HomeMy Public PortalAbout100_021_Agenda Request - Backhoe & Grader RFP AtC
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RFP # 2014-648
CITY OF TYBEE ISLAND
TYBEE ISLAND, GEORGIA
IS ISSUING THIS REQUEST FOR PROPOSAL FOR FURNISHING THE PRODUCT
DESCRIBED HEREIN:
BACKHOE AND GRADER
Bidders shall offer services and materials which may be upgraded with optional services and materials
which may not be purchased at time of bid award. Bidder shall specify in the proposal the delivery
schedule for the products and services from time of notification of award of bid.
BIDS ARE TO BE RETURNED NO LATER THAN: JULY 23,2014 AT 10:00AM
BIDS WILL BE OPENED ON JULY 23,2014 AT 11:00 AM AT CITY HALL.
ALL RESPONDENTS ARE INVITED TO ATTEND.
The City is seeking a total bid package for service/materials equal to or exceeding specifications set forth
on the attached pages which must meet or exceed stated specifications. Those not meeting these standards
will be rejected. The attached material specifications become and remain a part of this request for
proposal
All responses, inquiries, or correspondence relating to, or in reference to, this request for proposals, and
all reports, charts, displays, schedules, exhibits and other documentation by the bidders shall become the
property of the City when received. All proposals submitted in response to this invitation for bid shall
become the property of the City. The City retains the right to use any or all ideas presented in any
proposal to the invitation to bid, whether amended or not. Selection or rejection of the proposal does not
affect this right.
Mail proposal to: BID NUMBER 2014-648
MELISSA FREEMAN
403 BUTLER AVE
PO BOX 2749
TYBEE ISLAND, GA. 31328
(912) 472-5023
Inquiries or other need for clarification in this document should be submitted no later than
July 21, 2014.
Page 1 of 13
Questions to: Michael Ashdown
912-472-5044
Email: mashdown @cityoftybee.org
METHOD OF AWARD: Contracts shall be awarded to the lowest, responsive, and responsible bidder.
Bidders must respond completely by filling in all applicable blanks. Bids are subject to the terms and
conditions of this Request for Proposal.
Bids shall be submitted in a sealed envelope, clearly marked on the outside of the envelope, to the office
of the above address prior to the time specified.
Signature of bidder indicates that bidder understands and will comply with attached terms and conditions
and all other specifications made a part of this invitation for bid and any subsequent award or contract.
All terms, conditions and representations made in this invitation will become an integral part of the
contract. Nothing contained within this RFP is indicative of intent by the City of Tybee Island to
reimburse the bidder, in whole or in part, for any costs associated with preparation, submission,
or presentation of proposals.
WAIVER: The City of Tybee Island reserves the right to reject any or all bids received. The City reserves
the right to waive any variances from original bid specifications in cases where the variances are
considered to be in the best interest of the City.
SUBMISSION OF BIDS AND SUPPLEMENTAL MATERIALS
Bids and all required or requested supplemental materials in compliance with the attached
specifications shall be submitted to the office of the Clerk of Council. Supplemental materials
will not be accepted after the bids have been opened, unless requested by the City. Please include
a bid sheet, W-9, vendor application, and affidavit verifying status, which can be found at the end
of this request.
SPECIFICATIONS
2014/2015 14' BACKHOE
I. GENERAL
CURRENT PRODUCTION MODEL 14-FOOT CLASS BACKHOE LOADER. ALL
SPECIFICATIONS ADVERTISED MUST COMPLY WITH SAE OR ISO
STANDARDS.
II. SAFETY
UNIT TO BE EQUIPPED WITH THE FOLLOWING: ROLL OVER PROTECTIVE
STRUCTURE (ROPS),RETRACTABLE SEAT BELT MEETING SAE J1040, SAE
J386,AND SAE 231 CRITERIA. LOADER SERVICE STRUT. VANDALISM
PROTECTION TO INCLUDE THE FOLLOWING LOCKABLE COMPONENTS:
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ENGINE MONITOR,FRONT ENGINE GRILL,HYDRAULIC FILL,FUEL FILL,AND
EXTERNAL TOOLBOX. ALL LOCKS MUST BE OPENED WITH ENGINE START
KEY. FRONT AND REAR BUTTONS FOR HORN.
