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Contract 2025-024ADocusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D AGREEMENT No. 2025-024 SUPPLY OF PIPE FITTINGS AND ACCESSORIES THIS AGREEMENT is made and entered into this 12th day of March 2025, by and between the CITY OF CLERMONT, FLORIDA, a municipal corporation under the laws of the State of Florida whose address is: 685 W. Montrose Street, Clermont, Florida (hereinafter referred to as "CITY"), and CORE & MAIN LP, whose address is: 1830 Craig Park Court, Saint Louis, MO, 63146, (hereinafter referred to as "CONTRACTOR"). WHEREAS, City of Boynton Beach, through the public procurement process, awarded an Agreement for Supply of Pipe Fittings and Accessories Contract No. WH22-048; WHEREAS, CITY desires to utilize the above -referenced awarded bid, CONTRACTOR's response thereto, and Agreement in accordance with CITY's procurement policy; and WHEREAS, CONTRACTOR desires to enter into a contract with CITY based on the terms and conditions of the City of Boynton Beach Contract Number WH22-048; WITNESSETH: That the parties hereto, for the consideration hereinafter set forth, mutually agree as follows: 1. SCOPE OF WORK The CONTRACTOR shall furnish supply of pipe fittings and accessories as described in the City of Boynton Beach Contract Number WH22-048, which is attached hereto and incorporated herein as Exhibit "A" and shall perform everything required by this Agreement and the other exhibits attached hereto. Provided, however, that nothing herein shall require CITY to purchase or acquire any items or services from CONTRACTOR that is not specified in CITY's purchase order. To the extent of a conflict between this Agreement and Exhibit "A", the terms and conditions of this Agreement shall prevail and govern. In all instances, the CITY purchasing policy, resolutions, and ordinances shall apply. 2. THE CONTRACT SUM CITY shall pay CONTRACTOR for the faithful performance of the Agreement as set forth in the Agreement documents and the Price Schedule as set forth in Exhibit "B", attached hereto and incorporated herein. 3. TERM AND TERMINATION A. This Agreement is to become effective upon execution by both parties, and shall remain in effect until Saturday, October 4, 2025 unless terminated or renewed by City of Boynton Beach. B. Notwithstanding any other provision of this Agreement, CITY may, upon written notice to CONTRACTOR, terminate this Agreement: a) without cause and for CITY's 1 Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D convenience upon thirty (30) days written notice to CONTRACTOR b) if CONTRACTOR is adjudged to be bankrupt; c) if CONTRACTOR makes a general assignment for the benefit of its creditors; d) CONTRACTOR fails to comply with any of the conditions of provisions of this Agreement; or e) CONTRACTOR is experiencing a labor dispute, which threatens to have a substantial, adverse impact upon the performance of this Agreement, without prejudice to any other right or remedy CITY may have under this Agreement. In the event of such termination, CITY shall be liable only for the payment of all unpaid charges, determined in accordance with the provisions of this Agreement, for work properly performed and accepted prior to the effective date of termination. C. Upon mutual Agreement of the parties, this Agreement may be renewed for one (1) additional one-year term. 4. PROVISION OF SERVICES AND COMPLETION OF WORK A. The CONTRACTOR shall only provide to CITY the services contained under the Scope of Work upon receipt of an authorized order from CITY and shall provide the requested items in the timeframe and as set forth in City of Boynton Beach Contract Number WH22-048 or in the specific purchase order or authorized order submitted by CITY. Nothing herein shall obligate CITY to purchase any specific amount of product from CONTRACTOR or create an exclusive purchase agreement between CITY and CONTRACTOR. CITY shall not be obligated or required to pay for any items received until such time as CITY has accepted the items in accordance with the order provided to CONTRACTOR. B. CONTRACTOR, upon receipt of an order hereunder, shall immediately notify CITY if there is an issue or question related to the fulfillment of the order or whether there will be any delay in providing the items requested. Failure of CONTRACTOR to so notify CITY will preclude CONTRACTOR from seeking payment of any kind for any items that were delayed in delivery. Upon receipt of notification of the delay, CITY may, at its sole option, cancel the order and seek the items from any available source. C. COMPANY specifically acknowledges that this Contract does not bind or obligate CITY to purchase any minimum quantity of product during the term hereof. 5. PAYMENTS In accordance with the provisions fully set forth in the Contract Documents, the CONTRACTOR shall submit an invoice to the CITY upon completion of the services and delivery of products as set forth in the applicable purchase order. The CITY shall make payment to the CONTRACTOR for all accepted deliveries and undisputed products delivered and services provided within thirty (30) calendar days of receipt of the invoice. 2 Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D 6. DISPUTE RESOLUTION - MEDIATION A. Any claim, dispute, or other matter arising out of or related to this Agreement shall be subject to mediation as a condition precedent to voluntary arbitration or the institution of legal or equitable proceedings by either party. B. The CITY and CONTRACTOR shall endeavor to resolve claims, disputes, and other matters in question between them by mediation. C. The parties shall share the mediator's fee and any filing fees equally. The mediation shall be held in Clermont, Lake County, Florida unless another location is mutually agreed upon. Agreements reached in mediation shall be enforceable as settlement Agreements in any court having jurisdiction thereof. 