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HomeMy Public PortalAboutResponse - Quintech Solutions_Redacted.pdf SEALED BID ITB No. 2021-759 Pavilion Renovation March 9, 2021 2:00 PM Submitted To: City of Tybee Island, GA 403 Butler Avenue Tybee Island, GA 31328 Submitted By: 2550 Lithonia West Drive Lithonia, Georgia 30058 Mailing Address: 102 Sangaree Park Court, Suite 4 Summerville, SC 29486 BUSINESS SENSITIVE - PROPRIETARY This proposal or quotation includes data that shall not be disclosed outside the City of Tybee Island, GA (CTI) and shall not be duplicated, used, or disclosed—in whole or in part—for any purpose other than to evaluate this proposal or quotation. If, however, a contract is awarded to this offeror or quoter as a result of—or in connection with—the submission of this data, the CTI shall have the right to duplicate, use, or disclose the data to the extent provided in the resulting contract. This restriction does not limit CTI the right to use information contained in this data if it is obtained from another source without restriction. Sheets with data subject to this restriction are appropriately marked. DIGITAL COPY 1.0, A IA DocumentA310 TM -2010 Bid Bond 933 -BB CONTRACTOR: (Name, legal status and address) Quintech Solutions, Inc. 102 Sangaree Park Court, Suite 4 Summerville, SC 29486-5327 OWNER: (Name, legal status and address) City of Tybee Island 403 Butler Avenue Tybee Island, GA 31328 BOND AMOUNT: 5° o of Maximum Amount Bid SURETY: (Name, legal status and principal place of business) RLI Insurance Company 9025 N. Lindbergh Drive Peoria, IL 61615-1431 PROJECT: (Name, location or address, and Project number, if any) ITB No. 2021- 759: Pavilion Renovation Memorial Park Tybee Island, Georgia The Contractor and Surety are bound to the Owner in the amount set forth above, for the payment of which the Contractor and Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointly and severally, as provided herein. The conditions of this Bond are such that if the Owner accepts the bid of the Contractor within the time specified in the bid documents, or within such time period as may be agreed to by the Owner and Contractor, and the Contractor either (1) enters into a contract with the Owner in accordance with the terms of such bid, and gives such bond or bonds as may be specified in the bidding or Contract Documents, with a surety admitted in the jurisdiction of the Project and othenvise acceptable to the Owner, for the faithful performance of such Contract and for the prompt payment of labor and material furnished in the prosecution thereof; or (2) pays to the Owner the difference, not to exceed the amount of this Bond, between the amount specified in said bid and such larger amount for which the Owner may in good faith contract with another party to perform the work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. The Surety hereby waives any notice of an agreement between the Owner and Contractor to extend the time in which the Owner may accept the bid. Waiver of notice by the Surety shall not apply to any extension exceeding sixty (60) days in the aggregate beyond the time for acceptance of bids specified in the bid documents, and the Owner and Contractor shall obtain the Surety's consent for an extension beyond sixty (60) days ADDITIONS AND DELETIONS: The author of this document has added information needed for its completion. The author may also have revised the text of the original AIA standard form. An Additions and Deletions Report that notes added information as well as revisions to the standard form text is available from the author and shou;d be reviewed. A vertical line in the left margin of this document indicates where the author has added necessary information and where the author has added to or deleted from the original AIA text. This document has important legal consequences. Consultation with an attorney is encouraged with respect to its completion or modification. Any singular reference to Contractor, Surety, Owner or other party shall be considered plural where applicable. AIA Document A310n, — 2010. Copyright 1963, 1970 and 2010 by The American Institute of Architects. All rights reserved. WARNING: This