CLEVELAND STREET GATEWAY DEMO - 10-0053-EDOP ID: DI
ACORO'
CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDOIYYYY)
03/03/11
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERIS), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) most be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder In lieu of such endorsements .
PRODUCER 727447-6481 NAME:
Bouchard-Clearwater
101 Starcrest Drive 727-449-1267
PRONE AIC No :
P 0 Box 6090 E
aDRESs
1
A
Clearwater FL 33768.6090
J Raymona Bouchard 1
P
R
INSURE S AFFORDING COVERAGE NAIC q
INSURED Sonny Glasbrenner, Inc. INSURER A. American Guarantee & Liability 26247
3566126th Avenue North INSURERS:Zurich American Insurance Co
Clearwater, FL 337624261 INSURER c; Illinois Union Insurance Co 27960
INSURER O:
INSURER E ;
INSURER F :
r:AVFRAnrA r:FRTII:Ir:ATK NIIMRFR- REVISION NUMBER!
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
NSR 1YpEQF(NSURANCE
POLICYNUMBER EFP
MMA POLIC LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00
B X COMMERCIAL GENERAL LIABILITY X GLOS964514 01123111 01123112 PREMMES(EaoccumKm) $ 300,00
CLAIMS MADE f X] OCCUR MED FLIP (Any one person) S 10,00
X CONTRACTUAL LIAB PERSONAL& ADV INJURY S 1,000,00
X XCU GENERAL AGGREGATE $ 2,000,00
GERLAGGREGATELIMIT APPLIES PER: PRODUCTS-COMPIOPAGG $ 2,000,00
POLICY X ?O- LOG S
AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT S 1,000,00
01123111
0112
112 (Ea accidw)
A X AIVYAUTp BAP5864515 3
BODILY INJURY (Perpelson) S
ALL OWNED AUTOS BOD(LY INJURY (Per accident) $
SCHEDULED AUTOS
PROPERTY DAMAGE
$
X HIRED AUTOS (PersoddeM
X NONaWNEDAUTOS $
S
X UMBRELLA LIAR X OCCUR EACH OCCURRENCE S 5,000,00
EXCESS LIAR CLAIMS-MADE
01/23/11
01/23112 AGGREGATE $ 6,000,00
A UC5964637
DEDUCTIBLE S
X RETENTION S $
WORKERS COMPENSATION
M
L
E
I
BILITY
A
' X VAC S A - -
OY
ND E
P
RS
L
A
Y
A ANY PROPRIETORIPARTNEWEXECUnIVE 06964616 01123/11 01123112 E.L. EACH ACCIDENT $ 1,000,00
OFFICERIMEMBER EXCLUDED?
(Mandatory In NH) NIA
E.L. DISEASE - EA EMPLOYE
S 1,000,00
Ify es desa{ha under
DES I TIONOFOPERAT1ONS11efau
E.L. DISEASE-POLICY LIMIT
S 1,000,00
C 17ollution LIab PYG24884570002 11/16/10 11/16/11 RaClalm 1,000,00
1 r Aggregate 2,000,00
(3?DEACOQR0101' Add Mlonat Remarks Schedule, if mere space is required)
g 01M Q ?yg Q? Q MAY t 1
Dr W
P
O
C
L?O
Al
f;T
R
J E
T: C
N
T
CERTIFICATE HOLDER IS ADDITIONAL INSURED AS RESPECTS GENERAL LIABILITY, ONLY
IF REQUIRED BY WRITTEN CONTRACT, AND SUBJECT TO THE TERMS, CONDITIONS AND
LIMITS AS SPECIFIED IN THE POLICY.
CERTIFICATE HOLDER CANCELLATION
CITYCLI
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
CITY OF CLEARWATER THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
PURCHASING DEPARTMENT ACCORDANCE WITH THE POLICY PROVISIONS.
100 SOUTH MYRTLE AVE
CLEAARWATER, FL 33768 AUTHORIZED REPRESENTATIVE
1
®1988-2009 ACORD CORPORATION. All rights reserved.