7. INSURANCE AND INDEMNIFICATION RIDER 7.1. Worker's Compensation Insurance The CONTRACTOR shall take out and maintain during the life of this Agreement, Worker's Compensation Insurance for all its employees connected with the work of this Project and, in case any work is sublet, the CONTRACTOR shall require the subCONTRACTOR similarly to provide Worker's Compensation Insurance for all of the subCONTRACTOR employees unless such employees are covered by the protection afforded by the CONTRACTOR. Such insurance shall comply with the Florida Worker's Compensation Law. In case any class of employees engaged in hazardous work under this Agreement at the site of the Project is not protected under the Worker's Compensation statute, the CONTRACTOR shall provide adequate insurance, satisfactory to the CITY, for the protection of employees not otherwise protected. 7.2. CONTRACTOR's Commercial General Liability Insurance The CONTRACTOR shall take out and maintain during the life of this Agreement, Commercial General Liability and Business Automobile Liability Insurance as shall protect it from claims for damage for personal injury, including accidental death, as well as claims for property damages which may arise from operating under this Agreement whether such operations are by itself or by anyone directly or indirectly employed by it, and the amount of such insurance shall be as follows: A. CONTRACTOR's Commercial General Liability, $1,000,000 Each ($2,000,000 aggregate). Liability Coverages, Bodily Injury Occurrence, & Property Damage Combined Single Limit. Limits may be met through a combination of General Liability and Umbrella or Excess Liability coverage. B. Automobile Liability Coverages, $1,000,000 Each, Bodily Injury & Property Damage Occurrence, Combined Single Limit C. Excess Liability, Umbrella Form $2,000,000 Each Occurrence, Combined Single Limit Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D The insurance clause for both BODILY INJURY AND PROPERTY DAMAGE shall be amended to provide coverage on an occurrence basis. 7.3. Indemnification Rider A. To the fullest extent permitted by law, the CONTRACTOR shall indemnify and hold harmless the CITY and its employees from and against all claims, damages, losses, and expenses, including but not limited to reasonable attorney's fees, arising out of or resulting from its performance of the Work, provided that any such claim, damage, loss or expense (1) is attributable to bodily injury, sickness, disease or death, or to injury to or destruction of tangible property (other than the Work itself), and (2) to the extent caused by any negligent act or omission of the CONTRACTOR, any subcontractor, anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable. Such obligation shall not be construed to negate, abridge, or otherwise reduce any other right to obligation of indemnity which would otherwise exist as to any party or person described in this Article; however, this indemnification does not include the negligent acts or omissions, damage or losses caused by the CITY and its other contractors. B. In any and all claims against the CITY or any of its agents or employees by any employee of the CONTRACTOR, any subcontractor, anyone directly or indirectly employed by any of them, or anyone for whose acts any of them may be liable, the indemnification obligations under this Paragraph shall not be limited in any way by any limitation on the amount or type of damages, compensation or benefits payable by or for the CONTRACTOR or any subcontractor under workers' or workmen's compensation acts, disability benefit acts or other employee benefit acts. C. The CONTRACTOR hereby acknowledges receipt of ten dollars and other good and valuable consideration from the CITY for the indemnification provided herein. 8. NOTICES All notices shall be in writing and sent by United States mail, certified or registered, with return receipt requested and postage prepaid, or by nationally recognized overnight courier service to the address of the party set forth below. Any such notice shall be deemed given when received by the party to whom it is intended. CONTRACTOR: Core & Main LP 590 Ferguson Drive, Orlando, FL 32805 Attn: David Bryant, District Manager 4 Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D COPY TO: Core & Main LP 1830 Craig Park Court, St. Louis, MO 63146 Attn: Legal Department OWNER: City of Clermont 685 W. Montrose Street, Clermont, FL 34711 Attn: Tim Murry, Mayor Either party may change the name of the person receiving notices and the address at which notices are received by so advising the other party in writing. 9. MISCELLANEOUS 9.1. Attorneys' Fees In the event a suit or action is instituted to enforce or interpret any provision of this Agreement, the prevailing party shall be entitled to recover such sum as the Court may adjudge reasonable as attorneys' fees at trial or on any appeal, in addition to all other sums provided by law. 9.2. Waiver The waiver by CITY of breach of any provision of this Agreement shall not be construed or operate as a waiver of any subsequent breach of such provision or of such provision itself and shall in no way affect the enforcement of any other provisions of this Agreement. 