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EAST WRF FILTER FEED PUMP STATION & FORCE MAIN IMPROVEMENTS - 17-0048-UTSECTION V CONTRACT DOCUMENTS 0 -cd -Q5-1)0 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 17 SCRUTINIZED COMPANIES THAT BOYCOTT ISRAEL LIST CERTIFICATION FORM 18 SECTION V Pagel Updated: 7/9/2025 SECTION V — Contract Documents Bond No.: 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 SGS Contracting Services, Inc Principal Name PO Box 908 High Springs, FL 32655 SURETY OWNER Principal Name Principal Business Address Principal Business Address 386-361-5300 Principal Phone Number Principal Phone Number City of Clearwater Public Utilities PO Box 4748 Clearwater FL 33758-4748 (727) 562-4750 PROJECT NAME: East WRF Filter Feed Pump Station & Force Main Improvements PROJECT NO.: 17 -0048 -UT PROJECT DESCRIPTION: The Base Bid Work of this Project generally includes, but is not limited to, improvements to the existing Clearwater East Water Reclamation Facility (WRF) filter feed pump station, specifically consisting of replacement of existing valves, pumps, and their associated appurtenances. The work to modify these components may result in required modifications to the existing valve vault, including demolition and expansion efforts and a bypass of the entire system between clarifier effluent and filter influent. The work also includes relocating existing electrical components onsite to form a new panel and disconnect area, including panels and conduits, and replacing in kind the existing main duty pumps, jockey pumps, associated isolation valves, check valves, and additional ancillary equipment as indicated in the Contract Drawings If existing conditions result in the Base Bid not being practical to be constructed as described, and with the approval of the Owner, a Design Bid Alternate may be considered instead. Documents related to a Design Bid Alternate are included in the Contract Drawings as "DBA" Sheets, and generally describe the option to instead perform the work that generally includes, but is not limited to, demolishing portions of the valve vault and associated piping, fittings, valves, and appurtenances; abandoning portions of the valve vault in place; demolishing indicated discharge piping within the filter feed pump station, and outside through to the discharge header where indicated on the Contract Drawings; and installing new discharge piping, valves, fittings, concrete pad, supports, and appurtenances as required to bring the piping above grade and connect the existing filter feed pump station to the existing filter feed force main at a single location. All other elements of the base bid outside the piping, fittings, valves, appurtenances, and valve vault shall still apply (e.g. electrical infrastructure movement, etc.). SECTION V Page 1 of 18 Updated: 7/9/2025 SECTION V — Contract Documents The Contractor shall provide copies of a current Contractor License/Registration with the state of Florida and Pinellas County in the bid response. The Contractor shall provide Fixed 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: 365 Consecutive Calendar Days BY THIS BOND, We, , as Contractor, and , a corporation, as Surety, are bound to the City of Clearwater, Florida, herein called Owner, in the sum of $1,632,070, for payment of which we bind ourselves, our heirs, personal representatives, successors, and assigns, jointly and severally. THE CONDITION OF THIS BOND is that if Contractor: 1. Performs the contract dated , between Contractor and Owner for construction of , 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 18 Updated: 7/9/2025 SECTION V — Contract Documents Bond No.: 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 day of , 20 (If sole Ownership or Partnership, two (2) Witnesses are required). (If Corporation, Secretary only will attest and affix seal). SGS Contracting Services, Inc. By: Title: Print