ACORD 26 (2009109) The ACORD name and logo are registered marks of ACORD
SECTION V
CONTRACT DOCUMENTS
Table of Contents:
CONTRACT BOND .....................................................................................................................1
CONTRACT .................................................................................................................................. 3
CONTRACTOR'S AFFIDAVIT FOR FINAL PAYMENT ..................................................... G
PROPOSAL BOND ...................................................................................................................... 7
AFFIDAVIT .................................................................................................................................. 8
NON-COLLUSION AFFIDAVIT ............................................................................................... 9
PROPOSAL .................................................................................................................................10
CITY OF CLEARWATER ADDENDUM SHEET ................................................................. 13
131DDER'S PROPOSAL ............................................................................................................. 14
SectionV.doc Page i 9/27/2010
. fr
BOND NUMBER: 5098968
CONTRACT BOND
STATE OF FLORIDA
COUNTY OF Pinellas
KNOW ALL MEN BY THESE PRESENTS: Thal we SONNY _GLASBRENNER INC. as
Contractor and SureTec Insurance Company
(Surely) whose honk address is c 0 ane ?.?, --Foiisfon;
HEREINArrER CALLED THE "Surety", arc held and firmly bound into the (.7ity of Clearwater,
Florida (hereinafter called the "()viler") in the penal sum ol': EIGHTY-FOUR TIIOUSAND,
NINE HUNDRED FORTY-N1NI, DOLLARS AND NO CENTS ($84,949.00) for the payment of
which we bind ourselves, our heirs, executors, administrrlors, successors, and assigns 11or the fiaithlial
performance ofa certain written contract, dated (lie _ dory of , 2011.
entered into between the Contractor and the City of Clearwater tor:
CLEVELAND STREET GATEWAY DEMO (10-0053-ED)
a copy ol, which said contract is incorporated herein by reference and is nmdc a part hcrcol'as il' fully
copied herein.
NOW THEREFORE, THE CONDITIONS OF THIS 013L1GATION ARK SUCH, that il' the
Contractor shall in all respects comply with the lernas and conditions of said contract, including the
one-year guarantee of material and labor, and his obligations theretatder, including the contract
documents (which include the Advertisement 1'or Bids, Fornt of Proposal, Fontt ol'Coutruct, Form of
Surely Bond, Instructions to Bidders, (icneral Conditions and Tcehnical Specifications) and the
1111ns and Specifications therein referred to and made a part thereol, and such alterations as may be
made in said Plans :aril Specifications as therein provided liar, rand shall indcmltify arul salve h.arruless
the said Owner against and from all costs, expenses, damages, injury or conduct, want of care or
skill, negligence or default, including patent infringements on the part of the said Contractor agents
or employees, in the execution or per['onnauce of said contracl, ineluding errors in the plans
furnished by the Contractor, and further; ii'such "Contractor" or "Contractors" shall promptly make
payments to all persons supplying him, them or it, labor, malarial, and supplies used directly or
indirectly by said Contractor, Contractors, Sub-Contractor, or Sub-Contractors, in the prosectrtioll of
the work provided 1'or in said Contract, this obligation shall be void, otherwise, (lie Contactor and
Surely jointly and severally agree to pay to the Owner any difference between the sum to which the
said Contractor would be entitled on Ilse completion of the Contract, and that which the Owner may
be obliged to pay for the eompletion of said work by contract or otherwise, & any damages, direct or
indirect, or consequential, which said (wrier may sastaiu on account ol'such work, or ran account of
the I'ailtire oi'the said Contractor to properly and in all things, keep and execute all the provisions of
said contract.
s«aionv Pint 1 of 1-1 9127/2(1)0
CONTRACT BOND
(Z)
And the said Contractor and Surety hereby Walter bind themselves, their successors, executors,
administrators, and assigns, jointly and severally, that they will amply and fully protect the said
Owner against, and will pay any and all nn?ounts, damages, costs and judgments which may be
recovered against or which the Owner may be called upon to pay to any person or corporation by
reason of any damages arising from the perl'orntance ol'said work, or of the repair or maintenance
thereof', or the manner of doing the same or the neglect of the said Contractor or his agents or
servants or the improper performance of the said work by the Contractor or his agents or servants, or
the in.fi•ingen?ents of any patent rights by reason of the use of any material li?rnished or work done; as
aforesaid, or otherwise.
And the said Contractor and Surety hereby further bind then?sclves, their successors, heirs,
excculors, acbninisirators, and assigns, jointly and severally, to repay the owner any sum which the
Owner may be compelled to pay because of any lien for labor naterial lurnished for the work,
embraced by said Contract.