AIA Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA Document, or any portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law. 1 U ilnes s anielle Smith If this Bond is issued in connection with a subcontractor's bid to a Contractor, the term Contractor in this Bond shall be deemed to be Subcontractor and the term Owner shall be deemed to be Contractor. When this Bond has been fumished to comply with a statutory or other legal requirement in the location of the Project, any provision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted herefrom and provisions conforming to such statutory or other legal requirement shall be deemed incorporated herein. When so furnished, the intent is that this Bond shall be construed as a statutory bond and not as a common law bond. Signed and sealed this 9th Day of February, 2021 '- h• Quintech Solutions, Inc. (Principal) A' t F`}ea . Iff h S a 407 a (Title) President: Harold C. Gillens RLI Insurance Company (Surety) 1. (Title) Attorney-in-Fact7Kimber D. San ago (Seal) AIA Document A310TM —2010. Copyright m 1963,1970 and 2010 by The American Institute of Architects. All rights reserved. WARNING: Th.s AIA Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA` Document. or any portion of It. may result In severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the Iaw- 2 POWER OF ATTORNEY RLI Insurance Company Contractors Bonding and Insurance Company 9025 N. Lindbergh Dr. Peoria, IL 61615 Phone: 800-645-2402 Know All Men by These Presents: That this Power of Attorney is not valid or in effect unless attached to the bond which it authorizes executed, but may be detached by the approving officer if desired. That RLI Insurance Company and/or Contractors Bonding and Insurance Company, each an Illinois corporation, (separately and together, the "Company") do hereby make, constitute and appoint: Joshua Etemadi, Edin Zukanovic, Kimberly D. SantiaLo,Nebivou Avnudointly or severally in the City of Sterling , State of Virginia its true and lawful Agent(s) and Attorney(s) in Fact, with full power and authority hereby conferred, to sign, execute, acknowledge and deliver for and on its behalf as Surety, in general, any and all bonds and undertakings in an amount not to exceed Twenty Five Million Dollars ( $25,000,000.00 ) for any single obligation. The acknowledgment and execution of such bond by the said Attorney in Fact shall be as binding upon the Company as if such bond had been executed and acknowledged by the regularly elected officers of the Company. RLI Insurance Company and/or Contractors Bonding and Insurance Company, as applicable, have each further certified that the following is a true and exact copy of a Resolution adopted by the Board of Directors of each such corporation, and is now in force, to -wit: "All bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President, or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys in Fact or Agents who shall have authority to issue bonds, policies or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile." IN WITNESS WHEREOF, the RLI Insurance Company and/or Contractors Bonding and Insurance Company, as applicable, have caused these presents to be executed by its respective Vice President with its corporate seal affixed this 23rd day of September , 2019 . State of Illinois SS County of Peoria SEAL; kuNotS • On this 23rd day of September , 2019 , before me, a Notary Public, personally appeared Barton W. Davis , who being by me duly sworn, acknowledged that he signed the above Power of Attorney as the aforesaid officer of the RLI Insurance Company and/or Contractors Bonding and Insurance Company and acknowledged said instrument to be the voluntary act and deed of said corporation. By: 1P61(411/14- CfMtifiL Gretchen L. Johnigk Notary lyliblia. GE Cpf• • �� n v1�1TC r,•• By: L� - ' ' K Jean M • T%1} 377165562V12 ttl i" \ RLI Insurance Company Contractors Bonding and Insurance Company By: Barton W. Davis CERTIFICATE Vice President 1, the undersigned officer of RLI Insurance Company and/or Contractors Bonding and Insurance Company, do hereby certify that the attached Power of Attorney is in full force and effect and is irrevocable; and furthermore, that the Resolution of the Company as set forth in the Power of