GARDEN AVENUE PARKING GARAGE RESTORATION - 25-0013-ENSECTION V
CONTRACT DOCUMENTS
Table of Contents
PUBLIC CONSTRUCTION BOND 1
CONTRACT 4
CONSENT OF SURETY TO FINAL PAYMENT 8
PROPOSAL/BID BOND 9
AFFIDAVIT 10
NON -COLLUSION AFFIDAVIT 11
PROPOSAL 12
CITY OF CLEARWATER ADDENDUM SHEET 14
BIDDER'S PROPOSAL 15
SCRUTINIZED COMPANIES AND BUSINESS OPERATIONS WITH CUBA AND SYRIA
CERTIFICATION FORM 18
SCRUTINIZED COMPANIES THAT BOYCOTT ISRAEL LIST CERTIFICATION FORM 19
SECTION V Page i Updated: 7/9/2025
SECTION V — Contract Documents
BondNo.: TIC122009
PUBLIC CONSTRUCTION BOND
(1)
This bond is given to comply with § 255.05, Florida Statutes, and any action instituted by a claimant under
this bond for payment must be in accordance with the notice and time limitation provisions in subsections
(2) and (10).
Pursuant to § 255.05(1)(b), Florida Statutes, "Before commencing the work or before recommencing the
work after a default or abandonment, the contractor shall provide to the public entity a certified copy
of the recorded bond. Notwithstanding the terms of the contract or any other law governing prompt
payment for construction services, the public entity may not make a payment to the contractor until the
contractor has complied with this paragraph."
CONTRACTOR SURETY
Concrete Protection &
Restoration, LLC Indemnity National Insurance Company
Principal Name Principal Name
601 NE 44th St
Oakland Park, FL 33334
238 Bedford Way
Franklin, TN 37064
Principal Business Address Principal Business Address
305-389-3591 (615) 592-5346
Principal Phone Number Principal Phone Number
OWNER
City of Clearwater
Public Works
PO Box 4748
Clearwater FL 33758-4748
(727) 562-4750
PROJECT NAME: Garden Avenue Parking Garage Restoration
PROJECT NO.: 25 -0013 -EN
PROJECT DESCRIPTION: This project consists of rehabilitation of the Clearwater Garden Avenue
Parking Garage (located at 28 North Garden Avenue), including concrete repairs to floors, ceilings, column,
walls and precast tee beams. Floor slab cracks and joints will be sealed and the existing roof level traffic
bearing membrane will be recoated. Miscellaneous repairs will be completed throughout the garage,
including door hardware replacement, installation of bearing support brackets and miscellaneous painting.
The Contractor shall provide copies of current Contractor License/Registration with the state of Florida and
Pinellas County (if applicable) in the bid response.
The Contractor shall provide Fixed or Portable project signs as described in Section III, Section 23 of the
Contract Documents. The final number of project signs will be determined at the beginning of the project
based on the Contractor's schedule of work submitted for approval. Additional project signs may be
required at no additional cost to the city due to the Contractor's schedule of work.
Contract Period: 120 Consecutive Calendar Days
BY THIS BOND, We, Concrete Protection and Restoration. LLC , as Contractor, and
Indemnity National Insurance Company , a corporation, as Surety, are bound to the
City of Clearwater, Florida, herein called Owner, in the sum of $186,310.00, for payment of which we bind
ourselves, our heirs, personal representatives, successors, and assigns, jointly and severally.
SECTION V Page 1 of 19 Updated: 7/9/2025
SECTION V — Contract Documents
THE CONDITION OF THIS BOND is that if Contractor:
1. Performs the contract dated , between Contractor and Owner for construction
of Garden Avenue Parking Garage Restoration, 25 -0013 -EN, the contract documents being
made a part of this bond by reference (which include the Advertisement for Bids, Proposal,
Contract, Surety Bond, Instructions to Bidders, General Conditions, Plans, Technical
Specifications and Appendix, and such alterations as may be made in said Plans and Specifications
as therein provided for), at the times and in the manner prescribed in the contract; and
2. Promptly makes payments to all claimants, as defined in Section 255.05(1), Florida Statutes,
supplying Contractor with labor, materials, or supplies, used directly or indirectly by Contractor in
the prosecution of the work provided for in the contract; and
SECTION V Page 2 of 19 Updated: 7/9/2025
SECTION V — Contract Documents
Bond No.: TIC122009
PUBLIC CONSTRUCTION BOND
(2)
3. Pays Owner all losses, damages, expenses, costs, and attorney's fees, including appellate
proceedings, that Owner sustains because of a default by Contractor under the contract; and
4. To the limits of § 725.06(2), Florida Statutes, shall indemnify and hold harmless Owner, their
officers and employees, from liabilities, damages, losses and costs, including, but not limited to,
reasonable attorney's fees, to the extent caused by the negligence, recklessness, or intentional
wrongful misconduct of Contractor and persons employed or utilized by Contractor in the
performance of the construction contract; and
5. Performs the guarantee of all work and materials furnished under the contract for the time specified
in the contract, then this bond is void; otherwise, it remains in full force.
6. Any action instituted by a claimant under this bond for payment must be in accordance with the
notice and time limitation provisions in Section 255.05(2), Florida Statutes.
7. Any changes in or under the contract documents and compliance or noncompliance with any
formalities connected with the contract or the changes do not affect Surety's obligation under this
bond, and Surety does hereby waive notice of any such change, extension of time, alteration or
addition to the terms of the contract or to the work or to the specifications.
IN TESTIMONY WHEREOF, witness the hands and seals of the parties hereto this 31 day of
IketA , 20 20.
(If sole Ownership or Partnership, two (2) Witnesses are required).
(If Corporation, Secretary only will attest and affix seal).
Concrete Protection &Restoration, LLC.
By:
Title:
Print Name: Lc!i ll.aw lL'A:
WITNESS: WITNESS:
Corporate Secretary or Witness
Print Name:
(affix corporate seal)
Print Name:
Indemnity National Insurance Company
(Corporate Surety)
By: \JO r
ATTORNEY -IN- CT
Print Name: Vicki Johnston
(affix corporate seal)
(Power of Attorney must be attached)
SECTION V Page 3 of 19 Updated: 7/9/2025
INDEMNITY ®NATIONAL
Power of Attorney
Indemnity National Insurance Company
238 Bedford Way
Franklin, TN 37064
KNOW ALL PERSONS BY THESE PRESENTS: that Indemnity National Insurance Company, a Mississippi corporation,
(hereinafter the "Company"), does hereby constitute and appoint: ***Adam Martin, Michael Grillo, James Friedrichsen, Charles Bishop, Vicki Johnston***
**************************`**********•************`***********""*""************`*************"*`**`***m of **`The Baldwin Group Specialty Industry LLC*** to be
its true and lawful Attorney -in -Fact, with full power and authority hereby conferred to sign, seal, and execute on its behalf surety
bonds or undertakings and other documents of a similar nature issued in the course of its business up to a penal sum not to exceed
******************************Ten Millions Dollars ($10.000.000)*********AA*AAk************AAAAAk****** each, and to bind the Company
thereby as fully and to the same extent as if the same were signed by the duly authorized officers of the Company.