III. ENGINE
TURBOCHARGED,WATER-COOLED, 4-CYCLE,DIRECT INJECTION DIESEL
ENGINE MUST CONFORM TO U.S. EPA INTERIM TIER IV AND CARE
REGULATIONS.
HORSEPOWER OUTPUT: MINIMUM 90 SAE GROSS ENGINE HP AT 2200
RPM
THROTTLE CONTROL: TO BE HAND AND FOOT OPERATED
IV. TRANSMISSION:
4 SPEED POWER SHIFT MINIMUM
TOP SPEED OF AT LEAST 24 MPH
V. REAR AXLE:
LIMITED SLIP DIFFERENTIAL
NO LESS THAN 27,000 LBS. STATIC LOAD RATING.
VI. FRONT AXLE 4WD:
4WD TYPE: INDUSTRIAL DUTY,WITH OUTBOARD PLANETARY FINAL
REDUCTION, SHIFT ON THE GO. 11 DEGREES OF AXLE OSCILLATION EITHER
SIDE OF CENTERLINE. NO LESS THAN 26,000 LBS. STATIC LOAD RATING.
GROUND CLEARANCE: 11 INCHES MINIMUM
VII. BRAKES
SEALED WET MULTIPLE DISC. MUST BE ABLE TO OPERATE BRAKE PEDALS
INDEPENDENTLY AS TURNING BRAKES OR LOCKED TOGETHER FOR ROAD
OPERATION. HYDRAULIC ACTUATION.
VIII. ELECTRICAL SYSTEM:
Page 3 of 13
TYPE: 12 VOLT SYSTEM WITH 90 AMP (MINIMUM)ALTERNATOR.
ELECTRICAL CONNECTIONS MEET IP67 FOR CONNECTIONS LOCATED IN
THE CAB AND MEET IP69 FOR CONNECTIONS OUTSIDE THE CAB.
BATTERY: SINGLE RATED AT 950 COLD CRANKING AMPS (MINIMUM . 190
MINUTE RESERVE CAPACITY.MAINTENANCE FREE.
LIGHTING: FOUR HALOGEN WORK LIGHTS FRONT AND FOUR HALOGEN
WORK LIGHTS REAR(TOTAL OF EIGHT), STOP LIGHTS,TURN SIGNALS,FOUR
WAY HAZARD FLASHERS.
INSTRUMENTATION: GAUGES AND READOUTS CONSISTING OF A
TACHOMETER,FUEL GAUGE,ENGINE COOLANT TEMPERATURE GAUGE,
HOUR METER AND CLOCK. LIGHT AND ALARM FOR BATTERY CHARGE
CONDITION, COOLANT TEMPERATURE,ENGINE OIL PRESSURE,
TRANSMISSION OIL PRESSURE, TRANSMISSION OIL TEMPERATURE,AIR
CLEANER RESTRICTION,PARKING BRAKE ENGAGEMENT,AND WATER IN
THE FUEL. LIGHT INDICATORS FOR FRONT WORK LIGHTS ON,REAR WORK
LIGHTS ON,TURN SIGNAL, 4 WAY FLASHERS.
CIRCUIT PROTECTION: FUSES AND RELAYS LOCATED IN COMMON PANEL.
ACCESSORY: 12-VOLT OUTLET FOR ACCESSORIES
IX. SEAT/OPERATOR PLATFORM:
SEAT: SUSPENSION SEAT WITH ADJUSTMENTS FOR WEIGHT, SEAT ANGLE,
BACK ANGLE.ARMRESTS AND 2.5 INCH(MINIMUM) RETRACTABLE SEAT
BELT.
CAB: TILT STEERING COLUMN,FRONT WINDSHIELD WITH 2 SPEED PLUS
INTERMITTENT WIPER AND WASHER AND INTERIOR REAR VIEW MIRROR.
EXTERIOR REAR VIEW MIRRORS.
AMBER ROTATING BEACON
X. LOADER—MULTI-PURPOSE
UNIT TO BE EQUIPPED WITH AN INTEGRALLY MOUNTED FRONT-END
LOADER MEETING THE FOLLOWING CRITERIA:
MINIMUM 1.3 CUBIC YARD CAPACITY HEAVY DUTY BUCKET.
CLAMSHELL BUCKET WITH INTEGRAL PALLET FORKS.
MINIMUM 7,000 LBS LIFT CAPACITY.