Name: WITNESS: WITNESS: Corporate Secretary or Witness Print Name: Print Name: (affix corporate seal) (Corporate Surety) By: ATTORNEY-IN-FACT Print Name: (affix corporate seal) (Power ofAttorney must be attached) SECTION V Page 3 of 18 Updated: 7/9/2025 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 SGS Contracting Services, Inc, of the City of High Springs County of Alachua 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: EAST WRF FILTER FEED PUMP STATION & FORCE MAIN IMPROVEMENTS PROJECT NO.: 17 -0048 -UT in the amount of $1.632.070.00 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 18 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 18 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 a 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 18 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'saddress 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. A contractor who complies with a public records recjuest within 8 business days after the notice is sent is not liable for the reasonable costs of enforcement. j) 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: Jeer Polirier City Manager Countersigned: By: Bruce Rec Mayor Rosemarie Call City Clerk Cot actor must indicate whether: Corporation, Partnership, Matthew Mytych Senior Assistant City Attorney Company, or Individual 3GS C Coe.rrizikc-Zt 5E12-vicea-Fl c. (Contractor) a -k ,I \� By: Print Name: SE rut 5 iw.wwNs Title: P9-6 k IDE r-' (SEAL) The person signing shall, in his own handwriting, sign the Principal's name, his own name, antlayti4flb; "Y.A s, where the person is signing for a Corporation, he must, by Affidavit, show his authority to bifid F e rn 11,1,1 SEAL ' Corporation - provide Affidavit. 0 ! '- SECTION V Page 7 of 18 Updated: 7/9/2025 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, -------- ... ------ .... - SCSContracting Services, Inc. as Contractor, and r n.....,_.,<> ......................„_, Creat American insurance Company as Surety, whose address is 301 .13 4th Street Cincinnati, OH 0202 , are held and firmly bound unto the City of Clearwater, Florida, in the sum of IL%6 _d r rano Ann „v .N-,(; Dollars (SiO 1 ) (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 SGS Contracxing Services, Inc. — •�--«•__ as Contractor, and Great American Insurance Con �a as Surety, for work specified as: were...... 7.,............ .. . ... . ..... ......-.,.,s....,lr,...,.,...se....>.........r._,.,............ 17.004B -UT East WRF Filter Feed Pura Station & Porcc Main improvements , Project No, 03720=060=01 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; X Corporation, Partnership, Company, or _ Individual Signed this 29thday of April ,,R.irm,,,/�/ SOS Contracting Services, Inc. 25613 W. US Hwy 27 a �_/'/©gyp . -, Nigh Springs, FL 32643 & �j ; V -,,, m ; rrol Contractor = r ' , f es: SCS Contracting Services, Inc. - ''-?907../ .O' Principal .OR IDP o''' By; Title • Seth G. Si mons, President Great American Insurance Company Surety ,i9 L. : raeamont 1 tdtlfey-Tn.Pact .& orida Licensed Resident Agent Inquiries: (321) 400-6544 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 8 016 Updated: 7/9/2028 GREAT AMERICAN INSURANCE COMPANY® Adminiea rative Office; 301 E 4TH STREET • CINCINNATI, OHIO 413202 • 513-369-5000 • FAX 513423.2740 The number of persona authorized by this power of attorney is not more than THR€€ No. Q 22629 l'OWZIt QF ATTORNEY KNOWALLMEN tiYTtip'b[r ?RESENTS: SE.N1 S: That the GR,EATAMERICAN INSUR;ANCF COMPANY, a corporation organized and existing under and by virtue of the Jaws of the State of Ohio, does hereby nominate, constitute and appoint the person or persons named below each individually if more than one is named, its true and lawful attorneyrin=fact, for it and in its name, place and stead to exeente on behalf of the said Company, is surety, any and all bonds, undertakings and eoniracts of suretyship, or other written obligations