT IS IN COMPLIANCE WITH SECTION 287.087 OF THE FLORIDA STATUTES.

AND/OR

3. _____ THE VENDOR HAS A DRUG FREE WORKPLACE POLICY THAT IS IN COMPLIANCE WITH THE BROWARD COUNTY DRUG FREE

WORKPLACE ORDINANCE # 1992-08, AS AMENDED, AND OUTLINED AS FOLLOWS:

(a) Publishing a statement notifying its employees that the unlawful manufacture, distribution, dispensing, possession, or use of a

controlled substance is prohibited in the offeror's workplace, and specifying the actions that will be taken against employees for violations of such prohibition;

(b) Establishing a continuing drug-free awareness program to inform its employees about: (i) The dangers of drug abuse in the workplace;

(ii) The offeror's policy of maintaining a drug-free workplace; (iii) Any available drug counseling, rehabilitation, and employee assistance programs; and (iv) The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace;

(c) Giving all employees engaged in performance of the contract a copy of the statement required by subparagraph (a); (d) Notifying all employees, in writing, of the statement required by subparagraph (a), that as a condition of employment on a covered

contract, the employee shall: (i) Abide by the terms of the statement; and (ii) Notify the employer in writing of the employee's conviction of, or plea of guilty or nolo contendere to, any violation of Chapter

893, Florida Statutes, or of any controlled substance law of the United States or of any state, for a violation occurring in the workplace NO later than five (5) days after such conviction.

(e) Notifying Broward County government in writing within 10 calendar days after receiving notice under subdivision (d) (ii) above, from an employee or otherwise receiving actual notice of such conviction. The notice shall include the position title of the employee;

(f) Within 30 calendar days after receiving notice under subparagraph (d) of a conviction, taking one of the following actions with respect to an employee who is convicted of a drug abuse violation occurring in the workplace:

(i) Taking appropriate personnel action against such employee, up to and including termination; or (ii) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such

purposes by a federal, state, or local health, law enforcement, or other appropriate agency; (g) Making a good faith effort to maintain a drug-free workplace program through implementation of subparagraphs (a) through (f).

OR

4.____ THE VENDOR DOES NOT CURRENTLY HAVE A DRUG FREE WORKPLACE POLICY BUT IS WILLING TO COMPLY WITH THE REQUIREMENTS AS SPECIFIED IN NO. 3

______________________________________ (VENDOR SIGNATURE)

______________________________________ (PRINT VENDOR NAME) STATE OF __________________ COUNTY OF ________________ The foregoing instrument was acknowledged before me this ____day of ________________, 20___, by _________________________________________________ as _________________________ of (Name of person who's signature is being notarized) (Title) ____________________________________________ known to me to be the person described herein, or who produced (Name of Corporation/Company) ____________________________________________ as identification, and who did/did not take an oath. (Type of Identification) NOTARY PUBLIC: ________________________________ (Signature) ________________________________ My commission expires: _______________________ (Print Name)

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Non-Collusion Statement Form

By signing this offer, the vendor certifies that this offer is made independently and free from collusion. Vendor shall disclose below, to their best knowledge, any Broward County officer or employee, or any relative of any such officer or employee as defined in Section 112.3135 (1) (c), Fla. Stat. (1989), who is an officer or director of, or has a material interest in, the vendor’s business, who is in a position to influence this procurement. Any Broward County officer or employee who has any input into the writing of specifications or requirements, solicitation of offers, decision to award, evaluation of offers, or any other activity pertinent to this procurement is presumed, for purposes hereof, to be in a position to influence this procurement. For purposes hereof, a person has a material interest if they directly or indirectly own more than 5 percent of the total assets or capital stock of any business entity, or if they otherwise stand to personally gain if the contract is awarded to this vendor. Failure of a vendor to disclose any relationship described herein shall be reason for debarment in accordance with the provisions of the Broward County Procurement Code.