And the said Surety, for the value received, hereby stipulates and agrees that no change, extension of
time, alteration or addition to the terms of the contract or to the work to be perforn?ed (hereunder or
the specifications accompanying the same shall in any way al'1'ect its obligations on this bond, and it
does hereby waive notice of-any such change, extension of tittle, alteration or addition to the terms of
the contract or to the work or to the specifications,
IN TESTIMONY WHEREOF, wiIness the hands and seals of* the par(ies hereto this 17th
clay cif' January 2011
AT 1' . S
2 WI' ' l;, 2jcz? -
COUNTERSIGNED:
Sono tzmasbre. nnear, 4-m
CON'ri Ci'Olz
By:
SureTec Insurance Company
Slllti',i'1'
13y:
Ai°rURNr '-1N-FAct
Nancy L. Sheinberg
Secaionv Pope 2 of 14 9/2W2010
_ .... ._.__ ........ ........
............. ..__ __ _............
CONTRACT
This CONTRACT made and entered into this 9 day of(_•b CA_ , 2011by and between the
C' of Clearwater, Florida, a municipal corporation, hereinafter designated as the "City", and
" a01?-r , of the City of adu,,a t4 County of
and State of Florida, hereinafter designated as the "Contractor".
WITNESSETH:
That the parties to this contract each in consideration of the undertakings, promises and agreements
on the part of the other herein contained, do hereby undertake, promise and agree as follows:
The Contractor, and his or its successors, assigns, executors or administrators, in consideration of the
sums of money as herein after set forth to be paid by the City and to the Contractor, shall and will at
their, own cost and expense perform all labor, furnish all materials, tools and equipment for the
following:
CLEVELAND STREET GATEWAY DEMO (10-0053-ED) IN THE AMOUNT OF EIGHTY-
FOUR THOUSAND, NINE HUNDRED FORTY-NINE DOLLARS AND NO CENTS
($84,949.00)
In accordance with such proposal and technical supplemental specifications and such other special
provisions and drawings, if any, which will be submitted by the City, together with any
advertisement, instructions to bidders, general conditions, proposal and bond, which may be hereto
attached, and any drawings if any, which may be herein referred to, are hereby made a part of this
contract, and all of said work to be performed and completed by the contractor and its successors and
assigns shall be fully completed in a good and workmanlike manner to the satisfaction of the City.
If the Contractor should fail to comply with any of the terms, conditions, provisions or stipulations
as contained herein within the time specified for completion of the work to be performed by the
Contractor, then the City, may at its option, avail itself of any or all remedies provided on its behalf
and shall have the right to proceed to complete such work as Contractor is obligated to perform in
accordance with the provisions as contained herein.
THE CONTRACTOR AND HIS OR ITS SUCCESSORS AND ASSIGNS DOES HEREBY
AGREE TO ASSUME THE DEFENSE OF ANY LEGAL ACTION WHICH MAY BE
BROUGHT AGAINST THE CITY AS A RESULT OF THE CONTRACTOR'S ACTIVITIES
ARISING OUT OF THIS CONTRACT AND FURTHERMORE, IN CONSIDERATION OF
THE TERMS, STIPULATIONS AND CONDITIONS AS CONTAINED HEREIN, AGREES
TO HOLD THE CITY FREE AND HARMLESS FROM ANY AND ALL CLAIMS FOR
DAMAGES, COSTS OF SUITS, JUDGMENTS OR DECREES RESULTING FROM ANY
CLAIMS MADE UNDER THIS CONTRACT AGAINST THE CITY OR THE
CONTRACTOR OR THE CONTRACTOR'S SUB-CONTRACTORS, AGENTS, SERVANTS
OR EMPLOYEES RESULTING FROM ACTIVITIES BY THE AFOREMENTIONED
CONTRACTOR, SUB-CONTRACTOR, AGENT SERVANTS OR EMPLOYEES.
Sectionv Page 3 of 14 9/27/2010
CONTRACT
(2)
In addition to the foregoing provisions, the Contractor agrees to conform to the following requirements:
In connection with the performance of work under this contract, the Contractor agrees not to
discriminate against any employee or applicant for employment because of race, sex, religion, color, or
national origin. The aforesaid provision shall include, but not be limited to, the following:
employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; lay-off or
termination; rates of pay or other forms of compensation; and selection for training, including
apprenticeship. The Contractor agrees to post hereafter in conspicuous places, available for employees
or applicants for employment, notices to be provided by the contracting officer setting forth the
provisions of the non-discrimination clause.