Pagc 4 of 13
MINIMUM 10,000 LBS BREAKOUT FORCE.
MINIMUM 8' 6"DUMP HEIGHT.
MULTI-PURPOSE PIN-ON LOADER BUCKET W/REVERSIBLE BOLT-ON EDGE.
XI. BACKHOE,MAINFRAME AND HYDRAULICS:
UNITIZED, ONE PIECE MAINFRAME
24"HEAVY DUTY BACKHOE BUCKET W/TEETH AND D-RING.
BACKHOE WITH EXTENDING DIPPER: MAXIMUM DIGGING DEPTH TO EQUAL
OR EXCEED 14' 6"RETRACTED AND 18' 4"EXTENDED.
STABILIZER OPERATING WIDTH TO EQUAL OR EXCEED 10'
DIPPER LIFT AT 8' TO EQUAL OR EXCEED 5,000 LBS.
BOOM LIFT AT GROUND LEVEL TO EQUAL OR EXCEED 3,250 LBS.
DIPPER BREAKOUT TO EQUAL OR EXCEED 8,500 LBS.
BUCKET BREAKOUT FORCE TO EQUAL OR EXCEED 10,000 LBS.
STABILIZER CYLINDER GUARDS
HYDRAULICS: HEAVY DUTY
XII. TIRES 4WD:
4WD FRONT: 14 X 17.5-INDUSTRIAL TREAD PATTERN
4WD REAR: 19.5 X 24 R4 -INDUSTRIAL TREAD PATTERN
XIII. SERVICEABILITY AND MAINTENANCE:
SERVICE AND MAINTENANCE DESIGN TO ENHANCE OPERATOR
CONVENIENCE AND EASE OF MAINTENANCE.
TILT ENGINE HOOD THAT ALLOWS EASY ACCESS TO SERVICE POINTS AND
PROVIDES VANDAL PROTECTION.
FRONT GRILL SCREEN THAT IS KEY LOCKABLE.
ALL LOCKS MUST BE OPENED USING THE ENGINE START KEY.
MAINTENANCE FREE BATTERY
EXTERNAL TOOLBOX WITH INTEGRAL LOCKING HANDLE
RUBBER GRILL GUARDS
FACTORY MAINTENANCE AND PARTS MANUALS TO BE INCLUDED WITH
DELIVERY
CORROSION PREVENTION TREATMENT-BED LINER/EPDXY
UNDERCOATING
Page 5 of 13
XIV. WARRANTY
(MINIMUM) 12 MONTHS,NO HOUR LIMITATION WITH AN ADDITIONAL 12
MONTHS OR 2,000 HOURS OPTIONAL
DEMO ACCEPTABLE W/FULL 12 MONTH/UNLIMITED HOUR FULL MACHINE
WARRANTY
2014/2015 COMPACT MOTOR GRADER
-CURRENT MODEL YEAR OR LOW HOUR DEMO MODEL WITH FULL WARRANTY
ENGINE: 110 HP OR GREATER DIESEL
WEIGHT: MAX. OPERATING WT. 22,000 LBS.