NAME RELATIONSHIP

____________________________ _____________________________

____________________________ _____________________________

____________________________ _____________________________

____________________________ _____________________________

____________________________ _____________________________

____________________________ _____________________________

____________________________ _____________________________

_____________________________________ (Vendor Signature)

_____________________________________

(Print Vendor Name)

In the event the vendor does not indicate any names, the County shall interpret this to mean that the vendor has indicated that no such relationships exist.

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CONE OF SILENCE CERTIFICATION The undersigned vendor hereby certifies that: 1. _____ the vendor has read Broward County's Cone of Silence Ordinance, Section 1-266, Article xiii, Chapter 1 as revised of the Broward County Code; and

2. _____ the vendor understands that the Cone of Silence for this competitive solicitation shall be in effect beginning upon the appointment of the Evaluation Committee (for Requests for Proposals - RFPs) or Selection Committee (for Request for Letters of Interest - RLIs) for communication regarding this RFP/RLI with the County Administrator, Deputy and Assistants to the County Administrator and their respective support staff or any person, including Evaluation or Selection Committee members, appointed to evaluate or recommend selection in this RFP/RLI process. For Communication with County Commissioners and Commission staff, the Cone of Silence allows communication until the initial Evaluation or Selection Committee Meeting. 3.______the vendor agrees to comply with the requirements of the Cone of Silence Ordinance.

_____________________________________

(Vendor Signature)

_____________________________________

(Print Vendor Name)

STATE OF __________________ COUNTY OF ________________ The foregoing instrument was acknowledged before me this ____day of ________________, 20___, by _________________________________________________ as _________________________ of (Name of person who's signature is being notarized) (Title) ____________________________________________ known to me to be the person described herein, or who produced (Name of Corporation/Company) ____________________________________________ as identification, and who did/did not take an oath. (Type of Identification) NOTARY PUBLIC: ________________________________ (Signature) _______________________________ My commission expires: _______________________ (Print Name)

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Attachment “A” Litigation History

Party Vendor is Plaintiff Vendor is Defendant

Case Name

Case Number

Date Filed

Name of Court or other tribunal

Type of Case

Civil Administrative/Regulatory

Criminal Bankruptcy

Claim or Cause of Action and Brief description of

each Count

Brief description of the Subject Matter and

Project Involved

Disposition of Case

(Attach copy of any applicable Judgment,

Settlement Agreement and Satisfaction of

Judgment.)

Pending Settled Dismissed

Judgment Vendor’s Favor

Judgment Against Vendor

If Judgment Against, is Judgment Satisfied? Yes No

Opposing Counsel

Name:

Email:

Phone number:

NAME OF COMPANY: ______________________________________________

ATTACHMENT “B” OCIP Designated Project

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Overview. COUNTY has arranged with Aon Risk Services, Inc., (the “OCIP Administrator”) for this project (“Project”) to be insured under its Owner Controlled Insurance Program (“OCIP”). The OCIP is more fully described in the insurance manual (the “Insurance Manual”) for the Project, that is provided at http://www.broward.org/Purchasing/Documents/ocipmanual.pdf and into the contract documents by this reference. Parties performing labor or services at the Project site are required to enroll in the OCIP, unless they are Excluded Parties (as defined below). The OCIP will provide to Enrolled Parties (as defined below) Workers’ Compensation and Employer’s Liability insurance, Commercial General Liability insurance, Excess Liability insurance. Environmental Liability insurance and Builder’s Risk insurance, if applicable, as summarily described below, in connection with the performance of this Project (“OCIP Coverages”). Enrolled Parties and Their Insurance Obligations. OCIP Coverages shall cover Enrolled Parties. Enrolled Parties are: the COUNTY, the OCIP Administrator, Contractor and eligible Subcontractors of all tiers that enroll in the OCIP, and such other persons or entities as COUNTY may designate, in its sole discretion (each party insured under the OCIP is an “Enrolled Party.”) Excluded Parties and Their Insurance Obligations. The OCIP Coverages do not cover the following “Excluded Parties”:

(a) Hazardous materials remediation, removal and/or transport companies and their consultants;

(b) Architects, surveyors, engineers, and soil testing engineers, and their consultants; Vendors, suppliers, fabricators, material dealers, truckers, haulers, drivers and others who merely transport, pick up, deliver, or carry materials, personnel, parts or equipment, or any other items or persons to or from the Project site;

(c) Contractor and each of its Subcontractors of all tiers that do not perform any actual labor on the Project site; and

(d) Any parties or entities excluded by COUNTY in its sole discretion, even if they are otherwise eligible.