in the nature thereof, provided that the liability of the said Company on any such bond, undertaking ar contract of suretyship executed under this authority shall not exceed the limit stated below. NameAddress l.itnit of Power JOROE BRAEAMQNTE ALL OF ALL JEBSIE SWAN ORLANDO, FLORIDA $100,000,000 HALVE MARTIN This Power ofAttorncy revokes au previous powers issued en behalf of the attomey(s)-in•faet named above. IN WITNESS WHEREOF the GR.FAVAMFRICAN•INSiJRANC1✓ COMPANYhas caused these presents to be signed and attested by its appropriate oheers and its corporate seal hereunto affixed this 23RD day of MAY 2025 . Attest Ott.EAP:AjylERiCAN INSURANCE COMPANY dsststent,Sreretery Divisional Senior Vice t'restdant STATE OF OHIO, COUNTY OF HAMILTON = ss: JOHN K W598 €41 te77=377-a4M On this 23RD day of MAY known, being duly sworn, deposes and says that he resides in Cincinnati, Ohio, Olathe .is a Divisional Senior vice President of the Bond. Division of Great American Insurance Company, the Company described in and which executed the above, instrument, that he knows: the seal of the said Company; that the seal affixed to the said instrument is such corporate seal; that it was so affixed by authorityof his office under the Dy:Laws of said -Company. and that he signed his name thereto by like authority, , 2025 , before me personally appeared JOHN K, WEBSTER, to me MAR AMOW Rotary POW State of Ohio hty Comm. Expires May 16, 2036 A-ela-etaci64405‘ This Power of Attomey is granted by authority of the following resolutions adopted by the Hoard et -Directors of Great American Insurance Company by unanimous written consent dated June 9, 2008. RESOLVED; That t/i Divisional President, the several Divisional Senior Vice Presidents Divisional Vice Presidents and'taivisonal Assistant Vice Presidents, or any one of them, be and hereby is author: ed from time to lime, to appoint one or more Attor'neys•in-Pact to execute on behatjof this Company. as surety, any and all bonds undertakings and contracts r f sartiysmip or other written obligations in the nature thereof to prescribe their respective duties and the respective Was of their authority; and to revoke any melt appointment at any time. R. SO1 V1 W /'tJRT/LER: 77rat the Company seal and the signature of any of the, aforesaid officers and any Secretary or Assistant Secretary oj'lite Company may be faxed by facsimile to any power of attorney or certificate of either given for the exectaion of any bond, undertaking, conlram of suretyship, or other written obligation in the nature thereof such signature and seal when so used being hereby adopted by the Company as the original signature of such officer and the original seal of the Company, to be valid and binding upon the Company with the same force and oiled as though manuallyg1fiixed, CERTIFICATION I, STEPHEN C. DERMA, Assistant Secretary of Great American insurance Company, do hereby certify that the foregoing Power ofAttorney and the Resolutions of the Board ofDirecters of June 9, 2008 have not been, revoked and ars now in full force and effect, Signed and sealed this 29th day of April , 2020 , 61029AJ (0445) Assistant SECTION V — Contract Documents CONSENT OF SURETY TO FINAL PAYMENT TO OWNER: City of Clearwater PROJECT NAME: East WRF Filter Feed Pump Station & Force Main Improvements Public Utilities PROJECT NO.: 17 -0048 -UT 100 S Myrtle Ave CONTRACT DATE: ,[ Clearwater, FL 33756 BOND NO.: ;[ 1, recorded in O.R. Book ;[ 1, Page ![ 1, of the Public Records of Pinellas County, Florida. CONTRACTOR: SGS Contracting Services, Inc. 