9.3. Severability If any provision of this Agreement or the application thereof to any person or circumstance is to any extent invalid or unenforceable, such provision, or part thereof, shall be deleted or modified in such a manner as to make the Agreement valid and enforceable under applicable law, the remainder of this Agreement and the application of such a provision to other persons or circumstances shall be unaffected, and this Agreement shall be valid and enforceable to the fullest extent permitted by applicable law. 9.4. Amendment Except for as otherwise provided herein, this Agreement may not be modified or amended except by an Agreement in writing signed by both parties. Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D 9.5. Entire A;reement This Agreement, including the documents incorporated by reference, contains the entire understanding of the parties hereto and supersedes all prior and contemporaneous Agreements between the parties with respect to the performance of services by CONTRACTOR. 9.6. Assij4nment Except in the event of a merger, consolidation, or other change of control pursuant to the sale of all or substantially all of either party's assets, this Agreement is personal to the parties hereto and may not be assigned by CONTRACTOR, in whole or in part, without the prior written consent of CITY. 9.7. Venue The parties agree that the sole and exclusive venue for any cause of action arising out of this Agreement shall be Lake County, Florida. 9.8. Applicable Law This Agreement and any amendments hereto are executed and delivered in the State of Florida and shall be governed, interpreted, construed, and enforced in accordance with the laws of the State of Florida. 9.9. Public Records The CONTRACTOR expressly understands records associated with this project are public records and agrees to comply with Florida's Public Records law, including the following: A. Keep and maintain public records that ordinarily and necessarily would be required by the CITY in order to perform the services contemplated herein. B. Provide the public with access to public records on the same terms and conditions that the CITY would provide the records and at a cost that does not exceed the cost provided in Florida's Public Records law or as otherwise provided by law. C. Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law. D. Meet all requirements for retaining public records and transfer, at no cost, to the CITY all public records in possession of CONTRACTOR upon the termination of the contract and destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. The CONTRACTOR shall make reasonable efforts to provide all records stored electronically to the CITY in a format compatible with the information technology systems of the CITY. E. 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 CONTRACT, THE 11 Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D CONTRACTOR SHALL CONTACT THE CITY'S CUSTODIAN OF PUBLIC RECORDS AT THE CITY CLERK'S OFFICE, (352) 241-7331. 10. AGREEMENT DOCUMENTS The Agreement Documents, as listed below, are herein made fully a part of this Agreement as if herein repeated. Document Precedence: A. This Agreement B. Purchase Order (excluding any purchase order terms and conditions) / Notice To Proceed C. An applicable Contractor Quote or Statement of Work D. All documents contained in the City of Boynton Beach Contract Number WH22-048. 7 Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D IN WITNESS WHEREOF, the parties hereto have executed this Agreement. CITY OF CLERMONT Signed by: 2BA7692F758C492... SIGNATURE Tim Murry FULL NAME Mayor TITLE 4/9/2025 DATE SIGNED CORE & MAIN LP Signed by: E A� brr a 4EFD3F19B13D47D... SIGNATURE David Bryant FULL NAME 4/9/2025 DATE SIGNED District Manager TITLE ATTEST ET DocuSigned by: i4cy A44.,yd H.,wc 3AD7F34905B344A... SIGNATURE Tracy Ackroyd Howe FULL NAME City Clerk TITLE 4/ 10/2025 DATE SIGNED no 91 Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D Exhibit A WH22-048 Core and Main LP - City of Boynton Beach Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D The City of Boynton Beach PROCUREMENT SERVICES P.O. BOX 310 BOYNTONBEACH, PLORIDA 33425-0310 TELEPHONENO: (561) 742-6310 FAX.• (561) 742-6316 September 9, 2022 Core & Main LP Benjamin. strassergcoreandmain.com Susan.reed(a�coreandmain. com RE: "ANNUAL SUPPLY OF PIPE FITTINGS AND ACCESSORIES" BID #: WH22-048 Contract Period: October 5, 2022 thru October 4, 2023 Dear: Susan Reed and Benjamin Strasser, At the Commission meeting on September 8, 2022, the BID for "ANNUAL SUPPLY OF PIPE FITTINGS AND ACCESSORIES" was awarded and your company was one of two selected. A Blanket Purchase Order will be issued to your company on an "As Needed Basis". We would like to thank you for responding to this Bid. If you have any questions regarding this Bid, please contact Michael Dauta, Manager of Materials and Distribution, at dautam(a,bbfl.us Sincer]]�ely, Tly�a."J, Mara Frederiksen Director of Financial Services Enclosure: Tabulation Sheet AMERICA'S GATETVA Y TO THE G UTRSTREAM Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D ANTI -KICKBACK AFFIDAVIT STATE OF FLORIDA ) SS COUNTY OF PALM BEACH ) 1, the undersigned hereby duly sworn, depose and say that no portion of the sum herein submitted will be paid to any employees of the City of Boynton Beach as a commission, kickback, reward of gift, directly or indirectly by me or any member of my integrator or by an officer of the corporation. By: Agar Jeeed Sworn and subscribed before me this 22nd day of July 2022 r NOTA KY PUBLIC, State of Florida at Large us Ytu BENJAMIN STRASSER MY COMMISSION # GG 953162 =;or,Po' EXPIRES: May 1, 2024 Bonded Thru Notary PubNc Underwr tens "OFFICIAL NOTARY SEAL" STAMP NAME - SIGNATURE Printed Information: Susan Reed NAME Municipal Sales Coordinator TITLE Core & Main LP COMPANY Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D BIDDER ACKNOWLEDGEMENT Submit Bids To: PROCUREMENT SERVICES 100 E Ocean Ave Boynton Beach, Florida 33435 Telephone: (561) 742-6310 Bid Title: ANNUAL SUPPLY