Excluded Parties and parties no longer enrolled in or covered by the OCIP shall obtain and maintain, and shall require each of its or their Subcontractors of all tiers to obtain and maintain, the insurance coverage specified in the Insurance Manual for all on-site and off-site operations, page 14. Summary of OCIP Coverages. OCIP Coverages shall apply only to those operations of each Enrolled Party performed at the Project site in connection with the Work, and only to Enrolled Parties that are eligible for the OCIP. OCIP coverages shall not apply to ineligible parties, even if they are erroneously enrolled in the OCIP. An Enrolled Party’s operations away from the Project site, including product manufacturing, assembling, or otherwise, shall only be covered if such off-site operations are identified and are dedicated solely to the Project. OCIP Coverages shall not cover off-site operations until receipt by an Enrolled Party of written acknowledgment of such coverage from the OCIP Administrator. The OCIP shall provide only the following insurance to eligible and Enrolled Parties:



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Summary Only Workers’ Compensation insurance at the Statutory Limit in compliance with the Workers’ Compensation Law of the State of Florida, and in compliance with all federal laws, including U.S. Longshoremen & Harbor Workers Act, and Jones Act coverage, where appropriate. This insurance is primary for all occurrences at the Project site. Employer’s Liability Insurance with the following limits: Bodily Injury by Accident, each accident $1,000,000 Bodily Injury by Disease, each employee $1,000,000 Bodily Injury by Disease, policy limit $1,000,000 This insurance is primary for all occurrences at the Project site. Commercial General Liability Insurance provided on ISO Occurrence Form, or its equivalent, with the following limits: Each Occurrence Limit $2,000,000 General Aggregate Limit for all Enrolled Parties $4,000,000 Products & Completed Operations Aggregate for all Enrolled Parties $4,000,000 Ten (10) Years Products & Completed Operations Extension This insurance is primary for all occurrences at the Project site. Excess Liability Insurance (over Employer’s Liability & General Liability), with the following limits: Combined Single Limit $200,000,000 General Annual Aggregate for all Enrolled Parties $200,000,000 Products & Completed Operations Aggregate for all Enrolled Parties $200,000,000 Ten (10) Years Products & Completed Operations Extension COUNTY shall obtain and maintain Builder’s Risk insurance for the Project, providing coverage for all risks of direct physical loss or damage including flood, earthquake, business interruption and named windstorm, as more fully described in the original policy wording. CONTRACTOR and all subcontractors of every tier performing a portion of the Work on the Project shall be additional insureds under the Builder’s Risk insurance, as their respective interests appear.

The Builder’s Risk insurance will provide for property in the course of construction, including offsite storage, transit, buildings, structures, fixtures, materials, foundations, machinery and equipment, cold testing, and damage to existing property business interruption at Port Everglades, all as more fully described in the original policy wording. The Builder’s Risk insurance will provide minimum limits of liability of $50,000,000 for physical damage and loss per project, subject to additional sub-limits as set forth in the original policy wording. CONTRACTOR shall be responsible for all deductibles under the Builder’s Risk insurance up to $25,000.