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 o f Surety] ;[address] ,[address],,, SURETY, on bond of SGS Contracting Services, Inc PO Box 908 High Springs, FL 32655], 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 Utilities 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 18 Updated: 7/9/2025 SECTION V= Contract Documents AFFIDAVIT (To be filled in and execs. -lied if the bidder is a cosporation) STATE QF FLORIDA COUNTY OF 5C04 Sid4eti*L.) , being duly WPM, deposes and says that he/she 15 Secretaly of c, a corporation organized and existing under and by virtue of the laws oldie State of Florida, and having its principal office at 2 5-4 t3 Lk.) s+- (A.L'A'cbttAdvCOunty) (Street & Number) (City) (Stat) Affiant further says that he is familiar with the records, minute books and by-laws of cco izvic.4E-0 -to (Name of Corporation) Affiant further says that sWtb4D..t 'Ptp•eS /or r—rr (Title) (Offices's Name) of the corporation, is duly authorized to sign the Proposal for ev.5 Coxrto.4.e..0416-tune-Es,.t or saki corporation by virtue of r 0.•3 Z 12.02,C (state whether a provision of by laws or a Resolution of 13oard of Directors, If by Resolution give date of adoption). Affiant Sworn to before me this day ofAsum-. r 2024. 411i11401P—IILf,_ • ,•947,,,. MICHELLE MONTGOMERY Notary Public •• State 0 Florida commisston HH 276145 F fy,T, My Comm, Expires Jun 26, 2026 ' ffonded through tratfonal Notary Ann. SECTION N ary Public —114,%,Agle4+4 Type/print/stamp name Notary / Title or rank, and Serial No., if any Page 9 of 16 Updated: W3/2024 SECTION V —Contract Documents NON. COLLUSION AFFIDAVIT STATE OF FLORIDA ) COUNTY OF 4,4 ) 56t4 5w wtc»j being, first duly sworn, deposes and says that he is Pi�tnE�y� of �� f CoNtiw,•rc,t,� tzv�s{ (u� , the party making the foregoing Proposal or Bid; that such Rid is genuine an. 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 npt 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 .ti `r,,._. day of4'`"L `-"r 4 MICHELLE MONTGOMERY x ` inkNotary Public = State of Florida Commission # HH 274145 �My Comm, Expires Jun 28, 2026 3onde4 through National Notary ASM. Notary Pu.lac SECTION V Page 10 of 16 Updated; 8/3/2024 SECTION V—Contract Documents PROPOSAL (1) TO THE CITY OF CLEARWATER, FLORIDA, for East WRF Filter Feed Pump Station & Force Main Improvements (17 -0048 -UT) and doing such other work incidental thereto, all in accordance with the contract documents, marked East WRF Filter Feed Pump Station & Force Main Improvements (17 -0048 -UT) 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 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. SECTION V Page 12 of 18 Updated: 7/9/2025 SECTION V..- Contract ppcureent4 PRP(SAL (2) Attached hereto is a bond or certified cheek on 510 '2a0 f 4.v Bank, for the sum of t o % air gat. ,,„.(wr (being a minimum of 1O% of Contractor's total bid amount), The full names and residences of all persons and parties interested in the foregoing bid are as fellows: (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, enrichment, employment or possible benefit, whether subcontractor, mater_ialman, agent, supplier, or employer is contin$ent upon the award of The contract to the:.bidder).. NAMES: 5twtwto»t �At.t a r tw►t�n u*� 3 ADDRESSES: 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: -- at, 5 co1.-Zo.nc-ct,ls 1244- r any; Title: e 3 t o&A/ Company Legal Name; 3C, $ r -v 4c.E � (Ad Doing Business As(if different than above): 2514 l') t v tit 0, ' et. 2L 14, 01 5> ! (CL 52 -CD 4-3 Business Address of Bidder: City and State: et. A 5" 43 Zip code 3 2—(! 4-3 Phone:' $ % '"ti t ~530 b ..:._ EmailAddress: 5 Q 5 =' S c 5 <.. C -o tete, Dated at ; this 2 :5 day of SECTION V Page 12 of 16 A.D., 2124 Updated: 6/V2024 SECTION V Contract Document5 CITY OF CLEARWATER ADDENDUM SHEET - 001-53 -(Ar Eli 1-c cL,F-r-1FviF-e-eto ftivve 5 -G4 ---ti 0 &i PROJECT; 4 ,ttg AA A4 /4.) (.44" p Ftovoytivo-T Acknowledgment is hereby made of the followin$ addenda re eived since issuance of Plans and Specifications. Addendum No tDate: Z Addendum No. Date: Addendum No, Date: Addendum No, Date: Addendum No, Date; Addendum No, Date: Addendum No. Date: Addendum N9. Date; Addendum No. Date: Addendum No. Date: Addendum No. Date: SECTION Y coo,t4A-exti "2-0-,E 