TRANSMISSION: FULL POWERSHIFT WITH TORQUE CONVERTER(6) SPEEDS
FORWARD
TOP SPEED 24 MPH
FINAL DRIVE: TANDEM(4)WHEEL DRIVE,INDEPENDENT OSCILLATION-
SINGLE REDUCTION
TORQUE PROPORTIONING DIFFERENTIAL
FRONT AXLE: HIGH CLEARANCE,HYDRAULIC WHEEL LEAN 18°LEFT AND
RIGHT,36°TOTAL OSCILLATION
20" CLEARANCE AT CENTERLINE
STEERING: HYDROSTATIC,ORBITROL WITH GEAR TYPE PUMP, STEER
ANGLE 40°LEFT AND RIGHT
HYDRAULICALLY ACTUATED ARTICULATION,MINIMUM TURNING RADIUS
OF 18'
BRAKES: 4 -WHEEL,WET DISC, SELF-ADJUSTING,INDEPENDENT TANDEM-BY-
TANDEM SYSTEM
PARKING BRAKE-DISC BRAKE ON TRANSMISSION OUTPUT SHAFT
MOLDBOARD: 12' LONG X 21" HIGH,REPLACEABLE CUTTING EDGES AND END
BITS,HYDRAULIC LIFT OF 15"
ABOVE GROUND, 20" PENETRATION,POWER SIDE SHIFT MINIMUM 17" LEFT
AND RIGHT
CIRCLE: GEAR DRIVEN,MINIMUM 50" DIAMETER,360°ROTATION,
ATTACHED TO "A" TYPE DRAWBAR
TIRES: 15.00 X 19.5 (8 PR) G2 TUBELESS TRACTION
HYDRAULICS: GEAR TYPE PUMP,FULL HYDRAULIC OPERATION OF
ARTICULATION, CIRCLE TURN,CIRCLE SIDE
SHIFT,BLADE LIFT,BLADE SIDE SHIFT,WHEEL LEAN,BLADE PITCH PLUS
MOLDBOARD FLOAT
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CONTROL VALVES,MECHANICAL HYDRAULIC CONTROL LOCKS
ELECTRICAL: 100 AMP ALTERNATOR, 12 VOLT MAINTENANCE FREE
BATTERIES
OTHER EQUIP: BACK-UP ALARM,HORN,TURN SIGNALS,FRONT AND REAR
FLASHER LIGHTS,FRONT HEADLIGHTS,
STROBE LIGHT,INSIDE MIRROR AND (2) EXTERNAL REAR VIEW MIRRORS, 5
POINT TRANSPORT TIE DOWN SYSTEM
CAB: CERTIFIED ENCLOSURE TO INCLUDE TINTED SAFETY GLASS, 40,000 BTU
HEATER, (2)DEFROSTER
FANS,FRONT &REAR WINDSHIELD WIPER AND WASHERS,REAR SLIDING
WINDOW AND FABRIC SEAT
SCARIFIER -FRONT MOUNTED "V" TYPE,MINIMUM 41" WIDE,MINIMUM 9
TEETH
REAR RIPPER
FACTORY MAINTENANCE AND PARTS MANUALS TO BE INCLUDED
WITH DELIVERY
PAYMENT
The bidder shall specify terms of payment. The City prefers to make payment with a Purchasing Card.
SERVICES To BE PROVIDED
The successful bidder shall perform the following work for the City:
Sale and delivery of Backhoe and Grader
Supply all training needed at customer's premises.
INSURANCE REQUIREMENTS
Contractor shall provide a Certificate of Insurance naming the City of Tybee Island as also
insured, a 30 day cancellation notice, indicating the following minimum coverage:
Comprehensive General Liability $2,000,000.00
Automobile Public Liability $2,000,000.00
Workman's Compensation Insurance equal to the statutory requirements.
TAXES
The City of Tybee Island, Georgia is not subject to any State or Federal taxes. Documentation will be
provided with the invoice at the time of payment,if requested.
DELIVERY: F.O.B. DESTINATION
76 Polk St, Tybee Island, Georgia 31328 unless otherwise stated.
Page 7 of 13
TERMINATION OF CONTRACT
The City reserves the right to terminate the contract for reasons of violations by the successful bidder of
any term or condition of the contract by giving thirty(30) days written notice,unless otherwise stated
herein, stating the reasons therefore and giving the party ample time to remedy the deficiencies.
City of Tybee Island
TERMS AND CONDITIONS
DEFINITIONS. As used herein, the following terms shall have the meanings set forth below,
whether or not capitalized.
(a) "Purchase Order" or"Order"means this purchase order.
(b) "Buyer"means The City of Tybee Island.
(c) "Seller" or"Vendor"means the party furnishing the supplies under this order.
(d) "Supplies" means what the Seller furnishes the Buyer under this order and includes with
limitation, the following; (1) the work; materials; articles; deliverable items, items, data
and services, whether tangible or intangible or any combination thereof; and (2) what is
leased or licensed, pursuant to the lease(s) or license(s) signed by both the Buyer and the
lessor or licensor if attached to and made a part of this order.
(e) "Loss" means any or all the following: claims, liabilities, damages, losses, costs, or
expenses (including reasonable attorneys' fees and expenses and other legal costs).