OF PIPE FITTINGS AND ACCESSORIES Bid Number: WH22-048 Bid Due: AUGUST 2, 2022; NO LATER THAN 2:30 P.M. (LOCAL TIME) Bids will be opened in Procurement Services unless specified otherwise. Bid receiving date and time is scheduled for August 2, 2022; no later than 2:30 P.M. (local time) and may not be withdrawn within ninety (90) days after such date and time. All awards made as a result of this bid shall conform to applicable sections of the charter and codes of the City. Name of Vendor: Core & Main LP Federal I.D. Number: 03-0550887 A Corporation of the State of: Florida, Limited Partnership Area Code: 561 Telephone Number: 848-4396 Area Code: 561 FAX Number: 845-7267 Mailing Address: 1101 W. 17th Street City/State/Zip: Riviera Beach, FL 33404 Vendor Mailing Date: 07/22/22 E-Mail Address: susan.reed@coreandmain.com alai( Aced Authorized Signature Susan Reed Name Typed 'The Qualification of Core & Main LP is attached hereto and incorporated by reference as though fully set forth herein. Initial: 0 A Date: 07/22/22 Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D EXCEPTIONS TO THE SPECIFICATIONS of Core & Main LP Submitted to the City of Boynton Beach Invitation to Bid (ITB) Annual Supply of Pipe Fittings and Accessories ITB No. WH22-048 Notwithstanding anything contained in any bid or contract documents to the contrary, Core & Main LP ("Core & Main") hereby takes exception to the specifications as follows. The bid of Core & Main and acceptance by Core & Main of any subsequent agreement is made expressly conditioned upon assent by the City of Boynton Beach (the "Owner"), to the following additional or different terms, which shall supersede and control over the terms of any request for bid or request for proposal, any contract documents and specifications, and any prior addenda thereto: Core & Main will use commercially reasonable efforts to deliver materials ordered within the time specified in the bid documents or the Agreement. Core & Main reserves the right to extend those delivery times based on manufacturer lead times as impacted events beyond the control of Core & Main including but not limited to the current pandemic, global shipping delays and resin shortage. Core & Main will not be liable for liquidated damages or other delay damages arising from delays in delivery, manufacturer lead times or other circumstances beyond the control of Core & Main. 2. Due to current supply chain disruptions, all materials are subject to pricing at the time of shipment. Prices submitted with the bid of Core & Main LP reflect prices at the time of bid submission, are subject to change at any time and are not firm. Pricing, material availability and timeliness of shipments cannot be guaranteed. This term supersedes all other contractual provisions. Insurance: To the extent provided in its policy, Core & Main will only be able to provide a certificate of insurance, endorsements and coverage that are current form and meet industry standards subject to agreement by Core & Main's insurance provider. A Certificate of Insurance is attached to demonstrate the level of coverage carried by Core & Main. To the extent permitted by its policy, Core & Main will name only the Buyer and its affiliates, subsidiaries, parents, officers and employees as additional insureds. Notice of cancellation will be provided by e-mail per state guidelines. General aggregate limits apply per policy. Core & Main will not be required to provide copies of its policies and will not be required to provide Professional Liability, Builder's Risk, Owner's Protective Liability, Contractor's Protective Liability, Contractual Liability Insurance, or other coverages not specifically identified in the attached certificate. Notwithstanding anything contained in any bid documents or contract documents to the contrary, by acceptance of Core & Main's bid, the Buyer accepts Core & Main's certificate of insurance in full compliance with all insurance requirements, including but not limited to notice provisions, coverage, language, policy limits, policy forms, and deductible amounts. The parties agree that Core & Main's insurance is provided on a contributory basis, and is primary, but only to the extent of the products, services, and operations of Core & Main LP. Page 1 of 2 Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D 4. Warranty. The extent of the warranty to be provided by Core & Main is set forth in the attached Core & Main LP Warranty. 5. Risk of Loss: Title and risk of loss for materials provided hereunder will pass to the Owner upon delivery. CORE & MAIN LP Dated this 22nd day of July 2022. yaeay leeed Municipal Sales Coordinator Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D CORE Core & Main LP Warranty Core & Main LP ("Seller") is a reseller of goods only, and as such does not provide any warranty for the goods it supplies hereunder. Notwithstanding this As -Is limitation, Seller shall pass through to the Buyer any transferable manufacturer's standard warranties with respect to goods purchased hereunder. BUYER AND PERSONS CLAIMING THROUGH BUYER SHALL SEEK RECOURSE EXCLUSIVELY FROM MANUFACTURERS IN CONNECTION WITH ANY DEFECTS IN OR FAILURES OF GOODS, AND THIS SHALL BE THE EXCLUSIVE RECOURSE OF BUYER AND PERSONS CLAIMING THROUGH BUYER FOR DEFECTIVE GOODS, WHETHER THE CLAIM OF BUYER OR THE PERSON CLAIMING THROUGH BUYER SHALL SOUND IN CONTRACT, TORT, STRICT LIABILITY, PURSUANT TO STATUTE, OR FOR NEGLIGENCE. BUYER SHALL PASS THESE TERMS TO SUBSEQUENT BUYERS AND USERS OF GOODS. SELLER EXCLUDES AND DISCLAIMS ALL OTHER EXPRESS AND IMPLIED WARRANTIES, INCLUDING, BUT NOT LIMITED TO, ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE. SELLER ASSUMES NO RESPONSIBILITY WHATSOEVER FOR SELLER'S INTERPRETATION