The Contractor further agrees to insert the foregoing provisions in all contracts hereunder, including
contracts or agreements with labor unions and/or worker's representatives, except sub-contractors for
standard commercial supplies or raw materials.
It is mutually agreed between the parties hereto that time is of the essence of this contract, and in the
event that the work to be performed by the Contractor is not completed within the time stipulated
herein, it is then further agreed that the City may deduct from such sums or compensation as may be
due to the Contractor the sum of $1,000.00 per dav_ for each day that the work to be performed by the
Contractor remains incomplete beyond the time limit specified herein, which sum of $1,000.00 per
dav shall only and solely represent damages which the City has sustained by reason of the failure of
the Contractor to complete the work within the time stipulated, it being further agreed that this sum is
not to be construed as a penalty but is only to be construed as liquidated damages for failure of the
Contractor to complete and perform all work within the time period as specified in this contract.
It is further mutually agreed between the City and the Contractor that if, any time after the execution of
this contract and the surety bond which is attached hereto for the faithful performance of the terms and
conditions as contained herein by the Contractor, that the City shall at any time deem the surety or
sureties upon such performance bond to be unsatisfactory or if, for any reason, the said bond ceases to
be adequate in amount to cover the performance of the work the Contractor shall, at his or its own
expense, within ten (10) days after receipt of written notice from the City to do so, furnish an additional
bond or bonds in such term and amounts and with such surety or sureties as shall be satisfactory to the
City. If such an event occurs, no further payment shall be made to the Contractor under the terms and
provisions of this contract until such new or additional security bond guaranteeing the faithful
performance of the work under the terms hereof shall be completed and furnished to the City in a form
satisfactory to it.
SectionV Page 4 of 14 9/27/2010
CONTRACT
(3)
IN WITNESS WHEREOF, the parties to the agreement have hereunto set their hands and seals and
have executed this Agreement, in duplicate, the day and year first above written.
CITY OF CLEARWATER
IN PINELLAS COUNTY, FLORIDA
By: -0;'.
Wi iam B. Horne, II
City Manager
uf ryrC'
fir
,
a-Cc
Attest: ~~
Countersigned:
BY:
Frank Hibbard,
Mayor-Councilmember
(Contractor must indicate whether Corporation,
Partnership, Company or Individual.)
(The person signing shall, in his own
handwriting, sign the Principal's name, his own
name, and his title; where the person is signing
for a Corporation, he must, by Affidavit, show
his authority to bind the Corporation).
(?ak
Rosemarie Call
City Clerk
Cor ro??-iU?l
56np? C b6, brernne..r; -lr jC
(Contractor)
By: SEAL
SectionV Page 5 of 14 9/27/2010
Assistant City Attorney
CONTRACTOR'S AFFIDAVIT FOR FINAL PAYMENT
LCQRPORATION FORM)
STATE OF FLORIDA
COUNTY OF
On this day personally appeared before me, the undersigned authority, duly authorized to
administer oaths and take acknowledgments, , who after being duly sworn,
deposes and says:
That he is the (TITLE)
of , a Florida Corporation, with its principal
place of business located at 3565 126TH Avenue N. Clearwater Florida 33765
(herein, the "Contractor").
That the Contractor was the general contractor under a contract executed on the day
of , 2011_ with the CITY OF CLEARWATER, FLORIDA, a municipal
corporation, as Owner, and that the Contractor was to perform the construction of
CLEVELAND STREET GATEWAY DEMO (10-0053-ED)
That said work has now been completed and the Contractor has paid and discharged all sub-
contractors, laborers and material men in connection with said work and there are no liens outstanding
of any nature nor any debts or obligations that might become a lien or encumbrance in connection with
said work against the described property.
That he is making this affidavit pursuant to the requirements of Chapter 713, Florida Statutes,
and upon consideration of the payment of (Final Full Amount of Contract) in
full satisfaction and discharge of said contract.
That the Owner is hereby released from any claim which might arise out of said Contract.
The word "liens" as used in this affidavit shall mean any and all arising under the operation of
the Florida Mechanic's Lien Law as set forth in Chapter 713, Florida Statutes.