ACCEPTANCE. This order constitutes an offer which shall become a binding contract upon
the terms and conditions herein set forth upon acceptance by Seller either by acknowledgement
of this order or commencement of performance. Buyer objects to any difference, conflicting or
additional terms proposed by Seller in the acceptance of this order, and no such terms shall be
effective unless expressly accepted by Buyer in writing. Each shipment received by Buyer from
Seller shall be deemed to be only upon the terms and conditions contained in this order, except
by such written instrument modifying the order, signed by Buyer, notwithstanding any terms and
conditions that may be contained in any acknowledgment, invoice, or other form issued by Seller
and notwithstanding Buyer's act of accepting or paying for any shipment, or similar act by
Buyer.
PRICES. Seller represents that the prices, terms, warranties, and benefits contained in this order
are comparable to or better than those offered to any other customer of Seller for items which are
the same or substantially similar. Buyer shall receive the benefit prospectively or retrospectively
if Seller offers any item or service included in this order to any other customer at a lower price,
more favorable terms, more favorable warranties, or more favorable benefits up to one year after
completion of this order.
PACKING AND SHIPPING. All items shall be suitable packed and prepared for shipment to
insure their safe transportation, to secure the lowest transportation cost, and to comply with the
requirements of carriers. Buyer's order number shall appear on all documents and
correspondence relating to these items. Packing lists shall accompany the items and shall
include the order number, Buyer's part number, Seller model number, description of items
shipped and any other information called for in the order. Buyer's count or weight shall be final
and conclusive on shipments not accompanied by a packing list. Seller shall be liable for all
excess transportation or other charges resulting from Seller's failure to comply with Buyer's
packing, shipping, routing and delivery instructions.
Pagc 8 of 13
DELIVERY. Any delivery schedule made a part of this order is an important, material
condition; time is of the essence of the order. Unless otherwise agreed to in writing. Seller shall
not make material commitments or production arrangements in excess of the amount or in
advance of the time necessary to meet Buyer's delivery schedule. It is Seller's responsibility to
comply with this schedule, but not to anticipate Buyer's requirements. In addition to any other
rights or remedies, Buyer may cancel all or any part of this order for Seller's failure to deliver in
strict accordance with the delivery terms set forth herein. Seller shall promptly notify Buyer of
any anticipated delay in the delivery date and Buyer may require Seller to ship by alternate
means in order to expedite delivery. Any additional costs shall be paid by Seller and Seller shall
be liable for all resulting damages to Buyer occasioned by the delay. Delivery shall not be
deemed to be complete until the items have been received and accepted by Buyer. Advance and
excess shipments may at Buyer's option be rejected and returned to Seller at Seller's expense.
TRANSPORTATION. Except as otherwise provided on the face of this order, transportation
charges on Supplies shall be f.o.b. destination, at Seller's sole cost and expense. Risk of loss
from any casualty to supplies ordered hereunder, regardless of cause, shall be Seller's
responsibility until goods have been delivered to Buyer's designated delivery post. No insurance
or premium transportation costs beyond the price listed in this order will be allowed unless
authorized by Buyer in writing. If Seller does not comply with Buyer's delivery schedule, Buyer
may, in addition to any other rights that Buyer may have under this order, require delivery by
fastest way, and charges resulting from the premium transportation must be fully prepaid and
absorbed by Seller.
WARRANTY. Seller warrants that all supplies delivered pursuant to this order shall strictly
conform to the applicable specifications (including without limitation information or functional
performance, material content, size, appearance, response time, etc.), shall be free from all
defects and workmanship in materials including latent defects, shall be free from defects in
design and suitable for their intended purpose, and shall be free from all claims, encumbrances,
and liens. This warranty shall survive inspection, delivery and payments shall run to Buyer, its
successors, assigns and the users of the items and shall not be deemed to be exclusive. Seller
agrees to indemnify, defend and hold Buyer, Buyer's employees, and those for whom Buyer may
act as agent, harmless from all damages, including consequential and incidental damages,
incurred or sustained by Buyer by reason of any breach of any warranty with respect to the
supplies purchased. Buyer shall be promptly reimbursed for all expenses incurred in the
handling, inspection and return of defective items, and Seller shall bear the risk of loss on all
such items. If any of the supplies are found at any time prior to acceptance to be defective in
material or workmanship, or otherwise not in conformity with the requirements of this order,
Buyer (in addition to any other rights which it may have under warranties or otherwise) may at
its option (1) correct or have corrected the nonconformity at Seller's expense, or (2) reject and
return such supplies or other deliverable items at Seller's expense, such supplies or other
deliverable items not to be replaced without suitable written authorization from Buyer.
