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Home My Public Portal AboutAdams Sanitation_Crestview Trash RFP_Executed Bid documentsATTACHMENT #1 CITY OF CRESTVIEW, FLORIDA REQUEST FOR PROPOSAL (RFP) 23-04-18-PS PROPOSAL FOR "SOLID WASTE COLLECTION AND DISPOSAL SERVICES" SWORN STATEMENT UNDER SECTION 287.133 (3) (A)FLORIDA STATUTES ON PUBLIC ENTITY CRIMES THIS FORM MUST BE SIGNED IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICER AUTHORIZED TO ADMINISTER OATHS. 1. This sworn statement is submitted with Bid, Proposal, or Contract 2. This sworn statement is submitted by Adams Sanitation Holding Company LLC whose business address is 6366 John Diamond Road, Milton, FL 32583 and (if applicable) Federal Employer Identification Number (FEIN) is 82-4256128 (f the entity has no FEIN, include the Social Security Number of the individual signing this sworn statement: 3. My name is Nathan Boyles and my relationship to the entity named above is Chief Trash Office/(%'b„vic er 4. I understand that a "public entity crime" as defined in Paragraph 287.133(a)(g). Florida Statutes means a violation of any state or federal law by a person with respect to and directly related to the transaction of business with any public entity or with an agency or political subdivision of any other state or with the United States, including, but not limited to, any bid or contract for goods or services to be provided to any public entity or any agency or political subdivision of any other state or of the United States and involving antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material misrepresentation. 5. I understand that "convicted" or "conviction," as defined in paragraph 287.133(a)(b), Florida Statutes, means finding of guilt or a conviction of a public entity crime with or without an adjudication of guilt, in any federal or state trial court of records relating to charges brought by indictment or information after July 1, 1989, as a result of a jury verdict, non -jury trial, or entry of a plea of guilty or nolo contendere. 6. I understand that an "affiliate," as defined in Paragraph 287.133(1)(a), Florida Statutes, means: 1. A predecessor or successor of a person convicted of a public entity crime; or 2. An entity under the control of any natural person who is active in the management of the entity and who has been convicted of a public entity crime. The term "affiliate" includes those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in the management of an affiliate. The ownership by one of shares constituting a controlling income among persons when not for fair interest in another person or a pooling of equipment or income among persons when not for fair market value under a length agreement shall be a prima facie case that one person controls another person. A person who was knowingly convicted of a public entity crime in Florida during the preceding 36 months shall be considered an affiliate. RFP #23-04-28-PS SOLID WASTE COLLECTION AND DISPOSAL SERVICES Page 44 of 60 7. I understand that a "person," as defined in Paragraph 287.133(1)(e), Florida Statutes, means any natural person or entity organized under the laws of the state or of the United States with the legal power to enter into a binding contract for the provision of goods or services let by a public entity, or which otherwise transacts or applies to transact business with a public entity. The term "person" includes those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in the management of an entity. 8. Based on information and belief, the statement which I have marked below is true in relation to the entity submitting this sworn statement. (Please indicate which statement applies) Neither the entity submitting this sworn statement nor any officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity nor an affiliate of the entity have been charged with and convicted of a public entity crime subsequent to July 1, 1989. The entity submitting this sworn statement, or one or more of the officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity or an affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. (Please attach a copy of the final order) The person or affiliate was placed on the convicted vendor list. There has been a subsequent proceeding before a hearing officer of the State of Florida, Division of Administrative Hearings. The final order entered by the hearing officer determined that it was in the public interest to remove the person or affiliate from the convicted vendor list. (Please attach a copy of the final order) The person taken by, ( ignaturev\ �y Date: LI / �•�� ac7a3 STATE OF FLORIDA COUNTY OF s not been placed on the convicted vendor list. (Please describe any action Department of General Services.) The foregoing instrument was sworn to (or affirmed), subscribed, and acknowledged before me by means ,� I of physical appearance or online notarization, this 2 I - WI day of 14 OY i \ 202by N6t+VICtvt 13b4 Ieswho is personally known to me or has produced -- as identification. Notary Public My Commission expires: LQ!