Sworn and subscribed to before me
AFFIANT
This day of , 20
BY:
NOTARY PUBLIC
My Commission Expires: PRESIDENT
SectionV Page 6 of 14 9/27/2010
PROPOSAL BOND
(Not to be filled out if a certified check is submitted)
KNOWN ALL MEN BY THESE PRESENTS:
as Principal, and
as Surety, who's address is _
are held and firmly bound unto
the City of Clearwater, Florida, in the sum of
Dollars ($ ) (being a minimum of 10% of Contractor's total bid amount) for the payment
of which, well and truly to be made, we hereby jointly and severally bind ourselves, our heirs,
executors, administrators, successors and assigns.
The condition of the above obligation is such that if the attached Proposal of
as Principal, and
Surety, for work specified as:
all as stipulated in said Proposal, by doing all work incidental thereto, in accordance with the plans and
specifications provided herefor, all within Pinellas County, is accepted and the contract awarded to the
above named bidder, and the said bidder shall within ten days after notice of said award enter into a
contract, in writing, and furnish the required Performance Bond with surety or sureties to be approved
by the City Manager, this obligation shall be void, otherwise the same shall be in full force and virtue
by law and the full amount of this Proposal Bond will be paid to the City as stipulated or liquidated
damages.
Signed this day of , 2011
(Principal must indicate whether
corporation, partnership, company
or individual)
That we, the undersigned,
Principal
The person signing shall, in his own
handwriting, sign the Principal's
name, his own name and his title;
the person signing for a corporation
must, by affidavit, show his authority
to bind the corporation.
By:
Title
Surety
as
SectionV Page 7 of 14 9/27/2010
AFFIDAVIT
(To be filled in and executed if the bidder is a corporation)
STATE OF FLORIDA )
COUNTY OF )
being duly sworn, deposes and says that he/she is
Secretary of
a corporation organized and existing under and by virtue of the laws of the State of Florida, and having
its principal office at:
Street & Number
City
County State
Affiant further says that he is familiar with the records, minute books and by-laws of
(Name of Corporation)
Affiant further says that
is
(Officer's Name) (Title)
of the corporation, is duly authorized to sign the Proposal for
for said corporation by virtue of
(state whether a provision of by laws or a Resolution of the Board of
Directors. If by Resolution give date of adoption).
Sworn to before me this
Affiant
day of , 2011
Notary Public
Type/print/stamp name of Notary
Title or rank, and Serial No., if any
SectionV Page 8 of 14 9/27/2010
NON-COLLUSION AFFIDAVIT
STATE OF FLORIDA
COUNTY OF )
being, first duly sworn, deposes and says that he is
of
the party making the foregoing Proposal or Bid; that such Bid is genuine and not collusive or sham:
that said bidder is not financially interested in or otherwise affiliated in a business way with any other
bidder on the same contract; that said bidder has not colluded, conspired, connived, or agreed, directly
or indirectly, with any bidders or person, to put in a sham bid or that such other person shall refrain
from bidding, and has not in any manner, directly or indirectly, sought by agreement or collusion, or
communication or conference, with any person, to fix the bid price or affiant or any other bidder, or to
fix any overhead, profit or cost element of said bid price, or that of any other bidder, or to secure any
advantage against the City of Clearwater, Florida, or any person or persons interested in the proposed
contract; and that all statements contained in said proposal or bid are true; and further, that such bidder
has not directly or indirectly submitted this bid, or the contents thereof, or divulged information or data
relative thereto to any association or to any member or agent thereof.
Affiant
Sworn to and subscribed before me this day of 52011.
Notary Public
Sectionv Page 9 of 14 9/27/2010
PROPOSAL
(1)
TO THE CITY OF CLEARWATER, FLORIDA, for
CLEVELAND STREET GATEWAY DEMO (10-0053-ED
and doing such other work incidental thereto, all in accordance with the contract documents, marked
CLEVELAND STREET GATEWAY DEMO (10-0053-ED)
Every bidder must take notice of the fact that even though his proposal be accepted and the documents
signed by the bidder to whom an award is made and by those officials authorized to do so on behalf of
the City of Clearwater, Florida, that no such award or signing shall be considered a binding contract
without a certificate from the Finance Director that funds are available to cover the cost of the work to
be done, or without the approval of the City Attorney as to the form and legality of the contract and all
the pertinent documents relating thereto having been approved by said City Attorney; and such bidder
is hereby charged with this notice.