CHANGES. Buyer may at any time request in writing changes to this order in the
specifications, packing, shipment, quantities, delivery schedules, and other matters. If any such
change causes an increase or decrease in the costs of or the time required for performance, Seller
shall immediately notify Buyer. Any request for an equitable adjustment must be made in
writing with 30 days from the date of the written request for the change. No additional charge or
change in the specifications, packing, shipment, quantities, delivery schedules, and other matters
will be allowed unless authorized by Buyer in writing.
Page 9 of 13
TAXES. The Buyer, a municipality in the State of Georgia, is exempt from Georgia Sales Tax
under the Sales and Use Tax ID # 302 526 178. All sales and use tax due on materials purchased
by the city for installation by the seller under this contract are the responsibility of the contractor.
ASSIGNMENT. Neither this order nor any interest herein may be assigned, in whole or in part,
by Seller without the prior written consent of Buyer. Notwithstanding the above, Seller may
assign any monies due or to become due to him hereunder, provided that such assignment shall
not be binding upon Buyer until receipt of a copy of the assignment agreement is acknowledged
and approved by Buyer in writing.
SUBCONTRACTING. Seller shall not enter into a subcontract for any part of this order,
including completed or substantially completed items or major components thereof, with Buyer's
written consent. Nothing in this order shall be seen as prohibiting Seller's purchase of standard
commercial articles, raw materials, or other supplies specified in this order if these are typically
purchased by Seller in the normal course of business.
TERMINATION. Buyer may terminate or suspend performance under this order in whole or in
part from time to time by sending written notice to Seller. Upon receiving notice of such action
by Buyer, Seller shall immediately comply with its terms and take all reasonable steps to avoid
incurring any additional costs under this order. Buyer's sole liability to Seller shall be for items
completed and delivered to Buyer in accordance with this order and for Seller's reasonable costs
to the date of termination, such costs being solely attributable to this order and not being
recoverable from other sources.
INDEMNIFICATION. Seller agrees to indemnify, defend and hold Buyer, Buyer's employees,
and those for whom Buyer may act as agent harmless from (1) any and all claims and liabilities
for injuries or death of persons or damages to or destruction of property; (2) any other Loss
caused by or resulting from the acts or omissions of Seller, its agents, subcontractors, suppliers
or employees in the performance of this order; (3) any Loss caused by or resulting from the
supplies purchased under this order, (4) any intended use of products or materials provided by
Seller; (5) any defective products or materials provided by Seller, including without limitation
the use or disposal of hazardous and/or toxic materials, such materials to include at minimum all
materials recognized by the Environmental Protection Agency as hazardous; or(6) any breach by
Seller of any express or implied warranties. If Seller's work hereunder involves operations by
Seller's agents, subcontractors, suppliers or employees on Buyer's premises or any place where
Buyer conducts operations, Seller shall take all necessary precautions to prevent the occurrence
of any injury or damage to persons or property during the progress of such work. Further, Seller
shall indemnify, defend and hold Buyer, Buyer's employees, and those for whom Buyer may act
as agent harmless for any injuries occurring to Seller's agents, subcontractors, suppliers or
employees and Seller shall maintain public liability, property damage and employee's liability
and compensation insurance sufficient to protect Buyer from any claims under any applicable
law, statute, or regulation.
MODIFICATION; WAIVER. No waiver or modification of this order shall be effective unless
in writing and signed by both of the parties hereto. Failure of either party to enforce its rights
under this order shall not constitute a waiver of such rights or any other rights.
Page 10 of 13
ENTIRE AGREEMENT. This order is intended by the parties as a final expression of their
agreement and also as a complete and exclusive statement of the terms thereof, any prior or
contemporaneous oral or written agreements as to the same subject matter notwithstanding.
INVALIDITY. In the event that any provision of this order is declared invalid, illegal, or
otherwise unenforceable by any tribunal or law, the remainder of the provisions shall not be
affected thereby, and each term and provision not declared invalid, illegal or unenforceable shall
be valid and shall be enforced to the fullest extent permitted by law.
DRUG FREE WORKPLACE. By accepting this order, the Seller certifies that he shall provide
a drug free workplace for his employees in accordance with the laws of the State of Georgia.