OF PLANS OR SPECIFICATIONS PROVIDED BY BUYER, AND BUYER'S ACCEPTANCE AND USE OF GOODS SUPPLIED HEREUNDER SHALL BE PREMISED ON FINAL APPROVAL BY BUYER OR BY BUYER'S RELIANCE ON ARCHITECTS, ENGINEERS, OR OTHER THIRD PARTIES RATHER THAN ON SELLER'S INTERPRETATION. TO THE EXTENT NOT PROHIBITED BY APPLICABLE LAW, IN NO EVENT, WHETHER IN CONTRACT, WARRANTY, INDEMNITY, TORT (INCLUDING, BUT NOT LIMITED TO, NEGLIGENCE), STRICT LIABILITY OR OTHERWISE, ARISING DIRECTLY OR INDIRECTLY OUT OF THE PERFORMANCE OR BREACH OF THIS AGREEMENT, SHALL SELLER BE LIABLE FOR (a) ANY INCIDENTAL, INDIRECT, PUNITIVE, SPECIAL, CONSEQUENTIAL OR SIMILAR DAMAGES SUCH AS LOSS OF USE, LOST PROFITS, ATTORNEYS' FEES OR DELAY DAMAGES, EVEN IF SUCH DAMAGES WERE FORESEEABLE OR CAUSED BY SELLER'S BREACH OF THIS AGREEMENT, (b) ANY CLAIM THAT PROPERLY IS A CLAIM AGAINST THE MANUFACTURER, OR (c) ANY AMOUNT EXCEEDING THE AMOUNT PAID TO SELLER FOR GOODS FURNISHED TO BUYER WHICH ARE THE SUBJECT OF SUCH CLAIM(S). ALL CLAIMS MUST BE BROUGHT WITHIN ONE YEAR OF ACCRUAL OF A CAUSE OF ACTION. Notwithstanding anything contained in any bid or contract documents to the contrary, title and risk of loss for all materials will pass to Buyer upon delivery. Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D CITY OF RIVIERA BEACH ���vIERy 600 W BLUE HERON BLVD L RIVIERA BEACH FL 33404 CERTIFICATE OF USE Permit Year October 01, 2021 to September 30, 2022 1101 W 17th St Issued: CORE AND MAIN LP Vendor: 00696.1 CORE AND MAIN LP DUCHARME MCMILLEN & ASSOC PO BOX 80600 MUST BE POSTED CONSPICUOUSLY INDIANAPOLIS IN 46280 AT YOUR PLACE OF BUSINESS CITY OF RIVIERA BEACH oFR�viERq 600 W BLUE HERON BLVD RIVIERA BEACH FL 33404 CERTIFICATE OF USE Permit Year October 01, 2021 to September 30, 2022 1101 W 17th St Issued: CORE AND MAIN LP Vendor: 00696.1 CORE AND MAIN LP DUCHARME MCMILLEN & ASSOC PO BOX 80600 MUST BE POSTED CONSPICUOUSLY INDIANAPOLIS IN 46280 AT YOUR PLACE OF BUSINESS CITY OF RIVIERA BEACH �Et1VIERq 600 W BLUE HERON BLVD �9 RIVIERA BEACH FL 33404 CERTIFICATE OF USE e�cKco �v Permit Year October 01, 2021 to September 30, 2022 1101 W 17th St Issued: CORE AND MAIN LP Vendor: 00696.1 CORE AND MAIN LP DUCHARME MCMILLEN & ASSOC PO BOX 80600 MUST BE POSTED CONSPICUOUSLY INDIANAPOLIS IN 46280 AT YOUR PLACE OF BUSINESS Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D CITY OF RIVIERA BEACH ��R�v�Egq 600 W BLUE HERON BLVD RIVIERA BEACH FL 33404 BUSINESS TAX RECEIPT e� Permit Year October 01, 2021 to September 30, 2022 , 1101 W 17th St Issued: CORE AND MAIN LP Vendor: 00696.1 WHOLESALE MERCHANT CORE AND MAIN LP DUCHARME MCMILLEN & ASSOC PO BOX 80600 MUST BE POSTED CONSPICUOUSLY INDIANAPOLIS IN 46280 AT YOUR PLACE OF BUSINESS CITY OF RIVIERA BEACH �RNIERy 600 W BLUE HERON BLVD RIVIERA BEACH FL 33404 BUSINESS TAX RECEIPT cH ' _act Permit Year October 01, 2021 to September 30, 2022 1101 W 17th St Issued: CORE AND MAIN LP Vendor: 00696.1 WHOLESALE MERCHANT CORE AND MAIN LP DUCHARME MCMILLEN & ASSOC PO BOX 80600 INDIANAPOLIS IN 46280 MUST BE POSTED CONSPICUOUSLY AT YOUR PLACE OF BUSINESS CITY OF RIVIERA BEACH Oki 600 W BLUE HERON BLVD RIVIERA BEACH FL 33404 BUSINESS TAX RECEIPT e� `v Permit Year October 01, 2021 to September 30, 2022 CH 1101 W 17th St Issued: CORE AND MAIN LP Vendor: 00696.1 WHOLESALE MERCHANT CORE AND MAIN LP DUCHARME MCMILLEN & ASSOC PO BOX 80600 MUST BE POSTED CONSPICUOUSLY INDIANAPOLIS IN 46280 AT YOUR PLACE OF BUSINESS Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D Page 1 of 1 A�0 RRR CERTIFICATE OF LIABILITY INSURANCE DATE (MM/D) o7/30/20212021 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 Willis Towers Watson Northeast, Inc. c/o 26 Century Blvd P.O. Box 305191 CONTACT Willis Towers Watson Certificate Center NAME: AICNNo Ext: 1-877-995-7378 AIC No: 1-888-467-2378 E-MAIL cm ADDRESS:ertificates@willia.co INSURER(S) AFFORDING COVERAGE NAIC# Nashville, TN 372305191 USA INSURERA: National Union Fire Insurance Company of P 19445 INSURED Core & Main LP 1830 Craig Park Court INSURERB: Willis Submission Carrier GENRC INSURERC: ACE Property & Casualty Insurance Company 20699 INSURERD: XL Insurance America Inc 24554 Saint Louis, MO 63146 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: W21759150 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICYNUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE � OCCUR DAMAGE To PREMISES (Ea occurrDence)$ 1,000,000 X MED EXP (Any one person) $ 15,000 A SIR: $500,000* PERSONAL & ADV INJURY $ 1,000,000 GL 1728964 08/01/2021 08/01/2022 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 GEN'L POLICY PRO JECT LOC PRODUCTS - COMP/OPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 2,000,000 X BODILY INJURY (Per person) $ ANY AUTO B OWNED SCHEDULED AUTOS ONLY AUTOS SEE ATTACHED 08/01/2021 08/01/2022 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY C X UMBRELLA LIAB I X OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE G72535613 001 08/01/2021 08/01/2022 DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? No (Mandatory in NH) N/A SEE ATTACHED 08/01/2021 08/01/2022 PER OTH- X STATUTE ER E.L. EACH ACCIDENT $ 1, 000 , 000 E.L. DISEASE - EA EMPLOYEE $ 1, 000 , 000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 D Excess Liability US00111733LI21A 08/01/2021 08/01/2022 Occurrence $5,000,000 Aggregate $5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) * General Liability: The $1,000,000 per Occurrence and $2,000,000 Aggregate limits displayed is a combination of $500,000 Self -Insured Retention and $500,000 Per Occurrence /$1,500,000 Aggregate limits of liability provided by the carrier noted above. CERTIFICATE HOLDER CANCELLATION 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 Core & Main LP l/ "` 4 ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD SR ID: 21416308 BATCH: 2186050 Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D ADDITIONAL COVERAGE SCHEDULE AUTOMOBILE LIABILITY Policy Effective & Expiration Dates: See Page 1 Limits: See Page 1 POLICY NUMBER STATE INSURER(S) AFFORDING COVERAGE CA 4594395 All Other States National Union Fire Insurance Company of Pittsburgh CA 4594397 MA National Union Fire Insurance Company of Pittsburgh CA 4594396 VA National Union Fire Insurance Company of Pittsburgh WORKERS COMPENSATION & EMPLOYERS LIABILITY Policy Effective & Expiration Dates: See Page 1 Limits: See Page 1 POLICY NUMBER STATE INSURER(S) AFFORDING COVERAGE WC 016393321 All Other States AIU Insurance Company WC 016393322 CA AIU Insurance Company WC 016393323 WI AIU Insurance Company WC 016393324 NY AIU Insurance Company EXCESS LIABILITY Policy Effective & Expiration Dates: 08/01/2021-08/01/2022 POLICY NUMBER TYPE OF INSURANCE LIMITS INSURER(S) AFFORDING COVERAGE MKLM6MM50000028 Excess General $5,000,000 xs Markel American Insurance Liability $1,000,000 Primary Company NY21RXSZ02HYLIV Excess Automobile $3,000,000 xs Navigators Insurance Company Liability $2,000,000 Primary *Umbrella Liability shown on Page 1 applies after above shown limits are exhausted for their respective lines of coverage Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D 0,30 ,VYOON 0 BIDDER'S QUALIFICATION STATEMENT TO BE COMpI FTFn AND UPLOADED ONLINF The undersigned certifies under oath the truth and correctness of all statements and of all answers to questions made hereinafter: Submitted By: Name: Core & Main LP Address: 1101 W. 17th Street CITY, State, Zip: Telephone No.: Fax No.: Riviera Beach, FL 33404 561-848-4396 561-845-7267 Check One Corporation Partnership X Individual Other Email Address.: susan.reed@coreandmain.com 1. State the true, exact, correct and complete name of the partnership, corporation, trade or fictitious name under which you do business and the address of the place of business. The correct name of the Bidder is: Core & Main LP The address of the principal place of business is: 1830 Craig Park Court St. Louis, MO 63146 2. If Bidder is a corporation, answer the following: 3 a. Date of Incorporation: b. State of Incorporation: C. President's name: d. Vice President's name: e. Secretary's name: f. Treasurer's name: g. Name and address of Resident Agent: If Bidder is an individual or a partnership, answer the following: THIS PAGE MUST BE SUBMITTED ALONG WITH RESPONSE IN ORDER FOR PACKAGE TO BE CONSIDERED COMPLETE AND ACCEPTABLE Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D E. Date of organization: Nov. 22, 2004 b. Name, address and ownership units of all partners: Core & Main Intermediate GP, LLC — General Partner (Delaware LLC) Core & Main Midco, LLC — Limited Partner (Delaware LLC Address for all Partners: 1830 Craia Park Court. St. Louis. MO 63146 C. State whether general or limited partnership: Limited Partnership 4. If Bidder is other than an individual, corporation or partnership, describe the organization and give the name and address of principals: 5. If Bidder is operating under a fictitious name, submit evidence of compliance with the Florida Fictitious Name Statute. N/A 6. How many years has your organization been in business under its present business name? 5 years Under what other former names has your organization operated? HD SuDDIv Waterworks. Ltd. Hughes Water & Sewer, Ltd. 7. Indicate registration, license numbers or certificate numbers for the businesses or professions, which are the subject of this Bid. Please attach certificate of competency and/or state registration. Business License Number 00696.1 FL Contractor License No.: CUC1225503 FL Reaistration: A04000001840 8. Did you attend the Pre -Bid Conference if any such conference was held? YES F-] NO N/A 9. Have you ever failed to complete any work awarded to you? If so, state when, where and why: To the best of our knowledge, no. 10. List the pertinent experience of the key individuals of your organization (continue on insert sheet, if necessary) Multiple employees of our Riviera Beach branch have years of experience serving municipal customers. THIS PAGE MUST BE SUBMITTED ALONG WITH RESPONSE IN ORDER FOR PACKAGE TO BE CONSIDERED COMPLETE AND ACCEPTABLE Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D 11. State the name of the individual who will have personal supervision of the work: Javier Rezakhani 12. State the name and address of attorney, if any, for the business of the Bidder: Jackie Burkhardt, Director of Legal 1830 Craig Park Court, St. Louis, MO 63146 13. State the names and addresses of all businesses and/or individuals who own an interest of more than five percent (5%) of the Bidder's business and indicate the percentage owned of each such business and/or individual: Core & Main GP, LLC - General Partner CD&R Plumb Buyer, LLC - General Partner Core & Main Management Feeder, LLC - Limited Partner 14. State the names, addresses, and the type of business of all firms that are partially or wholly owned by Bidder: None. 15. State the name of Surety Company which will be providing the bond (if applicable), and name and address of agent: Sandra Diaz, Surety Analyst Aon Risk Solutions 1 Liberty Plaza, 165 Broadway, 33rd Floor, New York, NY 10006 THIS PAGE MUST BE SUBMITTED ALONG WITH RESPONSE IN ORDER FOR PACKAGE TO BE CONSIDERED COMPLETE AND ACCEPTABLE Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D 16. Annual Average Revenue of the Bidder for the last three years as follows: Revenue Index Number a. Government Related Work b. Non -Governmental Related Work Total Work a +b : $50 million or greater Revenue Index Number 1. Less than $100,000 2. $100,000 to less than $250,000 3. $250,000 to less than $500,000 4. $500,000 to less than $1 million 5. $1 million to less than $2 million 6. $2 million to less than $5 million 7. $5 million to less than $10 million 8. $10 million to less than $25 million 9. $25 million to less than $50 million 10. $50 million or greater 17. Bank References: Bank Address Telephone BANK OF AMERICA WWW.CONFIRMATION.COM For assistance using confirmation.com, contact 866-325-7201 18. Provide description of policies and methods for project monitoring and budgeting control as well as adherence to project schedule (continue on insert sheet, if necessary). Our technological solutions (including online ordering) and your branch contact (Javier Rezakhani) can assist with controlling inventory, project management, purchasing, material identification, and invoicing. 