The signer of the Proposal, as bidder, also declares that the only person, persons, company or parties
interested in this Proposal, are named in this Proposal, that he has carefully examined the
Advertisement, Instructions to Bidders, Contract Specifications, Plans, Supplemental Specifications,
General Conditions, Special Provisions, and Contract Bond, that he or his representative has made such
investigation as is necessary to determine the character and extent of the work and he proposes and
agrees that if the Proposal be accepted, he will contract with the City of Clearwater, Florida, in the form
of contract; hereto annexed, to provide the necessary labor, materials, machinery, equipment, tools or
apparatus, do all the work required to complete the contract within the time mentioned in the General
Conditions and according to the requirements of the City of Clearwater, Florida, as herein and
hereinafter set forth, and furnish the required surety bonds for the following prices to wit:
Sectionv Page 10 of 14 9/27/2010
PROPOSAL
(2)
If the foregoing Proposal shall be accepted by the City of Clearwater, Florida, and the undersigned shall
fail to execute a satisfactory contract as stated in the Advertisement herein attached, then the City may,
at its option determine that the undersigned has abandoned the contract, and thereupon this Proposal
shall be null and void, and the certified check or bond accompanying this Proposal, shall be forfeited to
become the property of the City of Clearwater, Florida, and the full amount of said check shall be
retained by the City, or if the Proposal Bond be given, the full amount of such bond shall be paid to the
City as stipulated or liquidated damages; otherwise, the bond or certified check accompanying this
Proposal, or the amount of said check, shall be returned to the undersigned as specified herein.
Attached hereto is a bond or certified check on
Bank, for the sum of
(being a minimum of 10% of Contractor's total bid amount).
The full names and residences of all persons and parties interested in the foregoing bid are as follows:
(If corporation, give the names and addresses of the President and Secretary. If firm or partnership, the
names and addresses of the members or partners. The Bidder shall list not only his name but also the
name of any person with whom bidder has any type of agreement whereby such person's
improvements, enrichment, employment or possible benefit, whether sub-contractor, materialman,
agent, supplier, or employer is contingent upon the award of the contract to the bidder).
NAMES:
ADDRESSES:
Signature of Bidder:
(The bidder must indicate whether Corporation, Partnership, Company or Individual).
SectionV Page 11 of 14 9/27/2010
PROPOSAL
(3)
The person signing shall, in his own handwriting, sign the Principal's name, his own name and his title.
Where the person signing for a corporation is other than the President or Vice-President, he must, by
affidavit, show his authority, to bind the corporation.
Principal:
By:
Business Address of Bidder:
City and State:
Dated at
Title:
Zip Code
this day of , A.D., 2011
SectionV Page 12 of 14 9/27/2010
CITY OF CLEARWATER
ADDENDUM SHEET
PROJECT: CLEVELAND STREET GATEWAY DEMO (10-0053-ED)
Not applicable
Acknowledgment is hereby made of the following addenda received since issuance of Plans and
Specifications.
Addendum No.
Addendum No.
Addendum No.
Addendum No.
Addendum No.
Addendum No.
Addendum No.
Addendum No.
Addendum No.
Addendum No.
Addendum No.
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
(Name of Bidder)
(Signature of Officer)
(Title of Officer)
(Date)
ScctionV Page 13 of 14 9/27/2010
ScctionV Page 14 of 14 9/27/2010
J W g g a a a a 0
V LL U go CD Oa as
?
2 (D M N LO 0
to LO to t• Nr LO r
n N
U
a
oMNai L1
LQ
N N
V
H w 90
N
CD
Q ?
z U3 CF3 V) V9 d3 d9 69
C¢ W
Z
w 0 0 0 0 0 0 (D
U m
W W o
0MMCd?t0) CiGi U r
d
7:
0 W)
F-- J
uj LQ W a y
Z J ¢ CO 00 04
n n
Cw) z 2
`L _
O O
69 69 N3 69 615, E9 69
U
J w
U 0 0 0 0
Q O O g 0
a a
q s
a W
U a a a a
a a 0 a a
O O
q O
R
z z
F
a
o000
0
r
LL
mooC
D
? ?
QO
LL
a
00aa o
o
m 0
aa
?
cn
a
r00F w
z
co
z
O
J
tD l
L
L N U
J
?