SPECIFICATIONS, PROPOSALS, BID DOCUMENTS. The documents which form the
basis for this order shall include the plans and specifications and bid documents as attached
hereto, together with any other documents so listed and enumerated, if any, and it is expressly
understood that any special conditions listed and attached hereto are specifically made a part of
this contract.
APPLICABLE LAW. The provisions and performance of this purchase order shall be
governed by the laws of the State of Georgia and applicable federal law. Seller agrees to bring
any and all actions relating to this purchase order only in the state and federal courts located
within Chatham County in the State of Georgia.
APPROPRIATION. Notwithstanding any other provision hereof, this agreement shall
terminate at the end of each calendar year without liability or obligation on the part of the city in
any calendar year where the City has not appropriated funds for the obligations hereunder for the
next calendar year.
QUOTATION SHEET
A. Description:
TOTAL COST: $
Quotation Expiration date:
Page 11 of 13
Form W-9 Request for Taxpayer Give form to the
(Rev.October 2004) Identification Number and Certification requester. Do not
Department of the Traeaury send to the IRS.
Internal Revenue .ace
Name(as reported on your income tax return)
m
rn
m
a Business Doane,If different from above
es c
c
e.p Exempt from backup
•t Check appropriate box: 1_1 Sole proprietor ❑ Corporation ❑ Partnership ❑ Other Is. withholding
.
.2 Address(number,street,and apt.or suite no.) Requester's name and address(optional)
•� e
d u
8 City,.state,and ZIP code
a
tJl
List account number(s)here(optional)
ns
try
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 Social security number
backup withholding.For individuals,this is your social security number(SSN). However,for a resident I 1 1 1 1 1 I I
alien.sole proprietor, or disregarded entity,see the Part I instructions on page 3.For other entities. it is
your employer identification number(EIN).If you do not have a number, see How to get a TIN on page 3. or
Note.If the account is in more than one name, see the chart on page 4 for guidelines on whose number Employer identification number
to enter. I 1- 1 1 1 1 1 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. person (including a U.S.resident alien).
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 an 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,you are not required to sign the Certification,but you must
provide your correct TIN. (See the instructions on page 4.)
Sign Signature of
Here V.S.person ■ Date •
City of Tybee Island, PO Box 2749, Tybee Island, GA 31328
912-786-4573 I (fax) 912-786-9465
What products/services do you provide to the City of Tybee Island:
To whom shall we direct the Purchase Order?
Sales Contact: Email:
Phone# Fax#
Location:
To whom shall we direct Payment?
A/R Contact: Email:
Phone# Fax#
Remittance Address:
Our terms are Net 30.
Page 12 of 13
♦1
s,.
M
n, Affidavit Verifying Status
for City Public Benefit Application
By executing this affidavit under oath, as an applicant for a City of Tybee Island, Georgia, Business License or
Occupation Tax Certificate, Alcohol License, Taxi Permit, Contract, or other public benefit as referenced in
O.C.G.A. Section 50-36-1,I am stating the following with respect to my application of a City of Tybee Island:
• Business License or Occupational Tax Certificate,
• Alcohol License,
(circle all that apply)
• Taxi Permit,
• Contract
• Other public benefit
for (printed name of natural person applying
on behalf of individual, business, corporation,partnership, or other private entity).
1) I am a United States citizen.
OR
2) I am a legal permanent resident 18 years of age or older or I am an otherwise qualified alien or
non-immigrant under the Federal Immigration and Nationality Act, 18 years of age or older and
lawfully present in the United States. *
In making the above representation under oath, I understand that any person who knowingly and willfully makes a
false,fictitious,or fraudulent statement or representation in an affidavit shall be guilty of a violation of Code Section
16-10-20 of the Official Code of Georgia.
Signature of Applicant
Date
Printed Name
*Alien Registration Number for Non-citizens
SUBSCRIBED AND SWORN BEFORE ME ON THIS
THE DAY OF ,20
Notary Public
My Commission Expires:
Note: O.C.G.A. § 50-36-1(e)(2) requires that aliens under the federal Immigration and Nationality Act, Title 8
U.S.C., as amended,provide their alien registration number. Because legal permanent residents are included in the
federal definition of"alien", legal permanent residents must also provide their alien registration number. Qualified
aliens that do not have an alien registration number may supply another identifying number below:
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