This appointment is made under and executed pursuant to and by authority of the following Minutes of Special Actions Taken by
Written Consent of the Board of Directors, which is now in full force and effect:
Authorization to Appoint Attorneys -in -Fact and the Use of Facsimile Signatures and Facsimile Seals for the Purpose of Issuing Bonds:
RESOLVED: That the president or any vice president may appoint attorneys -in -fact or agents with authority as defined or limited in the
instrument evidencing the appointment in each case, for and on behalf of the Company to execute and deliver and affix the seal of the
Company to bonds and related obligatory certificates and documents; and any one of said officers may remove any such attorney-in-fact or
agent and revoke any power previously granted to such person, whether or not such officer appointed the attorney-in-fact or agent.
RESOLVED: That any bonds and related obligatory certificates and documents shall be valid and binding upon the Company,
(i) when signed by the president, or any vice president, and sealed with the Company seal; or
(ii) when duly executed and sealed with the Company seal by one or more attorneys -in -fact or agents pursuant to and within the
limits of authority evidenced by the power of attorney issued by the Company to such person or persons a certified copy of which
power of attorney must be attached thereto in order for such obligation to be binding upon the Company.
RESOLVED: That the signature of any authorized officer and the seal of the Company may be affixed to any power of attorney or
certification thereof authorizing the execution and delivery of any bonds and related obligatory certificates and documents of the Company
and such signature and seal then so used shall have the same force and effect as though manually affixed.
IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Company and the corporate seal of
Indemnity National Insurance Company has been affixed thereto in Lexington, Kentucky this 22nd day of August, 2025.
SEALwrs
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1993
4143i1StO 't
////#199191110 \\\\
Indemnity National Insurance Company
By
Thomas F. Elkins, President
State of Kentucky
County of Fayette
On this 22nd day of August, 2025, before me, a Notary Public, personally came Thomas F. Elkins, to me known, and acknowledged that he
is President of Indemnity National Insurance Company; that he knows the seal of said corporation; and that he executed the above Power of
Attorney and affixed the corporate seal of Indemnity National Insurance Company thereto with the authority and at the direction of said corporation.
Omit*
CERTIFICATE
S�•O:y G%y
NOTARY qX
Vin, PUBLIC �a\41- isms--
orinnomoo
411111141.111119
My Commission Expires 09/26/2029
Notary ID Number. KYNP34336
I, James E. Hart, Secretary of Indemnity National Insurance Company, do hereby certify that the foregoing Power of Attorney is still in full force and
effect, and further certify that the Minutes of Special Actions Taken:by:Written Consent of the Board of Directors are now in full force and effect.
IN TESTIMONY WHEREOF I have subscribed my riaMe and affixed the: `seal of said Company. Dated this
day of , 20 .
Indemnity National Insurance Company
STATEMENT OF FINANCIAL CONDITION
December 31, 2024
Assets
Cash and short-term investments $ 46,476,464
Invested assets 306,816,923
Premium receivable 18,138,083
Other assets 13,747,581
Total assets $ 385,179,051
Liabilities
Loss and loss adjustment expense
reserves $ 44,463,960
Unearned and advance premiums 56,587,563
Amounts withheld or retained by
company for others 136,530,895
Other liabilities 11,013,011
Total liabilities
$ 248,595,429
Surplus as regards policyholders $ 136,583,622
Total Surplus and Liabilities $ 385,179,051
By:
arida' Officer,' Treasurer and Secretary
State of Tennessee
County of Williamson
7/4z5
Attest:
President
James Ewell Hart, Chief Financial Officer, Treasurer and Secretary, and Thomas Franklin Elkins, President
of Indemnity National Insurance Company, a Mississippi domiciled insurance company, being duly sworn do certify that
the foregoing is a true and correct statement of financial condition of said company as of December 31, 2024.
Subscribed and sworn to before me this 2nd day o`Aoratig?175
iTENIvESSEE
NOTAPIY
. PUl3flC =
��ssion Epices�9�
Notary Public
Corporate Acknowledgement
State of a t 4
County of 'Brovv0,4_ Ss.:
On this 3`Z day of 1,Ff t't i in the year 20G before me personally come(s)
V`Jv\\;Gle KUr►1 Ort i S
To me known, who, being by � duly sworn, deposes and says that the same resides in
oc .kkc 1PvA.rk L that same is the Vi Oe-
of
Cof the Con c :(c - C ?(&..(-o... 4 gr..a ' e corporation described in and which executed the foregoing instrument;
that same knows the seal of the said corporation; that the seal affixed to the said instrument is such corporate seal;
that it was so affixed by the order of the Board of Directors of said corporation, and that the same signed the names
thereto by like order.
(Signature of Notary taking Acknowledgment)
Limited Liability Company Acknowledgement
State of
County of Ss.:
On this day of in the year 20 , before me personally come(s)
To me known, who, being by me duly sworn, deposes and says that the same resides in
that same is the
of the the Limited Liability Company described in and which executed the
foregoing instrument; that same knows the seal of the said Limited Liability Company; that the seal affixed to the
said instrument; and that the same authorized under the Articles of Organization and Operating Agreement as
amended and in effect this date to execute the forgoing instrument and so bind the Limited Liability Company.
State of Connecticut
County of Hartford
On this 2nd day of April
Vicki Johnston
Ss.:
(Signature of Notary taking Acknowledgment)
Surety Acknowledgement
in the year 2026 before me personally come(s)
To me known, who, being by me duly sworn, desposes and says that the same resides in
Phoenixville, PA that same is the Attorney -In -Fact
of the Indemnity National Insurance Company the corporation described in and which executed the foregoing instrument;
that same knows the seal of the said corporation; that the seal affixed to the said instrument is such corporate seal;
that it was so affixed by the order of the Board of Directors of said c ation, and that the same signed the names
thereto by like order.
ADAM MARTIN
NOTARY PUBLIC - CT 171968
My Commission Expires July 31, 2026
Signature a of Notary taking Acknowledgment)
Adam 14 Martirt,Notaiv.Public
My Commission Expires; _J u Iv 31. :2026
The
Baldwin
Group
AUTHORIZATION TO INSERT DATE OF CONTRACT ON BONDS AND
POWER OF ATTORNEY
April 2, 2026
City of Clearwater
100 South Myrtle Beach
Clearwater, FL 33756
Re: Concrete Protection and Restoration, LLC
Bond No. TIC122009
Garden Avenue Parking Garage Restoration PROJECT NO.: 25 -0013 -EN
Dear Sir or Madam:
The undersigned is an authorized representative of Indemnity National Insurance Company, the surety for Concrete
Protection and Restoration, LLC for and during the entire period of construction of the project described above.
Authorization is hereby given by the surety to: City of Clearwater to insert the date of the execution of the contract on
the bonds and the power of attorney.
Inde, ational Insurance Company
Adam Martin, Attorney -In -Fact
Boston 1 Contact us
One Liberty Square, Suite 1120 i info@baIdwin.co m
Boston, MA 02109 i
Telephone: 857.322.4731 ? Baldwin.com
SECTION V — Contract Documents
CONTRACT
(1)
This CONTRACT made and entered into this _ day of , 20_ by and between the City
of Clearwater, Florida, a municipal corporation, hereinafter designated as the "City", and Concrete
Protection & Restoration, LLC., of the City of Oakland Park County of Broward and State of Florida,
hereinafter designated as the "Contractor".
[Or, if out of state:]
This CONTRACT made and entered into this day of , 20_ by and between the City,
of Clearwater, Florida, a municipal corporation, hereinafter designated as the "City", and
, a/an (State) Corporation authorized to do
business in the State of Florida, of the City of County of
and State of , 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:
PROJECT NAME: Garden Avenue Parking Garage Restoration
PROJECT NO.: 25 -0013 -EN
in the amount of $186,318.00
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, technical specifications, 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.