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Contractor’s Pollution Liability (“CPL”) insurance, providing coverage for claims for bodily injury, property damage, clean-up costs, and related legal defense expense for pollution conditions that result from, or are disrupted by, the services rendered in performance of the contract by or on behalf of CONTRACTOR or any Subcontractor. Coverage will include extensions for transportation and disposal, will include full severability of interests, and will not be restricted by any time element limitations, mold, asbestos, or lead based paint exclusions. Coverage will apply to pollution conditions on, at, under, or migrating from the Project site. The CPL insurance shall have the following limits: Each Loss $200,000,000 Aggregate $200,000,000 CONTRACTOR shall be responsible for all deductibles under the Contractor’s Pollution Liability (“CPL”) insurance, up to $50,000. Contractor(s) shall submit a certificate of insurance pursuant to the OCIP Insurance Manual at: http://www.broward.org/Purchasing/Documents/ocipmanual.pdf. Audits. Contractor agrees that COUNTY, the OCIP Administrator, and/or any OCIP Insurer may audit Contractor’s or any of its Subcontractors’ payroll records, books and records, insurance coverages, insurance cost information, bid estimates, pricing for any cost in the Contract Price/Contract Sum or any subcontracted Work, or any information that Contractor provides to COUNTY, the OCIP Administrator, or the OCIP Insurers to confirm their accuracy, and to ensure that the Costs of OCIP Coverages are not included in any payment for the Work. CONTRACTOR’S OCIP Obligations. CONTRACTOR shall: Enroll in the OCIP within five (5) days of execution of the Contract and maintain enrollment in the OCIP for the duration of the Contract, and assure that each of CONTRACTOR’S eligible Subcontractors of every tier enroll in the OCIP, and maintain enrollment in the OCIP for the duration of their respective subcontract within five (5) days of subcontracting and prior to the commencement of Work at the Project site. Comply with all of the administrative, safety, insurance, and other requirements outlined in the Insurance Manual, the OCIP insurance policies, or elsewhere in the Contract Documents.

Provide to each of its Subcontractors of every tier a copy of the Insurance and Safety Manual, and ensure Subcontractor compliance with the provisions of the OCIP insurance policies, the Insurance Manual, the OCIP Safety and Loss Prevention Manual that is provided at http://www.broward.org/Purchasing/Documents/ocipsafetymanual.pdf and in the Contract Documents. The failure of (a) COUNTY to include the Insurance Manual and Safety Manual at Purchasing Division’s Current Solicitations website: http://www.broward.org/Purchasing/Pages/CurrentSolicitation.aspx or (b) CONTRACTOR to provide to each of its eligible Subcontractors of every tier a copy of the same shall not relieve CONTRACTOR or any of its Subcontractors from any of the obligations contained therein. Acknowledge, and require all of its Subcontractors of every tier to acknowledge, in writing, that COUNTY and the OCIP Administrator are not agents, partners or guarantors of the insurance companies providing coverage under the OCIP (each such insurer, an “OCIP Insurer”), that neither COUNTY nor the OCIP Administrator are responsible for any claims or disputes between or among CONTRACTOR, its Subcontractors of any tier, and any OCIP Insurer(s), and


http://www.broward.org/Purchasing/Documents/ocipsafetymanual.pdf

http://www.broward.org/Purchasing/Pages/CurrentSolicitation.aspx


Page 42 of 44

that neither COUNTY nor OCIP Administrator guarantees the solvency or the availability of limits of any OCIP Insurer(s). Any type of insurance coverage or limits of liability in addition to the OCIP Coverages that CONTRACTOR or its Subcontractors of any tier require for its or their own protection, or that is required by applicable laws or regulations, shall be CONTRACTOR’S or its Subcontractors’ sole responsibility and expense, and shall not be billed to COUNTY. Exclude the Cost of OCIP Coverages from CONTRACTOR’S bid or proposal, and ensure that each Subcontractor of every tier excludes the Cost of OCIP Coverages from their respective bids or proposals. The “Costs of OCIP Coverages” is defined as the amount of CONTRACTOR’S and its Subcontractors’ reduction in insurance costs due to eligibility for OCIP Coverages which includes reduction in insurance premiums, related taxes and assessments, markup on the insurance premiums and losses retained through the use of a self-funded program, self-insured retention, or deductible program. The Cost of OCIP Coverages must include expected losses within any retained risk. CONTRACTOR must deduct the Cost of OCIP Coverages for all Subcontractors in addition to their own Cost of OCIP Coverages. Change orders must also be priced to exclude the Cost of OCIP Coverages. Provide, within five (5) days of COUNTY’S or the OCIP Administrator’s request, all documents or information requested of CONTRACTOR or its Subcontractors relating to eligibility for, enrollment in, or administration of the OCIP. Such information may include, but may not be limited to, payroll records, certified copies of insurance coverages, declaration pages of coverages, certificates of insurance, underwriting data, prior loss history information, safety records or history, OSHA citations, construction cost estimates for this Project, including auditable records of the calculation of the bid or Contract Price or any subcontract amount, pricing for each cost included in the bid or Contract Price or any subcontract amount, or such other data or information as COUNTY, the OCIP Administrator, or OCIP Insurers may request in the administration of the OCIP, to verify that the Costs of OCIP Coverages were not included in the Contract Price or any subcontract amount, or as required by the Insurance Manual. All such records shall be maintained through the term of the Contract and for a period of one (1) year thereafter. Comply, and require all of its Subcontractors to comply with OCIP Administrator’s instructions for electronically enrolling in the OCIP using “Aon Wrap” and for electronically reporting payroll using AonWrap.” If Subcontractors cannot electronically report its payroll, they may provide this information to the OCIP Administrator.