5„ 1 . (Name of 13' I er) (Signature of Officer) Poe 5 ivEwl (Title of Officer) (Pate) Page 13 of 16 Updated: 6/3/2024 SECTION V—Contract Documents BIDDER'S PROPOSAL PROJECT: East WRF Filter Feed Pump Station & Force Main Improvements (17 -0048 -UT) CONTRACTOR: BIDDER'S GRAND TOTAL: $ (Numbers) BIDDER'S GRAND TOTAL: (Words) • Line Item 1 Description ' Mobilization/Demobilization and General Conditions (not to exceed 8% of the Base Bid) ' Quantity ; 1 Unit of Measure I LS Unit Cost $75,000.00 : Total $75,000.00 2 Demolition and Removal 1 LS $85,000.00 $85,000.00 3 Bypass 1 LS $350,000.00 $350,000.00 4 Valve Vault Modifications 1 LS $100,000.00 $100,000.00 5 Pump and Valve Construction Installation 1 LS $870,700.00 $870,700.00 6 Surveyor's Record Drawings 1 LS $3,000.00 $3,000.00 Total $1,483,700.00 1 LineUnit Item 1 Description ; 10% of total above Quantity ! 1 of Measure ; LS Unit Cost •! $148,370.00 Total $148,370.00 Line Item DBA - 1 Description Alternate Demolition Quantity ; 1 1 Unit of Measure ; LS Unit Cost $55,000.00 Total $55,000.00 DBA- 2 Alternate Above Grade Piping and Valve Assembly 1 LS $349,700.00 $349,700.00 Total $404,700.00 SECTION V Page 15 of 18 Updated: 7/9/2025 [SGS CONTRACTING SERVICES, INC.] RESPONSE DOCUMENT REPORT ITB No. 17 -0048 -UT 17 -0048 -UT East WRF Filter Feed Pump Station & Force Main Improvements Certificate_of_Status_2026.pdf LICENSE_CGC1514772_exp08312026. pdf LICENSE_CUC1225090_exp08312026.pdf SGS_Contracti ng_Services,_I nc._SGS_Contracti ng_Services,_I nc._4-23-2026. pdf 7. W-9* Upload your current W-9 form. (available at https://www.irs.Rov/pub/irs-pdf/fw9.pdf) W-9_SGS_Contracti ng_Services,_I nc..pdf PRICE TABLES EAST WRF - FILTER FEED PUMP STATION Pricing shall be inclusive of all labor, equipment, supplies, overhead, profit, material, and any other incidental costs required to perform and complete all work as specified in Contract Documents. Line Item Description Quantity Unit of Measure Unit Cost Total 1 Mobilization/Demobilization and General Conditions (not to exceed 8% of the Base 1 LS $75,000.00 $75,000.00 Bid) 2 Demolition and Removal 1 LS $85,000.00 $85,000.00 3 Bypass 1 LS $350,000.00 $350,000.00 4 Valve Vault Modifications 1 LS $100,000.00 $100,000.00 5 Pump and Valve Construction Installation 1 LS $870,700.00 $870,700.00 [SGS CONTRACTING SERVICES, INC.] RESPONSE DOCUMENT REPORT Invitation To Bid - 17 -0048 -UT East WRF Filter Feed Pump Station & Force Main Improvements Page 5 [SGS CONTRACTING SERVICES, INC.] RESPONSE DOCUMENT REPORT ITB No. 17 -0048 -UT 17 -0048 -UT East WRF Filter Feed Pump Station & Force Main Improvements Line Item 6 Surveyor's Record Drawings Description Quantity 1 Unit of Measure LS Unit Cost Total $3,000.00 TOTAL $3,000.00 $1,483,700.00 CONTINEGENCY Line Item 1 10% of total above Description Quantity 1 Unit of Measure LS Unit Cost Total $148,370.00 TOTAL $148,370.00 $148,370.00 DESIGN BID ALTERNATE Line Item DBA -1 DBA -2 Description Alternate Demolition Alternate Above Grade Piping and Valve Assembly Quantity Unit of Unit Cost Total Measure 1 1 LS LS $55,000.00 $349,700.00 TOTAL $55,000.00 $349,700.00 $404,700.00 [SGS CONTRACTING SERVICES, INC.] RESPONSE DOCUMENT REPORT Invitation To Bid - 17 -0048 -UT East WRF Filter Feed Pump Station & Force Main Improvements Page 6 SECTION V—Contract Documents 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 16 of 18 Updated: 7/9/2025 SCRUTINIZED COMPANIES FORMS SCRUTINIZED COMPANIES AND BUSINESS OPERATIONS WITH CUBA AND SYRIA CERTIFICATION FORM IF YOUR BID/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 offiant, 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 cempanlespn the -Scrutinized Companies with Activities in Sudan List, the Scrutinized Companies with Activitiesin 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 (S) calendar days after any of its principals ere pieced on the, Scrutinized Companies with ,ACtivItie in Sudan ListtheScrutinized Companies with Activities in the Iran Petroleum Sector Listor engaged in bus $ operations in Cuba and Syria. Authorized Sna re Printed Name 81.60 tgaGlv 1 Title LQ et r-ht-Yteis, Name of Entity/Corporation STATE OF _ COUNTY OF The foregoing instrument was ackn wledgecl before me by means ofar.physical presence or 1:1 online notarization on, this 2 1 day of mi., , 207.1 ,, by Se•t/V_________wvt name of person whose signature is being notarized) as the CV: s cos -1.