SECTION V Page.4 of 19 Updated: 7/9/2025
SECTION V—Contract Documents
CONTRACT.
(2)
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, TO THE LIMITS OF § 725.06(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 day 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 day 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 public construction 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 public construction 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.
SECTION V Page 5 of 19 Updated: 7/9/2025
SECTION V — Contract Documents
CONTRACT
(3)
In addition to all other contract requirements as provided by law, the contractor executing this agreement
agrees to comply with public records law.
IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF
CHAPTER 119, FLORIDA STATUTES, THE CONTRACTORS DUTY TO PROVIDE PUBLIC
RECORDS RELATING TO THIS CONTRACT. CONTACT THE CUSTODIAN OF PUBLIC
RECORDS, Rosemarie Call, City Clerk, at Rosemarie.Call@myclearwater.com, 727-562-4092,
600 Cleveland St., 6th Floor, Clearwater, FL 33756.
The contractor's agreement to comply with public records law applies specifically to:
a) Keep and maintain public records required by the City of Clearwater (hereinafter "public
agency") to perform the service being provided by the contractor hereunder.
b) Upon request from the public agency's custodian of public records, provide the public agency
with a copy of the requested records or allow the records to be inspected or copied within a
reasonable time at a cost that does not exceed the cost provided for in Chapter 119, Florida
Statutes, as may be amended from time to time, or as otherwise provided by law.
c) Ensure that the public records that are exempt or confidential and exempt from public records
disclosure requirements are not disclosed except as authorized by law for the duration of the
contract term and following completion of the contract if the contractor does not transfer the
records to the public agency.
d) Upon completion of the contract, transfer, at no cost, to the public agency all public records in
possession of the contractor or keep and maintain public records required by the public agency
to perform the service. If the contractor transfers all public records to the public agency upon
completion of the contract, the contractor shall destroy any duplicate public records that are
exempt or confidential and exempt from public records disclosure requirements. If the
contractor keeps and maintains public records upon completion of the contract, the contractor
shall meet all applicable requirements for retaining public records. All records stored
electronically must be provided to the public agency, upon request from the public agency's
custodian of public records, in a format that is compatible with the information technology
systems of the public agency.
e) A request to inspect or copy public records relating to a public agency's contract for services
must be made directly to the public agency. If the public agency does not possess the requested
records, the public agency shall immediately notify the contractor of the request and the
contractor must provide the records to the public agency or allow the records to be inspected or
copied within a reasonable time.
f) The contractor hereby acknowledges and agrees that if the contractor does not comply with the
public agency's request for records, the public agency shall enforce the contract provisions in
accordance with the contract.
g) A contractor who fails to provide the public records to the public agency within a reasonable
time may be subject to penalties under Section 119.10, Florida Statutes.
h) If a civil action is filed against a contractor to compel production of public records relating to a
public agency's contract for services, the court shall assess and award against the contractor
the reasonable costs of enforcement, including reasonable attorney fees, if:
1. The court determines that the contractor unlawfully refused to comply with the public
records request within a reasonable time; and
SECTION V Page 6 of 19 Updated: 7/9/2025
SECTION V — Contract Documents
CONTRACT
(4)
2. At least 8 business days before filing the action, the plaintiff provided written notice of the
public records request, including a statement that the contractor has not complied with the
request, to the public agency and to the contractor.
i) A notice complies with subparagraph (h)2. if it is sent to the public agency's custodian of public
records and to the contractor at the contractor's address listed on its contract with the public
agency or to the contractor's registered agent. Such notices must be sent by common carrier
delivery service or by registered, Global Express Guaranteed, or certified mail, with postage or
shipping paid by the sender and with evidence of delivery, which may be in an electronic
format.
j) A contractor who complies with a public records request within 8 business days after the notice
is sent is not liable for the reasonable costs of enforcement.
IN WITNESS WHEREOF, the parties to the agreement have hereunto set their hands and seals and have
executed this Agreement, the day and year first above written.
CITY OF CLEARWATER
IN PINELLAS COUNTY, FLORIDA
By:
Countersigned:
By:
Bruce Re
Mayor
Contractor must indicate whether:
Net Corporation, Partnership,
Rosemarie Call
City Clerk
oved as to form:
1�cebb S,MQSo.? Coe
OwKohler
Lead Assistant City Attorney
Company, or
Individual
Concrete Protection & Restoration, LLC
(Contractor)
By: �� q
Print Name: Michael K. O'Malley
Title: CEO
The person signing shall, in his own handwriting, sign the Principal's name, his own name, and his ttie;
where the person is signing for a Corporation, he must, by Affidavit, show his authority to bind the;
Corporation — provide Affidavit.
SEAL)
SECTION V Page 7 of 19 Updated: 7/9/2025
SECTION V — Contract Documents
CONSENT OF SURETY TO FINAL PAYMENT
TO OWNER: City of Clearwater PROJECT NAME: Garden Avenue Parking Garage
Restoration
Public Works PROJECT NO.: 25 -0013 -EN
100 S Myrtle Ave CONTRACT DATE: [ 1
Clearwater, FL 33756 BOND NO,: [ ], recorded in O.R. Book [ ],
Page [ ], of the Public Records of Pinellas County, Florida.
CONTRACTOR: Concrete Protection & Restoration, LLC.
Pursuant to § 255.05(11), Florida Statutes, and in accordance with the provisions of the Contract between
the Owner and the Contractor as indicated above, the:
[insert name of Surety]
[address]
[address], SURETY,
on bond of
Concrete Protection & Restoration, LLC
601 NE 44th Street ]
Oakland Park, FL 33334, CONTRACTOR,
hereby approves of the final payment to the Contractor, and agrees that final payment to the Contractor
shall not relieve Surety of any of its obligations to
City of Clearwater
Public Works
PO Box 4748
Clearwater, FL 33758-4748, OWNER,
as set forth in said Surety's bond.
IN WITNESS WHEREOF, the Surety has hereunto set its hand this day of
Attest:
(Seal):
(Surety)
(Signature of authorized representative)
(Printed name and title)
SECTION V Page 8 of 19 Updated: 7/9/2025
1"
SECTION V — Contract Documents
PROPOSAL/BID BOND
(Not to be filled out if a certified check is submitted)
KNOWN ALL MEN BY THESE PRESENTS: That we, the undersigned,
Concrete Protection and Restoration. LLC as Contractor, and
Indemnity National Insurance Compan as Surety, whose address is
238 Bedford Way, Franklin, TN 37064 , are held and firmly bound unto the City
of Clearwater, Florida, in the sum of Ten Percent of Amount Bid Dollars
($ 10% ) (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 Concrete Protection and
Restoration, LLC as Contractor, and Indemnity National Insurance Company as Surety, for
work specified as: Garden Avenue Parking Garage Restoration
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 Public Construction 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/Bid Bond will be paid to the City as stipulated or liquidated damages.
Principal must indicate whether: Limited Liability
Corporation, Partnership, X Company, or Individual
Signed this 11th day of March ; 20 26
Concrete Protectio,Land Restoration LLC
Contractor
Concrete Pr
Principal
By: _:
Title
Indemni
and Restoration LLC
ational Insurance Compan
Surety Matt Arensdorf, Attorney -In -Fact
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 — provide Affidavit.