LU
2 ? Q e r r N ? ems- N ? ? c0 f0
O M O O
r O
g R
C Z F- U z O ? v O
z !S ' m O
O
? f F 69 d3 Vtl 0t) ea Er] U3, Z H u3 V
l Uf l eH br 64 b9
O
O
z
a
w J
U
U
V 000 0 C C Z w 040 0 4 0 } 3E
CL 0
O N L()
;: OD 9
N R
O
r
r
Y (
,)
a. 0
0000
co co to
6
0
6
(D
6
co
¢
Z LL
CL a
co I V)
0 N
pl co
M ?
?
0
U LL
a
N tD Nqq
LD
L?
Cl7
Z .?
_
F J O w J OD
(D r` CA W
U ¢ LT
u
I N N m 't
N G w
J Q T T
b N N in
? 2
r N N
M z N N
O
q m j O
F- H - 6& 49 69
6c v> 6f) V) LK H 613 C9 fn 6Fr M b3 b3
) Z
O = t7
U i
Q Cn
Y
W J 1:
~O a <
O D
J ?
Y
w a a a a a a s w a 0 a a a a s }
U aoaa a a s () gOaa a - - w
0000 0 co o -00- r C71 O
H O
z
0
a Ln OmO
wow? m
a CD
a co
s ?
a J
U-
a CA CAS f+
NCDNA m
M m
m m
rv
Q m
J
l L J CO N CA 0
' 0 m
F' w
Z
O
Z J 0 CO N M
Ln N M
O ~
J F
gr N M M
CRy
N
N
H
_
W
Z
c; 0
° °
Z rl! to-)L d3 b9 FA 4 9 6s EA U! l eR bl3 VF L e3 tFp
00
cl
? w U
(Y O H O
(? W
wW
a
H Cn Cn Cn Cn U H Cn U) Cn U) Cn
H ¢ Z-22g 2 2222 2
J J J J J J
Q J J J J
V
Q'
W
?
a CO
0 0 ? ?
o o
Z a
(l)
p
O J
?
a
} U
O J
? cr
U
Q
P M U
o zooo° wo X oooQ wo
W
, J
HF o U ¢molgm oQa U 20w 0 If a
QJ zwCL ?D Za w F Cr) Z W a?] za w W
$o?z w 0cl 9 ~ w 0Q 0z
0 ? HFZ¢ Z¢ p z ? F= JZQ zQ p z
aa W
L J¢ 2 w O D uj J< g w ? a H W
U 0
, o L) ¢ 2 0
?a OF a ?
z :3
(3 a
wa o =a
w
W
m
?¢(j)0
c¢ui(D
.1
°
U)
a
CL
O
F
oo g ?
000 l ?NM? Ln r-Nmd LO
`m`om
w 0 0 0 (D o c o
U 0 0 0 0 0 R R
cl? O p p CD CD N IN
Q a ED M v N
4? C N cn r-
??r
r r
o W
LL P
7 t
n
?
w
°a eA f9 e!). b4 et) 469 cta
¢ g
U r
r
uj
w a 0 0 0 CD 0 0
? U oooo °. C? o
J
U.
0 0 0 0
0
O
L a N0NO Q Q I? Q M
O V -
a J Co O C I
n Z W
CT) N c Z
w
z
WD ER Efa eta eta et? b)
a
a
a
O
a
U
W 0 0 0 0 0 0 o Cn
? U 0 0 0 0 0 0 0 }
0. C] eC! o co c7 ( Q
w LL 1
1 con n °o `c? ti p
Z a' L ? n Q M
W W r fo) CIO r
Q z
ED ° e» esa ua e» es e» eta
5
C7 ?
} J
Z U
Z
O
w 0 Q O
¢ J U 000 (0 M
H a a. N 0 4 C N N U'1 ? p
w cn a m rn - Lq °o a cn
z O CO Lf) N o- _
!p 0 w
Z Q u
? Q
O O
U) Va Ffa EA d9 pta eta tFo
J
W Q
I-
O
a' U
U
Z w 0 0 0 0
00x0 cc
u?
L cn
O U
o Q >
Lo 0 o o L 1- N Q
a
0 r- 7
4
n NN
4
?