-/-z (title) of C..6%/10.4-cra ?•E. I. N.c. (name of corporation/entity), personal! kno n , or produced (type of identification) as identification, an who did/did not take an oath, My Commission Expires; 6-0T—ea NOTARY SEAL ABOVE Notary Public Printed Name P1434 s,00 -it ''' MICHELLE MONTGOMERY - /1 .1 Notary Public - Rate pf Florida 1/ Commission d HH 276145 '..„.8t0/ My Comm, Expires Jun 20, 3026 donded throqb National Notary Assn, SECTION V — Contract Documents SCRUTINIZED COMPANIES THAT BOYCOTT ISRAEL LIST. CERTIFICATION FORM PER SECTION HI, ITEM 25, 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 Scru .nized Companies that Boycott Israel List, or engaged in a boycott of Israel. STATE OF ,r(0,6(a Authorized Sigature ��Clz'�—r tww nW PrinnSd Name r112 -C-5 ID -ire Title 3 CDN -V124- wj)e Er-vlc.E51(x)c. Name of Entity/Corporation COUNTY OF Attkt4 The foregoing instrument was acknowledged before me on this / 644 day of June , 20 ?(p, by�jp�4i7 S;160 pio -is (name of person whose signature is being notarized) as the P► {jolt o .F (title) of 6 6.5 ce+'l ci'uw4►, SPS r„,.S, I: c . (name of corporation/entity), personally known to me as described herein , or produced a (type of identification) as identification, and who did/did not take an oath. w _ PIF MICHELLE MONTGOMERY ;?t Notary Public - State of Florida ( Notary Public V [/ /00Y116 6 efy Qf Commission # HH 276145 , � V My Comm. Expires Jun 28; 2026 i"i , ' G ti 1 Bonded through National Notary Assn. I Printed Name My Commission Expires: (0,-Z- Z (� NOTARY SEAL ABOVE SECTION V Page 18 of 18 Updated: 7/9/2025 CoMpliance with Anti -Human Trafficking Laws Pursuant to Section 787 06 (1$), Florida $tatutes, 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 -govern onto' entity and the City of :ClearWater, The undersigned, on be alf of the entity listed below (_Entity"), hereby attests under penalty of perjury that: Entity does not use coer Ion for labor or services as defined in Section 787.06, Florida Statutes, The undersigned is authorized to execute this form on behalf of Entity, Date: Entity: 2 , 202‘ Signed; '30 KA", tt4 Name: Title; .1____„„2,,L*v City of Clearwater Public Works Marcus Williamson, Department Director 100 South Myrtle Avenue, Clearwater, FL 33756 [SGS CONTRACTING SERVICES, INC.] RESPONSE DOCUMENT REPORT ITB No. 17 -0048 -UT 17 -0048 -UT East WRF Filter Feed Pump Station & Force Main Improvements RESPONSE DEADLINE: April 29, 2026 at 2:00 pm Report Generated: Friday, May 1, 2026 SGS Contracting Services, Inc. Response CONTACT INFORMATION Company: SGS Contracting Services, Inc. Email: seth@sgscsi.com Contact: Seth Simmons Address: PO Box 908 High Springs, FL 32655 Phone: N/A Website: www.sgscsi.com Submission Date: Apr 29, 2026 12:58 PM (Eastern Time) [SGS CONTRACTING SERVICES, INC.] RESPONSE DOCUMENT REPORT ITB No. 17 -0048 -UT 17 -0048 -UT East WRF Filter Feed Pump Station & Force Main Improvements ADDENDA CONFIRMATION Addendum #1 Confirmed Apr 27, 2026 3:01 PM by Seth Simmons 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 [SGS CONTRACTING SERVICES, INC.] RESPONSE DOCUMENT REPORT Invitation To Bid - 17 -0048 -UT East WRF Filter Feed Pump Station &Force Main Improvements Page 2 [SGS CONTRACTING SERVICES, INC.] RESPONSE DOCUMENT REPORT ITB No. 17 -0048 -UT 17 -0048 -UT East WRF Filter Feed Pump Station & Force Main Improvements 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. [SGS CONTRACTING