SECTION V Page 8 of 16 Updated: 6/3/2024
r
INDEMNITY()NATIONAL
Power of Attorney
Indemnity National Insurance Company
238 Bedford Way
Franklin, TN 37064
KNOW ALL PERSONS BY THESE PRESENTS: that Indemnity National Insurance Company, a Mississippi corporation,
(hereinafter the "Company"), does hereby constitute and appoint: George James, Stephanie Venuti, Jenna Leuck, Kyle Bambule, Matt Arensdorf, Ryan Witte, Julia Marturano,
Dave Donato, Megan Bayer, Cori Keeler, Patty Shields, Jimmy Walsh, Kyle Garrett, Sarah Mainella, Charlotte Melendy, Megan Greidanus Of *******Trisura Insurance Company********** to be
its true and lawful Attorney -in -Fact, with full power and authority hereby conferred to sign, seal, and execute on its behalf surety
bonds or undertakings and other documents of a similar nature issued in the course of its business up to a penal sum not to exceed
**************************Twenty Million Dollars ($20.000.000.00)************************************ each, and to bind the Company
thereby as fully and to the same extent as if the same were signed by the duly authorized officers of the Company.
This appointment is made under and executed pursuant to and by authority of the following Minutes of Special Actions Taken by
Written Consent of the Board of Directors, which is now in full force and effect:
Authorization to Appoint Attorneys -in -Fact and the Use of Facsimile Signatures and Facsimile Seals for the Purpose of Issuing Bonds:
RESOLVED: That the president or any vice president may appoint attorneys -in -fact or agents with authority as defined or limited in the
instrument evidencing the appointment in each case, for and on behalf of the Company to execute and deliver and affix the seal of the
Company to bonds and related obligatory certificates and documents; and any one of said officers may remove any such attorney-in-fact or
agent and revoke any power previously granted to such person, whether or not such officer appointed the attorney-in-fact or agent.
RESOLVED: That any bonds and related obligatory certificates and documents shall be valid and binding upon the Company,
(i) when signed by the president, or any vice president, and sealed with the Company seal; or
(ii) when duly executed and sealed with the Company seal by one or more attorneys -in -fact or agents pursuant to and within the
limits of authority evidenced by the power of attorney issued by the Company to such person or persons a certified copy of which
power of attorney must be attached thereto in order for such obligation to be binding upon the Company.
RESOLVED: That the signature of any authorized officer and the seal of the Company may be affixed to any power of attorney or
certification thereof authorizing the execution and delivery of any bonds and related obligatory certificates and documents of the Company
and such signature and seal then so used shall have the same force and effect as though manually affixed.
IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Company and the corporate seal of
Indemnity National Insurance Company has been affixed thereto in Lexington, Kentucky this 22nd day of August, 2025.
k
cot`Po�r• m fid:
• SEAL m=
1993 n
4443090 #C).f
� rnIujlitttwi \\ •
Indemnity National Insurance Company
By
Thomas F. Elkins, President
' State of Kentucky
County of Fayette
On this 22nd day of August, 2025, before me, a Notary Public, personally came Thomas F. Elkins, to me known, and acknowledged that he
is President of Indemnity National Insurance Company; that he knows the seal of said corporation; and that he executed the above Power of
Attorney and affixed the corporate seal of Indemnity National Insurance Company thereto with the authority and at the direction of said corporation.
\lp uuAru�yy'4,
CERTIFICATE
Alt
*t LA
• NINIm t9
My Commission Expires 09/26/2029
Notary ID Number: KYNP34336
I, James E. Hart, Secretary of Indemnity National Insurance Company, do hereby certify that the foregoing Power of Attorney is still in full force and
effect, and further certify that the Minutes of Special Actions Taken by Written Consent of the Board of Directors are now in full force and effect.
IN TESTIMONY WHEREOF I have subscribed my name and affixed the seal of said Company. Dated this 11 day of March 20 26
STATE OF PENNSYLVANIA
COUNTY OF MONTGOMERY
On Arc). J,l Q o2 , before me, Patricia Shields, a Notary Public in
and for said County and State, duly commissioned and sworn, personally appeared,
Matthew Arensdorf, known to me to be the Attorney -In -Fact of Indemnity National
Insurance Company, the corporation described in and that executed the within and
foregoing instrument, and known to me to be the person who executed the said
instrument on behalf .of the said corporation, and she duly acknowledged to me that
such corporation executed the same.
IN WITNESS WHEREOF, I have herunto set my hand and affixed my official seal,
the day and year stated in this certificate above.
My Commission Expires December 12, 2027
Patricia Shields, Notary Public
Commission No. 1360993
COMMONWEALTH OF PENNSYLVANIA. NOTARY SEAL
Patricia Shields, Notary Public
Montgomery County
My Commission Expires 12/12/2027
COmmiSSiOn # 1360993
Indemnity National Insurance Company
STATEMENT OF FINANCIAL CONDITION
December 31, 2024
Assets
Cash and short-term investments $ 46,476,464
Invested assets 306,816,923
Premium receivable 18,138,083
Other assets 13,747,581
Total assets $ 385,179,051
Liabilities
Loss and Toss adjustment expense
reserves $ 44,463,960
Unearned and advance premiums 56,587,563
Amounts withheld or retained by
company for others 136,530,895
Other liabilities 11,013,011
Total liabilities
$ 248,595,429
Surplus as regards policyholders $ 136,583,622
Total Surplus and Liabilities
By:
$ 385,179,051
i/ �`��— Attest:
jiffancial Officer, Treasurer and Secretary President
State of Tennessee
County of Williamson
James Ewell Hart, Chief Financial Officer, Treasurer and Secretary, and Thomas Franklin Elkins, President
of Indemnity National Insurance Company, a Mississippi domiciled insurance company, being duly sworn do certify that
the foregoing is a true and correct statement of financial condition of said company as of December 31, 2024.
Subscribed and sworn to before me this 2nd day of A 5
e.......... „t,
so,
s LAC6,"/
Q . STATE
Notary Public
V OF
;TENNESSEE; =
NOTARY
;•
��'•.;PUBLIC
o�4p4�lMSON COJA\er
14%.�Ssion ExPicesCg
SECTION V—Contract Documents
AFFIDAVIT
(To be filled in and executed if the bidder is a corporation)
STATE OF FLORIDA )
COUNTY OF Broward )
Brian Greenbaum , being duly sworn, deposes and says that he/she is
Secretary of Concrete Protection and Restoration LLC
a corporation organized and existing under and by virtue of the laws of the State of Florida, and having its
principal office at:
601 NE 44th Street
(Street & Number)
Oakland Park Broward
(City)
FL
(County) (State)
Affiant further says that he is familiar with the records, minute books and by-laws of
Concrete Protection and Restoration LLC
(Name of Corporation)
Affiant further says that
Michael K. O'Malley
is
CEO
(Officer's Naive) (Title)
of the corporation, is duly authorized to sign the Proposal for 26-0002—PR BCBP Berm wall Repair
or said corporation by virtue of N/A
(state whether a provision of by laws a Resolution of
Board of Directors. If by Resolution give dat- of.'doption).
BR (A �!� CELT/CFO
Affiant
Sworn to before me this 25 day of February
,2
Notary Public
e�r(land T-01;
Type/print/stamp name of Notary
Title or rank, and Serial No., if any
•
FERNANDA ROLIM FIGUEIREDO
Notary Public -state of Florida
�` Commission 11 HH 345608
'•'rbF IP My Comm. Expires Jan 11, 2027,
,,.. Bonded through National Notary Assn.
arramarmon
SECTION V Page 9 of 16 Updated: 6/3/2024
SECTION V — Contract Documents
NON -COLLUSION AFFIDAVIT
STATE OF FLORIDA
COUNTY OF Broward )
Michael K O'Malley
being, first duly sworn, deposes and says that he is
CEO of Concrete Protection and Restoration LLC,
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.