(oI2o2S Natalie Mize Notary Public State of Florida Comm# HH140640 Expires 6/10/2025 RFP #23-04-28-PS SOLID WASTE COLLECTION AND DISPOSAL SERVICES Page 45 of 60 ATTACHMENT #2 CITY OF CRESTVIEW, FLORIDA REQUEST FOR PROPOSAL (RFP) 23-04-18-PS" PROPOSAL FOR "SOLID WASTE COLLECTION AND DISPOSAL SERVICES" DRUG -FREE WORKPLACE CERTIFICATION The below signed Bidder certifies that it has implemented a drug -free workplace program. In order to have a drug -free workplace program, a business shall: 1. Publish a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the workplace and specifying the actions that will be taken against employees for violations of such prohibition. 2. Inform employees about the dangers of drug abuse in the workplace, the business's policy of maintaining a drug -free workplace, any available drug counseling rehabilitation and employee assistance programs, and the penalties that may be imposed upon employees for drug abuse violations. 3. Give each employee engaged in providing the commodities or contractual services that are under bid a copy of the statement specified in subsection 1. 4. In the statement specified in subsection 1., notify the employees that, as a condition of working on the commodities or contractual services that are under bid, the employee will abide by the terms of the statement and will notify the employer of any conviction of, or plea of guilty or nolo contendere to, any violation occurring in the workplace no later than five (5) working days after such conviction. 5. Impose a sanction on or require the satisfactory participation in drug abuse assistance or rehabilitation program, if such is available in the employee's community, by any employee who is convicted. 6. Make a good -faith effort to continue to maintain a drug -free workplace through implementation of this section. As the person authorized to sign this statement, I certify that this firm complies fully with the above drug - free workplace requirements. COMPANY: Adams Sanitation Holding Company LLC ADDRESS: 6366 John Diamond Road CITY: Milton STATE: FL ZIP CODE: 32583 TELEPHONE NUMB ER:850-537-3282 SIGNATURE: NAME (TYPED OR PRINTED): DATE: 14/24( RFP #23-04-28-PS SOLID WASTE COLLECTION AND DISPOSAL SERVICES Page 46 of 60 ATTACHMENT #3 CITY OF CRESTVIEW, FLORIDA REQUEST FOR PROPOSAL (RFP) 23-04-18-PS PROPOSAL FOR "SOLID WASTE COLLECTION AND DISPOSAL SERVICES" CONFLICT OF INTEREST DISCLOSURE FORM Does any City employee acting as a purchasing agent, or City public officer acting in official or private capacity, or his/her spouse or child own more than 5 of the bidder/Proposer's interest? YES NO X Does any City employee acting as a purchasing agent or City public officer acting in official or private capacity hold any employment or contract with the bidder/Proposer? YES NO If either question number 1 or 2 above has been answered YES, does the bidder/Proposer assert any exemptions related to prohibited employment & business relationships? YES NO If YES, please describe the following: FIRM NAME: BY (PRINTED): BY (SIGNATURE): TITLE: ADDRESS: PHONE NO. E-MAIL RFP #23-04-28-PS SOLID WASTE COLLECTION AND DISPOSAL SERVICES Page 47 of 60 ATTACHMENT #4 CITY OF CRESTVIEW, FLORIDA REQUEST FOR PROPOSAL (RFP) 23-04-15-PS PROPOSAL FOR "SOLID WASTE COLLECTION AND DISPOSAL SERVICES" LIABILITY & INDEMNIFICATION FORM To the fullest extent permitted by law, CONSULTANT shall indemnify and hold harmless CITY, its officers, and employees from liabilities, damages, losses, and costs, including but not limited to reasonable attorney fees, to the extent caused by the negligence, recklessness, or intentionally wrongful conduct of the CONSULTANT and other persons employed or utilized by the CONSULTANT in the performance of this Agreement. Adams Sanitation Holding Co., LLC CONSULTANT'S Company Name Authorized Signa ure — Manual 6366 John Diamond Road, Milton, FL 32583 Nathan Boyles Physical Address Authorized Signature — Typed PO Box 953 Milton, FL 32572 Mailing Address 850-537-3282 Phone Number 850-582-2211 Cellular Number Nathan@adamssanitation.com Email address Chief Trash Officer Title N/A FAX Number Nathan Boyles 850-582-2211 After -Hours Number(s) 4/28/2023 DATE RFP #23-04-28-PS SOLID WASTE COLLECTION AND DISPOSAL SERVICES Page 48 of 60 ATTACHMENT #5 CITY OF CRESTVIEW, FLORIDA REQUEST FOR PROPOSAL (RFP) NO. 23-04-18-PS PROPOSAL FOR "SOLID WASTE COLLECTION AND DISPOSAL SERVICES" CERTIFICATION OF INDEPENDENCE AND NO CONFLICT OF INTEREST By submitting a proposal in response to the Request for Proposals for RFP No. 23-04-18-PS "SOLID WASTE COLLECTION AND DISPOSAL SERVICES" FOR THE CITY OF CRESTVIEW, the undersigned certifies the following: 1. The proposal has been developed independently, without consultation, communication, or agreement with any employee or consultant to the City who has worked on the development of this RFP or with any person serving as a member of the evaluation committee. 2. The proposal has been developed independently, without consultation, communication, or agreement with any other firm or parties, for the purpose of restricting competition. 3. Unless otherwise required by law, the information found in the proposal has not been knowingly disclosed and will not be knowingly disclosed prior to the award of the contract, directly or indirectly, to any other firm. 4. No attempt has been made or will be made by (Name of Firm) to induce any other firm to submit or not to submit a proposal for the purpose of restricting competition. 5. No relationship exists or will exist during the contract period between (Name of Firm) and the City that interferes with fair competition or is a conflict of interest. Sinc Name and Title kk fs (�()ckvIc.,yr RFP #23-04-28-PS SOLID WASTE COLLECTION AND DISPOSAL SERVICES Page 49 of 60 ATTACHMENT #6 CITY OF CRESTVIEW, FLORIDA REQUEST FOR PROPOSAL (RFP) NO. 23-04-18-PS PROPOSAL FOR "SOLID WASTE COLLECTION AND DISPOSAL SERVICES" PUBLIC ACCESS FORM Adams Sanitation Holding Co., LLC, as Proposer, shall comply with the requirements of Florida's Public Records law. In accordance with Section 119.0701, Florida Statutes, Contractor shall: a) Keep and maintain public records required by the public agency in order to perform the service. b) c) 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 under Florida's Public Records Law or as otherwise provided by law. d) Ensure that 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 this contract if the Contractor does not transfer the records to the public agency: and e) 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 this 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. f) If the Contractor has questions regarding the application of Chapter 119, Florida Statutes, to the Contractor's duty to provide public records relating to this Agreement, the Contractor shall contact the Custodian of Public Records at: Maryanne Schrader, City Clerk City of Crestview 198 North Wilson Street P.O. Box 1209 Crestview, Florida 32536 (850) 682-1560 Extension 250 citvclerk(Ecitvofcrestview.ora RFP #23-04-28-PS SOLID WASTE COLLECTION AND DISPOSAL SERVICES Page 50 of 60 g) In the event the public agency must initiate litigation against the Contractor in order to enforce compliance with Chapter 119, Florida Statutes, or in the event of litigation filed against the public agency because the Contractor failed to provide access to public records responsive to a public record request, the public agency shall be entitled to recover all costs, including but not limited to reasonable attorneys' fees, cos .' , , itness, fees, and expert witness fees extended as part of said liti:. '. .nd a .sequent appeals Signature lAir;,��o.v‘ 10 5/ inc\\A0, fir [Remainder of this page left intentionally blank] RFP #23-04-28-PS SOLID WASTE COLLECTION AND DISPOSAL SERVICES Page 51 of 60 BID BOND: ZAX50004 Attachment 8 BID BOND KNOW ALL PERSONS BY THESE PRESENTS, that we, Adams Sanitation Holding Company, LLC (hereinafter called "Principal"), and Axis Insurance Company as Surety (hereinafter called "Surety"), are held and firmly bound unto the City of Crestview, Florida (hereinafter called "Owner"), in the sum of $500,000.00 in lawful money of the United States of America, for payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators, and successors, jointly and severally, firmly by these presents: WHEREAS, the Principal contemplates submitting or has submitted a bid or proposal (the "Bid") to Owner for: RFP 23-04-28-PS SOLID WASTE COLLECTION AND DISPOSAL SERVICES WHEREAS, it was a condition precedent to the submission of said Bid that a certified check or Bid Bond in the amount of be submitted with said Bid as a guaranty that the Principal would, if awarded the contract, enter into a written contract with Owner and furnish a Performance Bond in an amount equal to $3,000,000.00 for