SERVICES, INC.] RESPONSE DOCUMENT REPORT Invitation To Bid - 17 -0048 -UT East WRF Filter Feed Pump Station & Force Main Improvements Page 3 [SGS CONTRACTING SERVICES, INC.] RESPONSE DOCUMENT REPORT ITB No. 17 -0048 -UT 17 -0048 -UT East WRF Filter Feed Pump Station & Force Main Improvements 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 good faith 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... SGS Scan_2026-04-27_150016.pdf 5. Compliance with Anti -Human Trafficking Laws* Please download the below documents, complete, and upload. • Compliance with 787.06 form... SGS_Scan_2026-04-27_151616.pdf 6. Section V - Contract Documents* Please download the below documents, complete, and upload. • Section V - Contract Docume... SGS_Scan_2026-04-27_170526.pdf Business Tax_Receipt_09-30-2026.pdf [SGS CONTRACTING SERVICES, INC.] RESPONSE DOCUMENT REPORT Invitation To Bid - 17 -0048 -UT East WRF Filter Feed Pump Station & Force Main Improvements Page 4 DISPLAY CE1114 ' ON 'ICb O'US'&At 1 USINI LOCATION Lit OWNER + , D S,Cntfiirrg Stets .25613 US 14Y27 q ., 006Y PO Bax "908 High7,5pii. ,FL 2655P 2 2026 S1N1E RESTRICTIOt FEE: State of Florida Department of State I certify from the records of this office that SGS CONTRACTING SERVICES, INC. is a corporation organized under the laws of the State of Florida, filed on October 8, 2012, effective July 25, 2007. The document number of this corporation is P12000085304. I further certify that said corporation has paid all fees due this office through December 31, 2026 and that its status is active. I further certify that said corporation has not filed Articles of Dissolution. Given under my hand and the' Great Seal of the State of Florida at Tallahassee, the Capital, this the Twelfth day of January, 2026 Secreta]!' of tate Tracking Number: 4472073930CC To authenticate this certificate,visit the following site,enter this number, and then follow the instructions displayed. https://services.sunbiz.org/Filings/CertificateOfStatus/CertificateAuthentication ---- .; - Ron DeSantis, Governor ;6 � Melanie S. Griffin, Secretary `��.., , .:, STATE OF FLORIDA COp prg'C DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION Florida CONSTRUCTION-I.NDUSTRY,itICENSING BOARD THE GENERAL CONTRAC-�T,� 'tom' f OR.HEREI;N I`S CERTfFIED UNDER THE PROVISIONfi S'-O_Fe'HAPfTER 489_ , FLORIDA---STATUTES - Lei 1:1A, , .1' = ,- :TA = ....:::, --''' ; �` • '-y-�. '. w,c"�i SI'IVhM®NSEfTjH g, li-�-�{,, h `���4-�-.�r-. � SGS �,`', `INT1RACTI�NG�SERVICES 10,01N11147 �2`5�613 WUS,HWI(f27 HIGH SPRRIN,G4,6., ri -�-�r. ${y T GjAR'RE"74- ~` r .r�� ��i-7 111 INtiC ? „-,+-� FL"32643 .� It an,.x �. tis Yf ( ! 11� ,� .-, � ��•i - 5 t �`z� !`rip. LICENSENUMBERtCGC1�514772 EXPIRATION DATE: AUGUST 31, 2026 Always verify licenses online at MyFloridaLicense.com • is ISSUED: 06/18/2024 }et 4't Do not alter this document in any form. '�' .' 4 This is your license. It is unlawful for anyone other than the licensee to use this document. E _ Ron DeSantis, Governor Melanie S. Griffin, Secretary P.t,Florida 5' mss''*51 " * • ICI. 12%1 1 i,ASIO ' ut W,,.=v .: DEPARTMENT OF BUSINESS CONSTRUCTIONi:NNBUSTRYILICENSING THE UNDERGROUND UTILITY&�EXC�AVA PROVISION .S'O,FaCHA,PrTE+R-489, `S.IM�Ma STATE fJ �•1 vti( b. (9'N>S' OF AND fir'„' O _ _ SETH FLORIDA PROFESSIONAL :COIHFEREIN J i REGULATION BOARD IS CERTIFIED UNDER THE FLORI'DA=STATUTES " ' d�q S f� �.+ r- GARRET . _. , * 4�t, ,,, SGS0_7�C 4-'45_61:3M- HIGHSPRINGS u i . 'Z'77.--,''. '. ' it U Ulr7 �7 NT„RACTING�SERV,I'CES IN,C H ' • 27 .,s -- F :. 01)FL 32643 ] LICENSE NUMBER:CUC1�2Q5090 EXPIRATION DATE: AUGUST 31, 2026 Always verify licenses online at MyFloridaLicense.com ■ •• ■ ISSUED: 06/18/2024 #iT v Do not alter this document in any form.. .. _ • ,o` This is your license. It is unlawful for anyone other than the licensee to use this document. ACORO® CERTIFICATE OF LIABILITY INSURANCE ‘.....