Sworn to and subscribed before me this 10 th day of March ,20 26.
Notary P
C2 -
FERNANDA ROLIM FIGUEIREDO
_° `0, Notary Public - State of Florida p
3
_al Commission 11 HH 345608
;:ept.,.'` My Comm. Expires Jan 11, 2027
Bonded through National Notary Assn.
SECTION V Page 10 of 16 Updated: 6/3/2024
SECTION V — Contract Documents
PROPOSAL
(1)
TO THE CITY OF CLEARWATER, FLORIDA, for
Garden Avenue Parking Garage Restoration (25 -0013 -EN)
and doing such other work incidental thereto, all in accordance with the contract documents, marked
Garden Avenue Parking Garage Restoration (25 -0013 -EN)
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 Public Construction 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:
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 ofsaid 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.
SECTION V Page 12 of 19 Updated: 7/9/2025
SECTION V— Contract Documents
PROPOSAL
(2)
Attached hereto is a bond or certified check on N/A
Bank, for the sum of
Nine Hundred Thirty-eight Dollars and 00/100 Cents
Sixteen Thousand
($ 16, 938.00
(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 a 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,
enriclunent, employment or possible benefit, whether sub -contractor, materialman, agent, supplier, or
employer is contingent upon the award of the contract to the bidder).
NAMES:
Michael K. O'Malley (CEO)
Don Caple (V.P.)
ADDRESSES:
601 NE 44th Street,Oakland Park, FL 33334
601 NE 44th Street, Oakland Park FL 33334
Brian Greenbaum (Secretary/Treasurer) 601 NE 44th Street, Oakland Park FL 33334
Signature of Bidder:
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 author}t3 -t9 bind the cor iiration.
Principal:
By: Michael K. O'Malley
Title:
CEO
Company Legal Name: Concrete Protection & Restoration LLC
Doing Business As (if different than above):
Business Address of Bidder: 601 NE 44th Street, Oakland Park FL 33334
City and State: Oakland Park FL
Zip Code 33334
Phone: 954-505-3977 Email Address: mferro@concretecpr . com
Dated at
this 10th day of March
, A.D., 202
SECTION V Page 12 of 16 Updated: 6/3/2024
SECTION V — Contract Documents
CITY OF CLEARWATER
ADDENDUM SHEET
PROJECT:25=0013=EN Gaiden=Avenue Parking Garage Restoration
Acknowledgment is hereby made of the following addenda received since issuance of Plans and
Specifications.
Addendum No. NSA Date:
Addendum No. Date:
Addendum No. Date:
Addendum No. Date:
Addendum No. Date:
Addendum No. Date:
Addendum No. Date:
Addendum No. Date:
Addendum No. Date:
Addendum No. Date:
Addendum No. Date:
Concrete Protection & Restoration LLC
(Name of' Bidder)
CEO
(Title of Officer)
March 10, 2026
(Date)
SECTION V Page 13 of 16 Updated: 6/3/2024
SECTION V—Contract Documents
BIDDER'S PROPOSAL
PROJECT: Garden Avenue Parking Garage Restoration (25 -0013 -EN)
CONTRACTOR: Concrete Protection & Restoration, LLC.
BIDDER'S GRAND TOTAL: $186,318.00 (Numbers)
BIDDER'S GRAND TOTAL: One Hundred Eighty Six Thousand Three Hundred Eighteen dollars and
zero cents.
(Words)
Garden
Avenue
Parking
Garage
Concrete Protection &
Restoration, LLC.
Line
Item
Description
Quantity
Unit of
Measure
Unit Cost
Total
1.0 GENERAL REQUIREMENTS
1.1
Project Mobilization,
Concrete Accessories,
Temporary Signage (W.I.
1.1)
1
LS
$25,000.00
$25,000.00
1.2
Permitting (W.I. 1.6)
1
LS
$0.00
$0.00
1.3
Special Inspection (W.I.
1.B)
1
LS
$3,300.00
$3,30.0.00
2.0 CONCRETE FLOOR REPAIR (W.I. 3.0)
2.1
Floor Repair- Partial
Depth (W.I. 3,1)
5
SF
$120.00
$600.00
2.2
Floor Repair-Curbs/Walks
(W.I. 3.4)
5
SF
$100.00
$500.00
3.0 CONCRETE CEILING REPAIR (W.I 4.0)
3.1
Ceiling Repair - Partial
Depth (W.I. 4.1)
17
SF
$225.00
$3,825.00
4.0 CONCRETE BEAM AND JOIST REPAIR (W.I 5.0)
SECTION V
Page 15 of 19
Updated: 7/9/2025
SECTION V - Contract Documents
4.1
Beam Repair - Partial
Depth (W.I. 5.1)
5
SF
$250.00
$1,250.00
4.2
Joist Repair -Partial
Depth(W.I. 5.7)
5
SF
$250.00
$1,250.00
5.0 CONCRETE COLUMN REPAIR (W..I 6.0)
5.1
Concrete Column Repair -
Haur.ch (W.I. 6.6)
3
SF
$800.00
$2,400.00
6.0 CONCRETE WALL REPAIR (W.I 7.0)
6.1
Concrete Wall Repair -
Panial Deplh (W.I. 7.1)
10
SF
$200.00
$2,000.00
6.2
Concrete Wall Repair -
Grout Pocket (W.I. 7.5)
7
EA
$80.00
$560.00
7.0 JOINTS AND CRACKS (W.I 11.0)
7.1
Seal Cracks ancl Joints
(W.I. 11.1)
50
LF
$8.00
$400.00
7.2
Repair Crack/Joint Sealant
(W.I. 11.2)
700
LF
$9.00
$6,300.00
7.3
Vertical Joint Sealant (W.I.
11.3)
300
LF
$12.00
$3,600.00
7.4
Cove Sealant (W.I. 11.7)
1250
LF
$8.00
$10,000.00
8.0 TRAFFIC COATINGS .(W.I.16.0)
8.1
Traffic Topping -Repair
(W.I. 16.3)
10
SF
$15.00
$150.00
8.2
Traffic Topping-Recoat
(W.I. 16.4)
29000
SF
$3.05
$88,450.00
9.0 Mechanical -Drainage (W.I. 25.0)
9.1
Mechanical Allowance
(W.1. 25.1) enter $5,000
1
LS
$5,000.00
$5,000.00
9.2
Mechanical- Clean Drains
and Piping (W.I. 25.6)
1
LS
$3,600.00
$3,600.00
10 DOORS, FRAMES AND HARDWARE (W.I.37 0)
10.1
Replace Door Hardware
(W.I. 37.3)
4
EA
$500.00
$2,000.00
11 CONNECTIONS/BEARINGS (W.I. 40.0)
SECTION V
Page 16 of 19
Updated: 7/9/2025
SECTION V — Contract Documents
11.1
Supplemental Bearing
Support (W.I. 40.4)
1
EA
$1,100.00
$1,100.00
12.0 PAINTING (W.I. 45.0)
12.1
Paint Traffic Markings
(W.I. 45.1)
29000
SF
$.21
$6,090.00
12.2
Paint Metal Bollards (W.I.