Attorney, is now in force. In testimony whereof, I have hereunto set my hand and the seal of the RLI Insurance Company and/or Contractors Bonding and Insurance Company this 9th day of March 2021 RLI Insurance Company Contractors Bonding and Insurance Company • tephenson ° Corporate Secretary A0058817 ATTACHMENT A CITY OF TYBEE - INSTRUCTIONS TO BIDDER SIGNATURE SHEET The Bidder certifies that he she has examined all documents contained in this ITB package, and is familiar with all aspects of the ITB and understands fully all that is required of the successful Bidder. The Bidder further certifies that his her Bid will not be withdrawn for sixty (60) days from the date on which his bid is submitted to the City. The Bidder agrees, if awarded this Contract, he she will: A. Furnish, upon receipt of an authorized City of Tybee Island Purchase Order, all items indicated thereon as specified in this ITB for the bid amount; or, B. Enter a contract with City of Tybee Island to do and/or furnish everything necessary to provide the service and/or accomplish the work as stated and/or specified in this ITB for the bid amount, and; QUINTECH SOLUTIONS, INC. 03/09/21 DATE President SIGNATURE TITLE (843) 695-0170 TELEPHONE NUMBER MINORITY/FEMALE BUSINESS DEVELOPMENT PROGRAM: City of Tybee Island City Council established goals oriented to increase participation of minority and female owned businesses, through MBE WBE certification and development In order to accurately document participation, businesses submitting bids, quotes or proposals are encouraged to report ownership status. A minority or women business is defused as a business that is at least 5100 owned and managed by minority or women. A responder that is certified by any agency of the Federal Government or State of Georgia may submit a copy oftheir certification with their bid as proof of qualifications. Bicker that intends to engage in joint ventures or utilize sub - consultants must submit a report of Minority/Women Business Enterprise participation to Melissa Freeman, P.O. Box 2749, and City of Tybee Island, GA 31328. African-American\Black V Asian American Hispanic Native American Alaskan Indian Female Certification: View Certification List Submit Change Request Add Date Alert Vendor Capabilities BUSINESS NAME SYSTEM VENDOR NUMBER PRIMARY OWNERS NAME EUINIC GROUP GENDER Quintech SO10110ns, Inc 20384218 Mr. Harold Gillen Black American Male Certification Information CERTIFYING AGENCY CERTIFIUTION TYPE EFFECTIVE DATE RENEWAL DATE Metropolitan Atlanta Rapid Transit Authority DBE - Disadvantaged Business Enterprise 12/5/2020 12/5/2021 Contact Information MAIN COMPANY EMAIL MAIN INTONE MAIN FAX MAIN COMPANY WEBSITE InfoPqulntechsolutIonsInc.com 8436950170 843695-0222 httpJ/www.qulntechsolutlonslnc.com Addresses PIIYSICAL. ADDRESS MAILING ADDRESS 2550 Lithonla West Drive Suite 4 Lithonla, GA 30058 102 Sangaree Park Court Suite4 Summerville, SC 29486 Business Capabilities BUSINESS CERTIFIED FOR Security Consulting and ConstmcUan Management 1 ULL DESCRIPTION OF CAPARII INLS/PROIHICTS Construction management, industrial building (except warehouses) Other Management Consulting Services Other Sciendac and Technical Consulting Services Security Systems Services (except Locksmiths) COMMODITY CODES NAICS 236210 NAICS 541618 NAILS 541690 NAICS 561621 Construction management, industrial building (except warehouses) (Halm) Other Management Consulting Services (Holm) Other Sdentlf c and Technkal Consulting servkes (Harr) Security Systems Services (except Locksmiths) (56 ) Owner Ethnicity and Gender LTI INIC GROUP GENDER Black American Male Location COUNTY Certification List Lotsntu.Lmma CopWgM 0 2021 82tiow. All rglxs ieserwd. Dame I P861 bilk= , I Pmrz to Pnr• I bans)+1a ATTACHMENT B CONTRACTOR AFFIDAVIT under O.C.G.A. § 13-10-91(b) (1) By executing this affidavit, the undersigned contractor verifies its compliance with O.C.G.A. § 13- 10-91, stating affirmatively that the individual, firm or corporation which is engaged in the physical performance of services on behalf of CITY OF TYBEE ISLAND has registered with, is authorized to use and uses the federal work authorization program commonly known as E -Verify, or any subsequent replacement program, in