19. Provide descriptions of quality assurance/quality control management methods (continue on insert sheet, if necessary): Core & Main LP serves municipal customers using best practices, processes, and technological solutions. Your branch contact will work with you to ship orders complete, accurate, and on time. THIS PAGE MUST BE SUBMITTED ALONG WITH RESPONSE IN ORDER FOR PACKAGE TO BE CONSIDERED COMPLETE AND ACCEPTABLE Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D 20. Is the financial statement submitted with your bid (if applicable) for the identical organization named on page one? YES F-1 NO F-1 N/A 21. If not, explain the relationship and financial responsibility of the organization whose financial statement is provided (e.g., parent -subsidiary). N/A 22. What will be your turnaround time for written responses to City inquires? Usually same or next day (depending on inquiry). 23. List and describe all bankruptcy petitions (voluntary or involuntary) which have been filed by or against the Bidder, its parent or subsidiaries or predecessor organizations during the past five (5) years. Include in the description, the disposition of each such petition. None. 24. List all claims, arbitrations, administrative hearings and lawsuits brought by or against the Bidder or its predecessor organization(s) during the last five (5) years. The list shall include all case names, case arbitration or hearing identification numbers, the name of the project which the dispute arose, and a description of the subject matter of the dispute. Core & Main LP ("Core & Main") is one of the country's largest distributors of waterworks products operating across the country in nearly every state. Core & Main enters into a significant number of contracts on a daily basis and is involved in litigation from time to time in the ordinary course of business) In the event issues arise, they are handled on a case by case basis. For further information, please see attachment. 25. List and describe all criminal proceedings or hearings concerning business related offenses to which the Bidder, its principals or officers or predecessors' organization(s) were defendants. To the best of our knowledge, none. THIS PAGE MUST BE SUBMITTED ALONG WITH RESPONSE IN ORDER FOR PACKAGE TO BE CONSIDERED COMPLETE AND ACCEPTABLE Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D 26. Has the Bidder, its principals, officers or predecessors' organization(s) been Convicted of a Public Entity Crime, debarred or suspended from bidding by any government during the last five (5) years? If so, provide details. To the best of our knowledge, none. The Bidder acknowledges and understands that the information contained in response to this Qualification Statement shall be relied upon by owner in awarding the contract and such information is warranted by Bidder to be true. The discovery of any omission or misstatement that materially affects the Bidder's qualifications to perform under the contract shall cause the owner to reject the bid, and if after the award, to cancel and terminate the award and/or contract. (Signed) (Title) Subscribed and sworn to before me This 22nd day of July , 2020 2022 BENJAMIN ST:MR MY COMMISSION # GG 953162 EXPIRES: May 1, 2024 Bonded Thru Notary Public Underwriters trial( 1eeed Municipal Sales Coordinator Notary P blic (Signature) My Commission Expires May 1, 2024 THIS PAGE MUST BE SUBMITTED ALONG WITH RESPONSE IN ORDER FOR PACKAGE TO BE CONSIDERED COMPLETE AND ACCEPTABLE Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D City of Boynton Beach Bidder: Core & Main LP Attachment to Bidder's Qualification Statement Question 24: List all claims, arbitrations, administrative hearings and lawsuits brought by or against the Bidder or its predecessor organization(s) during the last five (5) years. The list shall include all case names, case arbitration or hearing identification numbers, the name of the project which the dispute arose, and a description of the subject matter of the dispute. Core & Main Response: Core & Main LP ("Core & Main") is one of the country's largest distributors of waterworks products operating across the country in nearly every state. Core & Main enters into a significant number of contracts on a daily basis and is involved in litigation from time to time in the ordinary course of business. In the event issues arise, they are handled on a case by case basis. For additional information, Core & Main has been involved in the following litigation or arbitration matters in the state of Florida involving products Core & Main sells to its customers during the last five (5) years: 1. Latitude on the River: This matter stemmed from an alleged product defect in a fire sprinkler suppression system installed at the Latitude on the River Condominiums in Miami - Dade County. A settlement agreement was reached with the condominium association in February 2020 and all claims were dismissed, including cross claims filed by the general contractor and the developer. The fire sprinkler subcontractor had a cross claim remaining and that last piece was resolved in May 2021. Core & Main did not admit any fault as part of these settlements. 