the performance of said contract, after written notice being awarded said contract by Owner. NOW, THEREFORE, THE CONDITIONS OF THIS OBLIGATION ARE SUCH, that if the Bid of the Principal herein be accepted and said Principal, within ten consecutive calendar days after written notice being given of such acceptance, enters into a written contract with Owner, and furnishes a Performance Bond satisfactory to Owner, then this obligation shall be void; otherwise, the sum herein stated shall be due and payable to Owner, and the Surety herein agrees to pay said sum immediately upon demand of said Owner, in good and lawful money of the United States of America, as liquidated damages for failure thereof of said Principal. [Remainder of this page left intentionally blank, signatures are on the following page] RFP #23-04-28-PS SOLID WASTE COLLECTION AND DISPOSAL SERVICES Page 55 of 60 IN WITNESS WHEREOF, the said Principal and the said Surety have duly executed this bond the 27th day of April , 20 23 PRINCIPAL Company: (Corporate Seal) Signature Nathan Boyles Printed Name (.i- � „4,4t�aqvt Pr`' Title Witnesses: i April 27, 2023 Date Signatur Ateel , ,ei + Printed Name Signature ,____\ (l n t +� _r" R Gr GA -A—) Printed Name FLORIDA RESIDENT AGENT FOR SURETY Patricia Lane Schmaltz Printed Name 1300 N. Westshore Blvd., #110 Tampa, FL 33607 Address 813.282.1965 Phone RFP #23-04-28-PS SOLID WASTE COLLECTION AND DISPOSAL SERVICES SURETY Company: (Corporate Seal) Laurie M Crowley Printed Name Attorney -In -Fact Title April 27, 2023 Date Signature Scott Reis Printed Name Signature Kathaleen Stuve Printed Name NOTE: Power of attorney and certification of authority for issuance and current status thereof for Attorney - in -Fact and for Surety Company must be attached. Proof that Surety is licensed to transact business in the State of Florida must be submitted with this Bond. • Page 56 of 60 AXIS J226- r'— AXIS INSURANCE Surety Bond Claims 10000 Avalon Blvd Suite 200 Alpharetta GA 30009 COVID 19 Notice: We are sending most bonds out electronically due to the COVID-19 pandemic. The attached scanned Power of Attorney may show "Void" in the background, however, please consider it valid. If you have any concerns, please use the contact information below to verify. BOND VERIFICATION Should you wish to verify the authenticity of this bond, please send your request, including a copy of the bond, via email to: suretv(axiscapital.com OR Contact: Laurie M. Crowley — Sr. Administrative Assistant email: Iaurie.crowlev(u( axiscapital.com phone: 908.508.4310. OR Richard Zarandona — Executive Vice President email: rich.zarandonatc�axiscapital.com BONDS CLAIMS OR NOTICES Should you wish to file any notices to the Surety Department for the attached AXIS Surety Bond(s) they should be sent to: AXIS Insurance Company 10000 Avalon Blvd Suite 200 Alpharetta GA 30009 Attention: Surety Bond Claims suretv(a�axiscapital. com axiscapital.com POWER OF ATTORNEY AXIN-1014 Know Alt Men by These Presents: That AXIS Insurance Company, an Illinois property and casualty company, (the "Company") does hereby appoint: Richard Zarandona, Victoria Szot, Scott Reis, and Laurie M. Crowley, all of Berkeley Heights, NJ as its true and lawful Attomey(s)-In-Fact, to make, execute, seal and deliver for and on its behalf as surety, bonds and undertakings, such documents to be valid as though executed by the Company on its own behalf The Company may revoke this appointment at any time. EXCEPTION: NO AUTHORITY is granted to make, execute, seal and deliver bonds or undertakings that guarantee the payment or collection of any promissory note, check, draft or letter of credit. This Power of Attorney is signed, sealed and certified under and by the authority of resolutions adopted by unanimous written consent of the Board of Directors of the Company on April 1, 2016 and on January 10, 2020: RESOLVED, that upon the recommendation of Richard Zarandona, Victoria Szot, Scott Reis and Laurie M. Crowley, acting singly, are hereby appointed as the Company's true and lawful Attomeys-in-Fact to make, execute, seal and deliver for and on behalf of the Company, as surety, bonds and undertakings, and any such documents required in connection with such bonds and undertakings, to be valid as though executed by the Company on its own behalf. This Power of Attorney is signed, sealed and certified under and by the authority of resolutions adopted by unanimous written consent of the Board of Directors of the Company on July 12, 2013: RESOLVED, that any Vice President, Surety, acting singly, shall have the power and authority to appoint and revoke Attorneys -In -Fact to make, execute, seal and deliver for and on behalf of the Company, as surety, bonds and undertakings, such documents to be valid as though executed by the Company on its own behalf, subject to the terms and conditions of the subject Brokerage Agreements, In Witness Whereof, AXIS Insurance Company has caused this instrument to be signed and its corporate seal to be affixed by a duly elected and qualified officer, this I l th day of March, 2020. Attested and Ce.'fied AXIS Insuran ompan By: Printed Name: Andrew M. Weissert Title: Senior Vice President STATE OF 6e COUNTY OF./ Before me personally came Andrew M. Weissert Senior Vice President of AXIS Insurance Company to me known to be the individual and officer described herein, who acknowledged that they being duly authorized signed, sealed with the corporate seal and delivered the foregoing instrumentbythe authority and direction of said Company. 44V. ENDOil q��'I'#, VA it 4 t ..or �y ts$z:FiT'Z Iffif• S o2 ': ti.•.... I Frances R. Mathis Assistant Secretary of AXIS Insurance Company, do hereby certify that the attached Power of Attorn,ey type' 11, 2020 on behalf of the person(s) as listed above is a true and correct copy and the same has been in full force and effect since the date thereof and is in fuforce and effect on the date of this certificate; and I do further certify that the said Andrew M. Weissert , who executed the Power of Attorney, was a duly elected officer of AXIS Insurance Company on the date of the execution of the attached Power of Attorney. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my official CERTIFICATION IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the corporate seal of AXIS Insurance Company on this the By: Printed Name: Frances R. Mathis Title: Assistant Secrctaz, [Company Seal] STATE OF Florida Attachment 9 NONCOLLUSION AFFIDAVIT 0 v e+, : 1916, _.co COUNTY OF Okaloosa, being first duly sworn deposes and says that: 1. He (it) is the Chief Trash Officer hiiN u02 {— Adams Sanitation Holding Company LLC , the Bidder that Tias submitted the attached Bid; of 2. He is fully informed respecting the preparation and contents of the attached Bid and of all pertinent circumstances respecting such Bid; 3. Such Bid is genuine and is not a collusive or sham Bid; 4. Neither the said Bidder nor any of its officers, partners, owners, agents, representatives, employees, or parties in interest, including this affidavit, have in any way, colluded, conspired, connived or agreed, directly or indirectly, with any other Bidder, firm or person to submit a collusive or sham Bid in connection with the Contract for which the attached Bid has been submitted; or to refrain from bidding in connection with such Contract; or have in any manner, directly or indirectly, sought by agreement or collusion, or communication, or conference with any Bidder, firm, or person to fix the price or prices in the attached Bid or of any other Bidder, or to fix any overhead, profit, or cost elements of the Bid price or the Bid price of any other Bidder, or to secure through any collusion, conspiracy, connivance, or unlawful agreement any advantage against (Recipient), or any person interested in the proposed Contract; 5. The price or prices quoted in the attached Bid are fair and proper and are not tainted by any collusion, conspiracy, • • ance, or unlaw agreement on the part of the Bidder or any other of its agents, represe• ives, owners, employees or •arties in interest, including this affidavit. By , it/ 5,�� Sworn and subscribed to before me this 2.(( day of pit 1 , 202, in the State of ROYI CX_ , County of &Ccb° 0. . 1Notary Public My Commission Expires: (')LP) /U J 20ZS Natalie Mize Notary Public State of Florida comm# HH140640 Expires 6/10/2025 RFP #23-04-28-PS SOLID WASTE COLLECTION AND DISPOSAL SERVICES Page 58 of 60 ADDENDUM ACKNOWLEDGEMENT FORM City of Crestview Solid Waste Collection and Disposal Services 23-04-28-PS ADDENDUM NO. 2 Listed below are the dates of issue for each addendum received in connection with this solicitation: Addendum No. Addendum No. Addendum No. Dated: 9 I 1 LA 12023 Dated: 1-1 125 12025 Dated: ElNo Addenda issued for this solicitation Name of Firm: 1 Ciale►IS SCiV1�rq,��dvt�i0`C��v1G�GO, L Nci+hc&v, -0o11es Authorized Representative's Name: Title: G► I eC -T YGSVI t C eq(lA Qtv1 & Signature of of Authorized Representative: Email: 1'1 C1+ n 11 CI d G V1(r9SC1 to ; +Cti i O V1 CO Y►/k Phone Contact: % 5 O - 5$ By signing form, you acknowledge receipt of the addendums listed above and that you have a complete understanding of the material contained in the addendum(s). -END OF ADDENDUM-