accordance with the applicable provisions and deadlines established in O.C.G.A. § 13-10-91. Furthermore, the undersigned contractor will continue to use the federal work authorization program throughout the contract period and the undersigned contractor will contract for the physical performance of services in satisfaction of such contract only with subcontractors who present an affidavit to the contractor with the information required by O.C.G.A. § 13-10-91(b). Contractor hereby attests that its federal work authorization user identification number and date of authorization are as follows: Federal Work Authorization User Identification Number August 13, 2012 Date of Authorization Quintech Solutions, Inc. Name of Contractor Pavilion Renovation Name of Project City of Tybee Island, GA Name of Public Employer I hereby declare under penalty of perjury that the foregoing is true and correct. Execltte4 on March, 04 , 2021_ in Summerville (city), SC (state). Signature of Authorized Officer or Agent Harold Gillens, President Printed Name and Title of Authorized Officer or Agent SUBSCRIBED AND SWORN BEFORE ME ON THIS THE 04 DAY OF March, 20 21 NOTARY PUBLIC My Commission Expires: ! 27/15 ATTACHMENT D O.C.G.A. § 50-36-1(e)(2) Affidavit By executing this affidavit under oath, as an applicant for a(n) Construction contract for a public benefit as referenced in O.C.G.A. § 50-36-1, from the CITY OF TYBEE ISLAND, Georgia, the undersigned applicant verifies one of the following with respect to my application for a public benefit: 1) V _ I am a United States citizen. 2) I am a legal permanent resident of the United States. 3) 1 am a qualified alien or non-immigrant under the Federal Immigration and Nationality Act with an alien number issued by the Department of Homeland Security or other federal immigration agency. My alien number issued by the Department of Homeland Security or other federal immigration agency is: The undersigned applicant also hereby verifies that he or she is 18 years of age or older and has provided at least one secure and verifiable document, as required by O.C.G.A. § 50-36-1(e)(1), with this affidavit. The secure and verifiable document provided with this affidavit can best be classified as: SC Driver's License 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 will be guilty of a violation of O.C.G.A. § 16-10-20, and face criminal penalties as allowed by such criminal statute. Executed in Summerville (city), South 1Cgolina (state). Signature of Applicant Harold Gillens Printed Name of Applicant SUBSCRIBED AND SWORN BEFORE ME ON THE 04 DAY OF March c" --NOT Y PUBLIC My Commission Expires: of/2T/ 25 , 20 21 UINTECH I SOLUTIONS SECURITY CONSULTING ENGINEERING CONSTRUCTION SERVICES HAROLD GILLENS S.C. DRIVER'S LICENSE Secure and Verifiable Document f-05 /a-Caroli . _DRIVER'S LUCENS RAIIP SC & MAILING ADDRESS 102 Sangaree Park Court, Suite 4 Summerville- SC 29486 (843) 695-0170 o (843) 695-0222 f www.QuintechSolutionslnc.com GA ADDRESS 2550 Lithonia West Drive Lithonia, GA 30058 ATTACHMENT E CITY OF TYBEE ISLAND VENDOR INFORMATION Vendor Name: QUINTECH SOLUTIONS, INC. Product or Services Provided: Construction Services Sales Contact Information Contact: HAROLD GILLENS Email: Info@QuintechSolutionslnc.com Phone: 843 695 0170 Fax: 843 695 0222 Address: 2550 Lithonia West Drive, Lithonia, GA 30058; 102 Sangaree Park Court, Suite 4, Summerville, SC 29486 Accounts Receivable Information Contact: LEOLA RICHARDS Phone: 843 695 0170 Email: Accountant@QuintechSolutionslnc.com Fax: 843 695 0222 Remittance Address: 102 Sangaree Park Court, Suite 4, Summerville, SC 29486 Federal Tax Id #: 58-2337331 Attach Copy of W-9 and Occupational Tax Certificate Provide Copy of Worker's Comp Coverage when providing any service involving labor on City property. Our terms are net 30 Form —9 (Rev. OWctober 201 tl) Department of the Treaswy Internal Revenue Service 1 ► Go to www.irs.gov/FormW9 for instructions and the latest Information. Request for Taxpayer Identification Number and Certification Give Form to the requester. Do not send to the IRS. 1 Name (as shown on your income tax retum). Name is required on this line; do not leave this line blank. QUINTECH SOLUTIONS, INC. 2 Business name/disregarded