---- DATE(MM/DD/YYYY) 4/23/2026 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 INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or 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 endorsement(s). PRODUCER Acentria Insurance — Newberry 216 NW 135th Way, Suite 30 Newberry FL 32669 License#: L100460 NAME CONTACT Tyler Ramey PHONE 352-571-6028 FAX, No): (A/C. No. Ext): ADDRESS: tyler.ramey@acentria.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Evanston Insurance Company 35378 INSURED SGSCONT-01 SGS Contracting Services, Inc. 90 PO Box 908 High Springs FL 32655 INSURER B: Auto -Owners Insurance Company 18988 INSURER C: Southern -Owners Insurance Company 10190 INSURER D : Insurance Company of the West 27847 INSURER E : $100,000 INSURER F : COVERAGES CERTIFICATE NUMBER: 1935324209 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. INSR LTRINSD TYPE OF INSURANCE ADDL SUBR WVD POLICY NUMBER POLICY EFF (MMIDD/YYYY) POLICY EXP (MMIDD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY MKLV2ENV105534 4/26/2026 4/26/2027 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $100,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $10,000 PERSONALBADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE POLICY OTHER: X LIMIT APPLIES PER: PE� LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE X LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY _ SCHEDULED AUTOS NON -OWNED AUTOS ONLY 5280685600 4/26/2026 4/26/2027 COMa accidenBINEDq SINGLE LIMIT (E $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ A X UMBRELLA MB EXCESS LIAB X OCCUR CLAIMS -MADE MKLV2EFX101837 4/26/2026 4/26/2027 EACH OCCURRENCE $5,000,000 AGGREGATE $ 5,000,000 $ DED RETENTION$ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y/N NIA WFL507556902 2/1/2026 2/1/2027 X STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE- EA EMPLOYEE $1,000,000 E.L. DISEASE- POLICY LIMIT $1,000,000 A A C Professional Liability Pollution Liability Leased/Rented Equipment MKLV2ENV105534 MKLV2ENV105534 78806880 4/26/2026 4/26/2026 4/26/2026 4/26/2027 4/26/2027 4/26/2027 Each Claim Each Occurrence Limit 1,000,000 1,000,000 200,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) '**"SAMPLE CERTIFICATE OF INSURANCE**** USED FOR BIDDING PURPOSES COVERAGE CAN BE ADJUSTED AS NEEDED FOR PROJECT -SPECIFIC REQUIREMENTS CERTIFICATE HOLDER CANCELLATION SGS Contracting Services, Inc. PO Box 908 32655 FL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 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/FomiW9 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. 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 line 2.) SGS Contracting Services, Inc. 2 Business name/disregarded entity name, if different from above. memo type. Specific Instructions on mai V ■ egJ ❑ D O Rg [U 9 7&Fk k az 2!r Jfo0 2,I ° k 2 /\( 2\\)} » R� J=x• &.g,Ea \£ e/E § E&§E ( - 2 gEt§K(k( 2�g . §0 [` K 3E @/A fk(\ O §k P�� *cn 0 E \ P 1 X251 -• I cv SEA k}( Pt - § 9-, %� Cr) R. ' II S E. \CD s8 0. ® -A®® ® k s,a 11 1 ! _ st ,§§ 0 2 °� ��e 138 mil e. \2. S .• �' k(kN. § .2i a-- -a - .§g [{. e \ ' (/• . O o • • \ «2 2. . / _ °, \ gl / 0 80 ( S a 4 Exemptions (codes apply only to certain entities, not individuals; see Instructions on page 3): Exempt payee code (if any) Exemption from Foreign Account Tax Compliance Act (FATCA) reporting code (if any) lies to accounts maintained (Applies outside the United States.) 5 Address (number, street, and apt. or suite no.). See instructions. 25613 W US Hwy 27 6 City, state, and ZIP code High Springs, FL 32643 Requester's name and address (optional) 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 Social security number 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. or Employer identification number 4 6 1 1 4 7 8 9 1 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, ou 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 g' -e9(0 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)