45.3)
4
EA
$200.00
$800.00
12.3
Clean and Cold Galvanize
Steel Connections (W.I.
45.6)
7
EA
$90.00
$630.00
12.4
Clean and Paint Elevator
Vestible Supports
Baseplates (W.I. 45.9)
5
EA
$75.00
$375.00
13 Stucco (W.I. 85.0)
13
Stucco Repair (W.I. 85.1)
1
SF
$200.00
$200.00
Total
$169,380.00
Line
Item
Description
Quantity
Unit of
Measure
Unit Cost
Total
1
10% contingency from
total in above table
1
LS
$16,938.00
$16,938.00
Total
$16,938.00
Grand Total
$186,3180.00
THE BIDDER'S GRAND TOTAL ABOVE IS HIS TOTAL BID BASED ON HIS, UNIT PRICES
AND LUMP SUM PRICES AND THE ESTIMATED QUANTITIES REQUIRED FOR EACH
SECTION. THIS FIGURE IS FOR INFORMATION ONLY AT THE TIME OF OPENING BIDS.
THE CITY WILL MAKE THE TABULATION FROM THE UNIT PRICES AND LUMP SUM
PRICE BID. IF THERE IS AN ERROR IN THE TOTAL BY THE BIDDER, IT SHALL BE
CHANGED AS ONLY THE UNIT PRICES AND LUMP SUM PRICE SHALL GOVERN.
THE CONTRACTOR SHALL PROVIDE COPIES OF A CURRENT CONTRACTOR
LICENSE/REGISTRATION WITH THE STATE OF FLORIDA AND PINELLAS COUNTY IN
THE BID RESPONSE.
SECTION V Page 17 of 19 Updated: 7/9/2025
SCRUTINIZED COMPANIES FORMS
SCRUTINIZED COMPANIES AND BUSINESS OPERATIONS WITH
CUBA AND SYRIA CERTIFICATION FORM
IF YOUR B1D/PROPOSAL IS $1,000,000 OR MORE, THIS FORM MUST BE COMPLETED AND
SUBMITTED WiTH THE BID/PROPOSAL. FAILURE TO SUBMIT THIS FORM AS REQUIRED MAY
DEEM YOUR SUBMITTAL NONRESPONSIVE.
The affiant, by virtue of the signature below, certifies that:
1. The vendor, company, individual, principal, subsidiary, affiliate, or owner is aware of the requirements
of section 287.135, Florida Statutes, regarding companies on the Scrutinized Companies with Activities in Sudan
List, the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List, or engaging in business
operations in Cuba and Syria; and
2. The vendor, company, individual, principal, subsidiary, affiliate, or owner is eligible to participate in this
solicitation and is not listed on either the Scrutinized Companies with Activities in Sudan List, the Scrutinized
Companies with Activities in the Iran Petroleum Sector List, or engaged in business operations in Cuba and
Syria; and
3. Business Operations means, for purposes specifically related to Cuba or Syria, engaging in commerce
in any form in Cuba or Syria, including, but not limited to, acquiring, developing, maintaining, owning, selling,
possessing, leasing or operating equipment, facilities, personnel, products, services, personal property, real
property, military equipment, or any other apparatus of business or commerce; and
4. If awarded the Contract (or Agreement), the vendor, company, individual, principal, subsidiary, affiliate,
or owner will immediately notify the City of Clearwater in writing, no later than five (5) calendar days after any of
its principals are placed on the Scrutinized Companies with Activities in Sudan List, the Scrutinized Companies
with Activities in the Iran Petroleum Sector List, or engaged in buslneperations in Cuand Syria.
STATE OF Florida
COUNTY OF Broward
uthorized Signature
Michael K. O'Malley
Printed Name
CEO
Title
Concrete Protection and Restoration LLC
Name of Entity/Corporation
The foregoing instrument was acknowledged before me by means of E2 physical presence or 0 online
notarization on, this 25 day of February , 20 26 , by Michael K. O'Malley
(name of person whose signature is being notarized) as the CEO (title) of
Concrete Protection and Restoration LLC (name of corporation/entity), personally known ,or
produced (type of identification) as identification, and who did/did not take
an oath.
My Commission Expires: Oil III Zo27
NOTARY SEAL ABOVE
Notary Public
Printed Name
,'fir'r'e.,, FERNANDA ROLIM FIGUEIREUO'
? \ <-
r: Notary Public • State of. Florida
.s i. Commission N HH 345608.
''''ex.04' My Comm. Expires Jan 11, 2027
Bonded through National Notary Assn.
SCRUTINIZED COMPANIES FORMS
SCRUTINIZED COMPANIES THAT BOYCOTT ISRAEL LIST CERTIFICATION FORM
THIS FORM MUST BE COMPLETED AND SUBMITTED WITH THE BID/PROPOSAL.
FAILURE TO SUBMIT THIS FORMAS REQUIRED MAY DEEM YOUR SUBMITTAL
NONRESPONSIVE.
The affiant, by virtue of the signature below, certifies that:
1. The vendor, company, individual, principal, subsidiary, affiliate, or owner is aware of the requirements
of section 287.135, Florida Statutes, regarding companies on the Scrutinized Companies that Boycott
Israel List, or engaged in a boycott of Israel; and
2. The vendor, company, individual, principal, subsidiary, affiliate, or owner is eligible to participate in this
solicitation and is not listed on the Scrutinized Companies that Boycott Israel List, or engaged in a
boycott of Israel; and
3. `Boycott Israel" or "boycott of Israel" means refusing to deal, terminating business activities, or taking
other actions to limit commercial relations with Israel, or persons or entities doing business in Israel or
in Israeli -controlled territories, in a discriminatory manner. A statement by a .company that it is
participating in a boycott of Israel, or that It has initiated a boycott in response to a request for a boycott
of Israel or in compliance with, or in furtherance of, calls for a boycott of Israel, may be considered as
evidence that a company is participating in a boycott of Israel; and
4. If awarded the Contract (or Agreement), the vendor, company, individual, principal, subsidiary, affiliate,
or owner will immediately notify the City of Clearwater in writing, no later than five (5) calendar days
after any of its principals are placed on the Scrutinized Companies that Boycott Israel List, or engaged
in a boycott of Israel.
uthorized Signature
Michael K. O'Malley
Printed Name
CEO
Title
Concrete Protection and Restoration LLC
Name of Entity/Corporation
STATE OF Florida
COUNTY OF Broward
The foregoing instrument was acknowledged before me by means of 0 physic 1 presence or 0 online
ci
notarization on, this 25 day of February , 20 26 , by rt.; c.e,\ k. O' f`tG.1LR>`J
(name of person whose signature is being notarized) as the (title) of
(name of corporation/entity), personally known , or
produced (type of identification) asdantification, and who did/did not take
an oath.
My Commission Expires: 0
NOTARY SEAL ABOVE
Notary Public
el. Cur. A_e. 12A 1 „ .�e re
Printed Name
4Y PVB.• FERNANDA ROLIM FIGUEIREDO
r° 1 i' Notary Public State of Florida
< Commission # HH 34560B
°'.'..'oF,a My Comm. Expires Jan 11, 2027
Bonded through National Notary Assn.
Compliance with Anti -Human Trafficking Laws
Pursuant to Section 787.06 (13), Florida Statutes, this form must be completed by an officer or
representative of a non-governmental entity when a contract is executed, renewed, or extended
between the non-governmental entity and the City of Clearwater.