entity name, if different from above 3 Check appropriate box for federal tax classification of the person whose name Is entered on line 1. Check only one of the following seven boxes. ❑ Indivktuaysole proprietor or ❑ C Corporation 0 S Corporation ❑ Partnership ❑ Trust/estate single -member LLC ❑ Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership) ► Note: Check the appropriate box in the line above for the tax classification of the single -member owner. Do not check LLC if the LLC is classified as a single -member LLC that is disregarded from the owner unless the owner of the LLC la another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single -member LLC that Is disregarded from the owner should check the appropriate box for the tax classification of its owner. ❑ Other (see instructions) ► 5 Address (number, street, and apt. or suite no.) See instructions. 4 Exemptions (codes apply only to certain entitles, not Individuals; see Instructions on page 3): Exempt payee code (if an Fxemnptan from FATCA code Of any) gpp6u b accounts maintained calfskin 102 SANGAREE PARK COURT, SUITE 4 8 City, state, and ZIP code SUMMERVILLE, SC 29486 7 List account number(s) here (optional) Requesters name and address (optional) Part I Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The 11N provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a T1N, later. Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and Number To Give the Requester for guidelines on whose number to enter. 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! 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, you p nk}) 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/For►W9. Purpose of Form An individual or entity (Form W-9 requester) who is required to file an information retum with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number (111N), adoption taxpayer identification number (ATiN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an infomnation return. Examples of information retums include, but are not limited to, the following. • Form 1099-INT (interest earned or paid) Date 1 L'f31ZUfiiZY I i r 2 —oz.-` • Form 1099-DIV (dividends, including those from stocks or mutual funds) • Form 1099-MISC (various types of income, prizes, awards, or gross proceeds) • Form 1099-B (stock or mutual fund sales and certain other transactions by brokers) • Form 1099-S (proceeds from real estate transactions) • Form 1099-K (merchant card and third party network transactions) • Form 1098 (home mortgage interest). 1098-E (student loan interest), 1098-T (tuition) • Form 1099-C (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (Including a resident alien), to provide your correct TIN. if you do not return Form W-9 to the requester with a T1N, you might be subject to backup withholding. See What is backup withholding, later. Cat. No. 10231X Form W-9 (Rev. 10-2018) U I NTECH I SOLUTIONS SECURITY CONSULTING ENGINEERING CONSTRUCTION SERVICES STONECREST BUSINESS LICENSE CITY OF STONECREST rxe CITY or BUSINESS LICENSE STRNECAE5T OCCUPATIONAL TAX CERTIFICATE 3120 STONECREST BLVD GEORGIA- STONECREST, GA 30038 DATE ISSUED: 01/19/2021 EXPIRES: 12/31/2021 MAIL TO: OUINTECH SOLUTIONS, INC 102 SANGAREE PARK CT SUITE 4 SUMMERVILLE SC 29486 NON REFUNDABLE - NON TRANSFERABLE 2021 ACCOUNT NUMBER: BL18-000317 BUSINESS NAME: QUINTECH SOLUTIONS INC DESCRIPTION: COMMERCIAL AND INSTITUTIONAL BUILDING CONSTRUCTION NAICS CODE 236220 BUSINESS LOCATION 2550 LITHONIA WEST DR STONECREST, GA 30058 THIS LICENSE MUST BE POSTED IN PUBLIC VIEW SC / MAILING ADDRESS 102 Sangaree Park Court, Suite 4 Summerville, SC 29486 (843) 695-0170 o I (843) 695-0222 f www.QuintechSolutionslnc.com GA ADDRESS 2550 Lithonia West Drive Lithonia, GA 30058 Client#: 1811350 QUINTSOLI ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD!YYYY) 5/22/2020 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER USI Insurance Services LLC 6100 Fairview Road, Suite 800 Charlotte, NC 28210 855 874-1396 INSURED Quintech Solutions, Inc. 102 Sangaree Park Court, Suite 4 Summerville, SC 29486 CONTACTJane McInnis NAME: PHONE 980-495-0870 A/C.,No, Ext�: A DRESS: .ane.mcinnis@usi.com INSURER(S) AFFORDING COVERAGE FAX LAIC, Not: NAIC # INSURER A : Cincinnati