Page 43 of 44

Attachment 1-1

OWNER CONTROLLED INSURANCE PROGRAM CERTIFICATION

The undersigned vendor hereby certifies that: 1. The vendor has read and understands the insurance requirements set forth in the contract documents, including but not limited to the Owner Controlled Insurance Program ("OCIP") requirements set forth in the general conditions, and in the OCIP Insurance Manual, and the OCIP Safety and Loss Prevention Manual; 2. The vendor acknowledges and understands that the OCIP will provide to enrolled parties, as specified in the insurance requirements, workers’ compensation and employer’s liability insurance, commercial general liability insurance, excess liability insurance, builder’s risk insurance, U.S. Longshoremen & Harbor Workers’ act, Jones Act and contractor’s pollution liability insurance; 3. The vendor has removed from its’ bid or bids submitted for the project the cost to provide any of the insurance provided under the OCIP, as instructed in the insurance requirements, and vendor shall not include, in any request for payment, request for compensation, change order, or claim, any of vendor’s costs to provide the insurance coverages provided under the OCIP. 4. The vendor acknowledges and understands that vendor will still be required to provide additional insurance for risks and losses not covered by the OCIP, including but not limited to automobile liability insurance, commercial general liability insurance, workers’ compensation, and employer’s liability insurance, for off-site exposures, and such other insurance as required by owner, all as specified in the insurance requirements; 5. The vendor acknowledges and understands that County, its agents, employees, and officers, and the OCIP administrator, are not and have not acted as an insurance agent or broker for vendor. Vendor has reviewed and understands the OCIP coverages, and has solely relied upon vendor’s own independent review and analysis of the OCIP coverages in formulating any understanding and/or belief as to the amount, nature, type, or extent of any OCIP coverage and its potential applicability to any potential claim or loss, or in deciding, in whole or in part, to submit a bid for the project.

(CONTINUED ON NEXT PAGE)


Page 44 of 44

Attachment 1-1

OWNER CONTROLLED INSURANCE PROGRAM CERTIFICATION (Continued) 6. The vendor acknowledges and agrees that County, its agents, employees, and officers, and the OCIP administrator are not agents, partners, or guarantors of the insurance companies providing coverage under the OCIP, and that neither County, its agents, employees, officers, nor the OCIP Administrator are responsible for any claims or disputes between or among vendor and any OCIP insurer.

________________________________ VENDOR By: _____________________________ (Signature) ________________________________ (Print/Type Name and Title)

STATE OF __________________ COUNTY OF ________________ The foregoing instrument was acknowledged before me this ____day of ________________, 20___, by _________________________________________________ as (Name of person who's signature is being notarized) _________________________ of _____________________________________

(Title) (Name of Corporation/Company)

known to me to be the person described herein, or who produced ____________________________________________ as identification, and who

(Type of Identification)

did/did not take an oath. NOTARY PUBLIC: ________________________________ (Signature) ________________________________ (Print Name) _______________________ My commission expires