The undersigned, on behalf of the entity listed below ("Entity"), hereby attests under penalty of
perjury that:
Entity does not use coercion for labor or services as defined in Section 787.06, Florida Statutes.
The undersigned is authorized to execute this form on behalf of Er.Ztity.
Date: February 25 , 2026 Signed:
Entity.Concrete Protection and Restoration LLC
Name: Michael K. O'Malley
Title: CEO
City of Clearwater
Public Works
Marcus Williamson, Department Director
100 South Myrtle Avenue, Clearwater, FL 33756
[CONCRETE PROTECTION & RESTORATION, LLC.] RESPONSE DOCUMENT REPORT
ITB No. 25 -0013 -.EN
Garden Avenue Parking Garage Restoration
RESPONSE DEADLINE: March 11, 2026 at 2:00 pm
Report Generated: Thursday, March 19, 2026
Concrete Protection & Restoration, LLC. Response
NTACT.INFORMATION
Company:
Concrete Protection & Restoration, LLC.
Email: -
fdefigueiredo@concretecpr.com
Contact:
Fernanda De Figueiredo
Address:
601 NE 44th Street
Oakland Park, MD 33334
Phone:
(305) 389-3591
Website:
www.concretecpr.com
Submission Date:
Mar 10, 2026 3:51 PM (Eastern Time)
[CONCRETE PROTECTION & RESTORATION, LLC.] RESPONSE DOCUMENT REPORT
ITB No. 25 -0013 -EN
Garden Avenue Parking Garage Restoration
No addenda issued
ADDENDA CONFIRMATION
QUESTIONNAIRE.
1. Certified Business*
Are you a Certified Small Business or a Certified Minority, Woman or Disadvantaged Business Enterprise?
No
2. Vendor Certification*
By submitting this response, the Vendor hereby certifies that:
A. It is under no legal prohibition on contracting with the City of Clearwater.
B. It has read, understands, and is in compliance with the specifications, terms and conditions stated herein, as well as its
attachments, and any referenced documents.
C. It has no known, undisclosed conflicts of interest.
D. The prices offered were independently developed without consultation or collusion with any of the other vendors or potential
vendors or any other anti-competitive practices.
E. No offer of gifts, payments or other consideration were made to any City employee, officer, elected official, or consultant who
has or may have had a role in the procurement process for the commodities or services covered by this contract. The Vendor
has not influenced or attempted to influence any City employee, officer, elected official, or consultant in connection with the
award of this contract.
F. It understands the City may copy all parts of this response, including without limitation any documents or materials copyrighted
by the Vendor, for internal use in evaluating respondent's offer, or in response to a public records request under Florida's public
[CONCRETE PROTECTION & RESTORATION, LLC.] RESPONSE DOCUMENT REPORT
Invitation To Bid - Garden Avenue Parking Garage Restoration
Page 2
[CONCRETE PROTECTION & RESTORATION, LLC.] RESPONSE DOCUMENT REPORT
ITB No. 25 -0013 -EN
Garden Avenue Parking Garage Restoration
records law (F.S. Chapter 119) or other applicable law, subpoena, or other judicial process; provided that the City agrees not to
change or delete any copyright or proprietary notices.
G. It hereby warrants to the City that the Vendor and its subcontractors will comply with, and are contractually obligated to comply
with, all federal, state, and local laws, rules, regulations, and executive orders.
H. It certifies that Vendor is not presently debarred, suspended, proposed for debarment, declared ineligible, voluntarily excluded,
or disqualified from participation in this matter from any federal, state, or local agency.
I. It will provide the commodities or services specified in compliance with all federal, state, and local laws, rules, :regulations, and
executive orders if awarded by the City.
J. It is current in all obligations due to the City.
K. It will accept all terms and conditions as set forth in this solicitation if awarded by the City.
L. The signatory is an officer or duly authorized representative of the Vendor with full power and authority to submit binding offers
and enter into contracts for the commodities or services as specified herein.
Confirmed
3. E -Verify System Certificattion*
PER FLORIDA STATUTE 448.095, CONTRACTORS AND SUBCONTRACTORS MUST REGISTER WITH AND USE THE E -VERIFY SYSTEM TO
VERIFY THE WORK AUTHORIZATION STATUS OF ALL NEWLY HIRED EMPLOYEES.
The affiant, by virtue of confirming below, certifies that:
A. The Contractor and its Subcontractors are aware of the requirements of Florida Statute 448.095.
B. The Contractor and its Subcontractors are registered with and using the E -Verify system to verify the work authorization status
of newly hired employees.
C. The Contractor will not enter into a contract with any Subcontractor unless each party to the contract registers with and uses
the E -Verify system.
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D. The Subcontractor will provide the Contractor with an affidavit stating that the Subcontractor does not employ, contract with,
or subcontract with unauthorized alien.
E. The Contractor must maintain a copy of such affidavit.
F. The City may terminate this Contract on the goodfaith belief that the Contractor or its Subcontractors knowingly violated Florida
Statutes 448.09(1) or 448.095(2)(c).
G. If this Contract is terminated pursuant to Florida Statute 448.095(2)(c), the Contractor may not be awarded a public contract for
at least 1 year after the date on which this Contract was terminated.
H. The Contractor is liable for any additional cost incurred by the City as a result of the termination of this Contract.
Confirmed
4. Scrutinized Company Certification*
Please download the below documents, complete, notarize, and upload.
• SCRUTINIZED COMPANIES AND B...
CP&R= _SCRUTINIZED_COMPANIES_AND_BUSINESS_OPERATIONS_CERTIFI_-_signed.pdf
5. Compliance with Anti -Human Trafficking Laws*
Please download the below documents, complete, and upload.
• Compliance with 787.06 form...
CP&R_ _Com pliance_with_787.06_form= _signed.pdf
6. Section V - Contract Documents*
Please download the below documents, complete, and upload.
• Section V - Contract Docume...
CP&R= Section V-_Contract_Documents= _signed.pdf
[CONCRETE PROTECTION & RESTORATION, LLC.] RESPONSE DOCUMENT REPORT
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Garden Avenue Parking Garage Restoration
7. W-9*
Upload your current W-9 form. (available at https://www.irs.gov/pub/irs-pdf/fw9.pdf)
CP&R W9_Signed.pdf
PRICE TABLES
GARDEN AVENUE PARKING GARAGE
- -- - ----- - --- - --- - - - -- -- ----- ---- --- - — --- - -- - - -- -- - --- - -- - -- - - - - -
Line Item Description Quantity Unit of Unit Cost Total
Measure.
1.0 GENERAL ;REQUIREMENTS
1.1
Project Mobilization, Concrete Accessories, Temporary Signage (W.I. 1.1)
1
LS
$25,000.00
$25,000.00
1.2 •
Permitting (W.I. 1.6)
1
LS
$0.00
$0.00
1.3
Special Inspection (W.I. 1.B)
1
LS
$3,300.00
$3,300.00
2.0 CONCRETE: FLOOR REPAIR.(W.I. 3.0)`
2.1
Floor Repair- Partial Depth (W.I. 3,1)
5
SF
$120.00
$600.00
2.2
Floor Repair-Curbs/Walks (W.I. 3.4)
5
SF
$100.00
$500.00
3:0 CONCRETE CEILING REPAIR(W.I 4.0)
3.1
Ceiling Repair - Partial Depth (W.I. 4.1)
17
SF
$225.00
$3,825.00
4.0. CONCRETE: BEAM AND JOIST REPAIR (W:1.5.0)
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Garden Avenue Parking Garage Restoration
Line Item Description
Quantity
5
Unit of
Measure
SF
Unit Cost
$250.00
Total
$1,250.00
4.1
Beam Repair- Partial Depth (W.I. 5.1)
4.2
Joist Repair -Partial Depth(W.I. 5.7)
5
SF
$250.00.