Specialty Underwriting 13037 INSURER B : American Builders insurance Company INSURER C : INSURER D : 11240 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LSTED 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 POL CIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. R LTR TYPE OF INSURANCE A°R S SUBR R POLICY NUMBER POLICY EFF D( {MMID YYYY} POLICY EXP fMM1D YVYYI LIMITS A X COMMERCIAL GENERAL LIABILITY X CSU0150984 05/19/2020 05/19/2021 OCCURRENCE EACHEA S1,000,000 CLAIMS -MADE X OCCUR PRE �� ISES {Ea M ocwErrrance} S100,000 MED EXP (Any one person) $ 5.000 X BI/PD Ded:5,000 PERSONAL & ADV INJURY S1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L X ' AGGREGATE LIMIT APPLIES PER: POLICY JECOT LOC OTHER: PRODUCTS - COMP/OP AGG 52,000,000 $ AUTOMOBILE LIABILITY — — SCHEDULED AUTOS NON -OWNED AUTOS ONLY COMBINED SINGLE LIMIT (Ea accident} $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per acadentl $ S A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE CSU0151003 05/19/2020 05/19/2021 EACH OCCURRENCE $2,000,000 AGGREGATE $ DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY AFYICER/MEMBER PROPRIETOR PAR NERJE ECUTIVE (Mandatory in NH) If yes. describe under DESCRIPTION OF OPERATIONS below YY N / A X WCV0303214 05/19/2020 05/19/2021 X PER TE OTH- ER E.L. EACH ACCIDENT $1,000,000 E L. DISEASE -EA EMPLOYEE $1,000,000 EL DISEASE - POLICY LIMIT $1,000,000 111, DESCRIPTION OF OPERATIONS ! LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) ** Workers Comp Information -- Proprietors/Partners/Executive Officers/Members Excluded: Harold Gillens CERTIFICATE HOLDER CANCELLATION PROOF ONLY 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 LS -O )tAtL . "nit d © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S28834025/M28831250 NJM92 Certificate Holder W M BROWN JR INC PO BOX 1339 HOLLY HILL, SC 29059 1-803-496-3080 Certificate of Insurance PROGREll/UE COMMERC/AL Policy number: 02184624-0 Underwritten by: PROGRESSIVE NORTHERN INSURANCE CO June 3, 2020 Page 1 of 2 PROOF ONLY ; Insured QUINTECH SOLUTIONS, INC 102 SANGAREE PARK CT. STE 4 SUMMERVILLE, SC 29486 Agent/Surplus Lines Broker W M BROWN 1R INC PO BOX 1339 HOLLY HILL, SC 29059 This document certifies that insurance policies identified below have been issued by the designated insurer to the insured named above for the period(s) indicated. This Certificate is issued for information purposes only. It confers no rights upon the certificate holder and does not change, alter, modify, or extend the coverages afforded by the policies listed below. The coverages afforded by the policies listed below are subject to all the terms, exclusions, limitations, endorsements, and conditions of these policies. Policy Effective Date: May 31, 2020 Insurance coverage(s) Policy Expiration Date: May 31, 2021 Limits BODILY INJURY/PROPERTY DAMAGE $1,000,000 COMBINED SINGLE LIMIT UNINSURED MOTORIST BODILY INJURY $1,000,000 COMBINED SINGLE LIMIT $1,000,000 COMBINED SINGLE LIMIT UNDERINSURED MOTORIST BODILY INJURY EMPLOYER'S NON -OWNED AUTO BIPD $1,000,000 COMBINED SINGLE LIMIT / $1,000,000 COMBINED SINGLE LIMIT HIRED AUTO BODILY INJURY/PROPERTY DAMAGE Description of LocationNehicles/Special Items Scheduled autos only 2014 CHEVROLET SILVERADO C1500 3GCUKTECOEG542556 UNINSURED MOTORIST PROPERTY DAMAGE INCLUDED IN COMBINED SINGLE LIMIT UNDERINSURED MOTORIST PROPERTY DAMAGE INCLUDED IN COMBINED SINGLE LIMIT MEDICAL PAYMENTS $5,000 COMPREHENSIVE $500 W/$0 GLASS DED COLLISION $500 DED 2020 GMC SIERRA Cl 500/K1 3GTP8DED5LG1 58103 UNINSURED MOTORIST PROPERTY DAMAGE UNDERINSURED MOTORIST PROPERTY DAMAGE MEDICAL PAYMENTS COMPREHENSIVE COLLISION INCLUDED IN COMBINED SINGLE LIMIT INCLUDED IN COMBINED SINGLE LIMIT $5,000 $500 W/$0 GLASS DED $500 DED Continued ATTACHMENT F CERTIFICATION REGARDING DEBARMENT INSTRUCTIONS FOR CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION: By signing and submitting this bid, the prospective lower tier participant is providing the signed certification set out below. 1. The certification referred to in this paragraph is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the City of Tybee Island may pursue available remedies, including suspension and/or debarment. 