J N O T MIN M N ?.Qj
rn N ? ?
r a ? ? T F-
w
z e» ets es e» eta eta eta z
O
U
O
U
W 0 0 0 0 0 00
00000 19 OR
J 0. MNCOOM M
Z
LL
a u
7m
Cli
Z Cl) N N
N
m
J o Q C
D
(V
r _
O
w cl eta en e» ets 6Fa cn va
a
w 0 e-
U 40004 0
Z oodoo 00 0 Q
IL °
°
°
o
° o = ?
c
v
oa
?u
?
m ?
¢ it
Do CO N
M
CO
[
7
cr LL w
~ r
O
g
LU
O
Z d r e»e»e»b3eta Hes
¢
z r
Y
w 0 0 0 0 0 0 0 Z
U OOQC?CD 00
?
oo L? N Z0
Z a u
a0
000 , O
J 0 Ci q Ct L cq 2 w
Lj LL J Lc) N CD Co CS (? r J
CD N z
O
r O 0
r V! H1 V! b3 b4 ti4 bT
a
O
F co v) in in w r cn in cn ch cn
¢ aaaC1_ a Z aclaa a
:3 Z) M 73 :3 :3 M D
? ¢ N
O 0
a O
U
o¢w <
Zo
a wo 2
U oo
a0m ow cc
c
i? ?
?
Zw
(n Z D.
Z0. w
h.
w
o a?za za o z
O22? r
Ob
w
2
2 CL
w e- N M sY lt7
r
J F
O p
O
Z
O a
w J
? w0. Q U
Y U
0
0 wo
v 00
°
¢ ?,
wa oc
c
n
C) 0?
Z
2
? za w F
?F-
Q zQ O Z
O
zga r
O
U?
a
?
w (1CL <
) CL
O
r
¢
? ¢ cn U' cn a
wl - NMI
tz
O
N
0 P
0
N '
aD 0
a
0
a
7
m
w
F-
LU
Q.
U) E
0
H C
0.
Q E
BID RESPONSE FORM (08-11)
Item (quantity Description
I 1 LOT DEMOLITION OF COMMERCIAL STRUCTURES
CLEVELAND STREET, C'LEARWATER, FLORIDA
(per the attached Specifications and Bid Response Form)
Contact Ed Chesney at 727/562-4742, for any technical questions regarding this bid.
Please return two (2) conies of Bid Response
F.O.B. CLEARWATER
Start date'- '/j ` _
Payment Terms:
BIDDER REPRESENTATION
I represent that this bid. is submitted in compliance with all terms. conditions and specifications of flit Invitation for Bid 'mid that I am
autliorixed, by the owners/principals to exectite and submit this bid on behalf of the husiness identified below,
BUSINESS NAME: 7 / lei" -L16,
STREET ADDRESS: /d , ?- `e JV
CITY, STATE, ZIP C'OUE:??L--t_3 7. ,
PRINT/TYPE NAME OF AUTHORIZED REP:
TITLE/POSITION OF AUTHORIZED REP: (%ice. rYs?c?er;(
SIGNATURE OF Al.)THORIZED REP:
I)ATEE SUBMITTED: / / :?S /-20//
PHONE: NO: 7,.??... ? j? - FAX NO: -7,,1 ? ... ' 13 ... //O'1
-.I-
4 C
31"i,'arwater
BIDDER'S PROPOSAL
u
PROJECT. (10-00,53-Ell) (1311) 08-11)
CLEVELAND STREET CxA'FEWAY DEMO
BID i I I: 41 ti UNIT
EST.
T Q
TY. -
- C7Nr PRICE
TOTAL y __..._.
Demolition & disposal of 35,580 total gross square
l fect. comnict-clal structures located along Cleveland LUMP
cx?
Street. Clearwater. Florida. as per the attached scope SUM I ? $
of work.
Complete late asphalt and pavement removal and disposal LUMP 1 CID
6(?
1
SLIM o
,
Removal of two swimming pools, pump houses and
associated piping. Cost includes clean backfill liar '
U LlJ1u1um1
1
$
pool foot ,. ri nts. sum
4 Grade and sod (Bahia) entire site LUMP
S rz,
? /ate
d??'
Slllvl ,
•
SUB-TOTAL (ITEMS 14)
5
?
10% CONTINGENCY L
UN1 1 S $ 7
7023
,
SLIM
TOTAL PROJECT C'OS"r (ITEMS 1-S) 1 -/ ,
CONTRACTOR:
BIDDER'S TOTAL
$ Y"Y ' ?1-19. C-11i
BIDDER'S TOTAL