$1,250.00
5.0 CONCRETE COLUMN REPAIR (W.I 6:0) •
5.1
Concrete Column Repair- Haur.ch (W.I. 6.6)
3
SF
$800.00
$2,400.00
6.0 CONCRETE. WALL REPAIR (W.I 7.0)
6.1
Concrete Wall Repair - Panial Deplh (W.I. 7.1)
10
SF
$200.00
$2,000.00
6.2
Concrete Wall Repair - Grout Pocket (W.I. 7.5)
7
EA
$80.00
$560.00
7.0 JOINTS AND CRACKS (W.I 11.0)
7.1
Seal Cracks ancl Joints (W.I. 11.1)
50
.LF
$8.00
$400.00
7.2
Repair Crack/Joint Sealant (W.I. 11.2)
700
LF
$9.00
$6,300.00
7.3
Vertical Joint Sealant (W.I. 11.3)
300
LF
$12.00
$3,600.00
7.4
Cove Sealant (W.I. 11.7)
1,250
LF
$8.00
$10,000.00
8.0 TRAFFIC COATINGS (W.I. 16.0)
8.1
Traffic Topping -Repair (W.I. 16.3)
10
SF
$15.00
$150.00
8.2
TrafficTopping-Recoat (W.I. 16.4)
29,000
SF
$3.05
$88,450.00
9.0 Mechanical -Drainage (W.I. 25.0)
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Line Item
Description
Quantity Unit of Unit Cost
Measure
Total
9.1
Mechanical Allowance (W.1. 25.1) enter $5,000
1
L5
$5,000.00
$5,000.00
9.2
Mechanical- Clean Drains and Piping (W.I. 25.6)
1
LS
$3,600.00
$3,600.00
10 DOORS, FRAMES AND HARDWARE (° W.I..37.0)
10.1
Replace Door Hardware ( W.I. 37.3)
4
EA
$500.00
$2,000.00
11 CONNECTIONS/BEARINGS (W.I. 40.0)
11.1
Supplemental Bearing Support (W.I. 40.4)
1
EA
$1,100.00
$1,100.00
12.0 PAINTING (W.L 45.0)
12.1
Paint Traffic Markings (W.I.45.1)
29,000
SF
$0.21
$6,090.00
12.2
Paint Metal Bollards (W.I. 45.3)
4
EA
$200.00
$800.00
12.3
Clean and Cold Galvanize Steel Connections (W.I. 45.6)
7
EA
$90.00
$630.00
12.4
Clean and Paint Elevator Vestible Supports Baseplates (W.I. 45.9)
5
EA
$75.00
$375.00
13 Stucco (W.I.:85.0)
13.0
Stucco Repair (W.I. 85.1)
1
SF
$200.00
$200.00
TOTAL
$169,380.00
CONTIGENCY
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Line Item
1
Description
10% contingency from total in above table
Quantity
1
Unit of
Measure
LS
Unit Cost Total
$16,938.00
TOTAL
$16,938.00
$16,938.00
[CONCRETE PROTECTION & RESTORATION, LLC.] RESPONSE DOCUMENT REPORT
Invitation To Bid - Garden Avenue Parking Garage Restoration
Page 8
Form W-9
(Rev. March 2024)
Department of the Treasury
Internal Revenue Service
Request for Taxpayer
Identification Number and Certification
Go to www.irs.gov/FormW9 for instructions and the latest information.
Give form to the
requester. Do not
send to the IRS.
Before .you begin. For guidance related to the purpose of Form W-9, see Purpose of Form, below.
Print or type.
See Specific Instructions on page 3.
1 Name of entity/individual. An entry is required. (For a sole proprietor or disregarded entity, enter the owner's name on line 1, and enter the business/disregarded
entity's name on Zine 2.)
Concrete Protection and Restoration, LLC
2 Business name/disregarded entity name, if different from above.
CP&R
3a Check the appropriate box for federal tax classification of the entityfindividual whose name is entered on line 1. Check
only one of the following seven boxes.
4 Exemptions (codes apply only to
certain entities, not individuals;
see instructions on page 3):
Exempt payee code (if any)
• Individual/sole proprietor • C corporation El S corporation • Partnership
I. Trust/estate
. . S
0 LLC. Enter the tax classification (C = C corporation, S = S corporation, P = Partnership) . .
Note: Check the "LLC" box above and, in the entry space, enter the appropriate code (C, S, or P)
classification of the LLC, unless it Is a disregarded entity. A disregarded entity should instead check
box for the tax classification of its owner.
for the tax
the appropriate
Exemption from Foreign Account Tax
Compliance Act (FATCA) reporting
code (if any)
• Other (see instructions)
3b If on line 3a you checked "Partnership" or "Trust/estate," or checked "LLC" and entered "P" as its tax
and you are providing this form to a partnership, trust, or estate in which you have an ownership interest,
this box if you have any foreign partners, owners, or beneficiaries. See Instructions
classification,
check
(Applies to accounts maintained
outside the United States.)
•
5 Address (number, street, and apt. or suite no.). See instructions.
601 NE 44th Street
Requester's name and address (optional)
6 City, state, and ZIP code
Oakland Park, FL 33334
7 List account number(s) here (optional)
Part I Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid
backup withholding. For individuals, this is generally your social security number (SSN). However, for a
resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a
TiN, later.
Note: If the account is in more than one name, see the Instructions for line 1. See also What Name and
Number To Give the Requester for guidelines on whose number to enter.
Social security number
or
Employer identification number
8
1
3
9
9
0
0
2
2
Part II
Certification
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. I am not subject to backup withholding because (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding; and
3. I am a U.S. citizen or other U.S. person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding
because you have failed to report all interest and dividends on your tax return. For real estate transactions, Item 2 does not apply. For mortgage Interest paid,
acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and, generally, payments
other than interest and dividends, are of required to sign the certification, but you must provide your correct TIN. See the instructions for Part II, later.
Sign
Here
Signature of
U.S. person
General Instructions
Section references are to the Internal Revenue Code unless otherwise
noted.
Future developments. For the latest information about developments
related to Form W-9 and its instructions, such as legislation enacted
after they were published, go to www.irs.gov/FormW9.
What's New
Line 3a has been modified to clarify how a disregarded entity completes
this line. An LLC that is a disregarded entity should check the
appropriate box for the tax classification of its owner. Otherwise, it
should check the "LLC" box and enter its appropriate tax classification.
Date 03) I 0 120 2
New line 3b has been added to this form. A flow-through entity is
required to complete this line to indicate that it has direct or Indirect
foreign partners, owners, or beneficiaries when it provides the Form W-9
to another flow-through entity in which it has an ownership interest. This
change is intended to provide a flow-through entity with information
regarding the status of its indirect foreign partners, owners, or
beneficiaries, so that it can satisfy any applicable reporting
requirements. For example, a partnership that has any indirect foreign
partners may be required to complete Schedules K-2 and K-3. See the
Partnership Instructions for Schedules K-2 and K-3 (Form 1065).
Purpose of Form
An individual or entity (Form W-9 requester) who is required to file an
information return with the IRS is giving you this form because they
Cat. No. 10231X
Form W-9 (Rev. 3-2024)