2. The prospective lower tier participant shall provide immediate written notice to the City if at any time the prospective lower tier participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 3. The terms "covered transaction," "debarred." "suspended," "ineligible," "lower tier covered participant," "persons," "lower tier covered transaction," "principal," "bid," and "voluntarily excluded," as used in this paragraph, have the meanings set out in the Definitions and Coverage sections of rules implementing Executive Order 12549, 49 CFR part 29. 4. The prospective lower tier participant agrees by submitting this bid that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized in writing by the City. 5. The prospective lower tier participant further agrees by submitting this bid that it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion — Lower Tier Covered Transaction," without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 6. A participant in a covered transaction may rely upon certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principles. Each participant may, but is not required to, check the Nonprocurement List issued by U.S. General Service Administration. 7. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this paragraph. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 8. Except for transactions authorized under paragraph 4 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the City may pursue available remedies, including suspension and/or debarment. NAME OF COMPANY: QUINTECH SOLUTIONS, INC. COMPANY TAX ID: 58-2337331 NAME OF AUTHORIZED REPRESENTATIVE: Harold Gillens TITLE OF AUTHO REPRESENTATIVE: President SIGNATURE: c DATE: 03/04/2021 ATTACHMENT G DRUG FREE WORKPLACE CERTIFICATION The undersigned certifies that the provisions of Code Sections 50-24-1 through 50-24-6 of the Official Code to Georgia Annotated, related to the Drug Free Workplace have been complied with in full. 1.A drug -free workplace will be provided for the employees during the performance of the contract; and; 2.Each sub -contractor under the direction of the Contractor shall secure the following written certification: QUINTECH SOLUTIONS, INC. (Contractor) certifies to City of Tybee Island that a drug -free workplace will be provided for the employees during the performance of any contract with the City. Pursuant to paragraph (7), of subsection (B) of Code Section 50-24-3. Also, the undersigned further certifies that he she will not engage in the unlawful manufacture, sale, distribution, dispensation, possession or use of a controlled substance or marijuana during the performance of the contract. President SIGNATURE TITLE QUINTECH SOLUTIONS, INC. MP►RCA{ (4, 20a? COMPANY DATE Subscribed and sworn to before me on this 04 day of March , 2021 by Harold Gillens representing him/herself to be President of the company named herein. .Comm . E?9 otary Public ATTACHMENT H BID SHEET ITB 2021-759 PAVILION RENOVATION Please attach all specifications regarding materials, installation, and warranties to this sheet with your total bid cost below. Specifications are in accordance with Project Manual, Drawings and Addenda #1. Quintech Solutions, Inc. warrants the work performed to be free from defects in material, workmanship and craftsmanship under conditions of normal use for a period of one (1) year from the date of final inspection and acceptance. TOTAL BID including contractor fees: QUINT CH SOLUTIONS, INC. (Firm) (Signature) President (Title) March 09, 2021 (Date) $92,500.00 ATTACHMENT I CHECKLIST FOR SUBMITTING BID Sign below and submit this sheet with your bid NOTE: All of the following items must be submitted with your bid to be considered "responsive". Remember to follow the Instructions in the ITB Documents. ACKNOWLEDGMENT OF ANY/ALL ADDENDUMS W-9 OCCUPATIONAL TAX CERTIFICATE BID BOND COMPLETE AND SUBMIT ALL ATTACHMENTS TO THE BID: A. SIGNATURE SHEET B. CONTRACTOR AFFIDAVIT D. SAVE AFFIDAVIT E. VENDOR INFORMATION F. DEBARMENT CERTIFICATION G. DRUG FREE CERTIFICATION H. BID SHEET I. CHECKLIST Harold Gillens, President NAME/TILE QUINTECH SOLUTIONS, INC. COMPANY NAME 2550 Lithonia West Drive ADDRESS Lithonia, GA 30058 CITY/STATE/ZIP 843 695 0170 PHONE NUMBER Info@QuintechSolutionsInc.com EM SIGNATURE 03/04/21 DATE