2. Phillip Elie v. Miami -Dade County, Core & Main, et al.: Plaintiff filed a Complaint against Miami -Dade County and Core & Main claiming injuries that allegedly occurred on December 7, 2017, when Plaintiff tripped over a utility cover whose flap was ajar. The Complaint alleges Core & Main was responsible for defective utility cover and/or improper installation. However, Core & Main did not produce the product nor did we install the product (or have any involvement in the installation). Core & Main is optimistic it will be dismissed from this matter in the near future. Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D CERTIFICATION PURSUANT TO FLORIDA STATUTE § 287.135 TO BE COMPLETED AND UPLOADED ONLINE Susan Reed, 1, Municipal Sales Coordinator , on behalf of Core & Main LP certify Print Name and Title Company Name that Core & Main LP does not: Company Name 1. Participate in a boycott of Israel; and 2. Is not on the Scrutinized Companies that Boycott Israel List; and 3. Is not on the Scrutinized Companies with Activities in Sudan List; and 4. Is not on the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List; and 5. Has not engaged in business operations in Syria. Submitting a false certification shall be deemed a material breach of contract. The City shall provide notice, in writing, to the Consultant of the City's determination concerning the false certification. The Consultant shall have ninety (90) days following receipt of the notice to respond in writing and demonstrate that the determination of false certification was made in error. If the Consultant does not demonstrate that the City's determination of false certification was made in error then the City shall have the right to terminate the contract and seek civil remedies pursuant to Florida Statute § 287.135. Section 287.135, Florida Statutes, prohibits the City from: 1) Contracting with companies for goods or services if at the time of bidding on, submitting a bid for, or entering into or renewing a contract if the company is on the Scrutinized Companies that Boycott Israel List, created pursuant to Section 215.4725, F.S. or is engaged in a boycott of Israel; and 2) Contracting with companies, for goods or services that are on either the Scrutinized Companies with activities in the Iran Petroleum Energy Sector list, created pursuant to s. 215.473, or are engaged in business operations in Syria. THIS PAGE MUST BE SUBMITTED ALONG WITH RESPONSE IN ORDER FOR PACKAGE TO BE CONSIDERED COMPLETE AND ACCEPTABLE Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D As the person authorized to sign on behalf of the Consultant, I hereby certify that the company identified above in the section entitled "Consultant Name" does not participate in any boycott of Israel, is not listed on the Scrutinized Companies that Boycott Israel List, is not listed on either the Scrutinized Companies with activities in the Iran Petroleum Energy Sector List, and is not engaged in business operations in Syria. I understand that pursuant to section 287.135, Florida Statutes, the submission of a false certification may subject the company to civil penalties, attorney's fees, and/or costs. I further understand that any contract with the City for goods or services may be terminated at the option of the City if the company is found to have submitted a false certification or has been placed on the Scrutinized Companies with Activities in Sudan list or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List. Core & Main LP Jasaff eeed COMPANY NAME SIGNATURE Susan Reed PRINT NAME Municipal Sales Coordinator TITLE THIS PAGE MUST BE SUBMITTED ALONG WITH RESPONSE IN ORDER FOR PACKAGE TO BE CONSIDERED COMPLETE AND ACCEPTABLE Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D CONFIRMATION OF DRUG -FREE WORKPLACE Preference shall be given to businesses with drug -free workplace programs. Whenever two or more bids which are equal with respect to price, quality, and service are received by the City of Boynton Beach or by any political subdivision for the procurement of commodities or contractual services, a bid received from a business that certifies that it has implemented a drug -free workplace program shall be given preference in the award process. Established procedures for processing tie bids will be followed if none of the tied vendors have 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 employee 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 of Chapter 893 or of any controlled substance law of the United States or any state, for a violation occurring in the workplace no later than five (5) days after such conviction. 5) Impose a sanction on, or require the satisfactory participation in a drug abuse assistance or rehabilitation program if such is available in the employee's community by, any employee who is so 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 the statement, I certify that this firm complies fully with the above requirements. yasat leeed Vendor's Signature Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D CONFIRMATION OF MINORITY OWNED BUSINESS A requested form to be made a part of our files for future use and information. Please fill out and indicate in the appropriate spaces provided which category best describes your company. Return this form with your bid proposal sheet making it an official part of your bid response. Is your company a Minority Owned Business ? X Yes No If Yes, please indicate by an "X" in the appropriate box: ( ) AMERICAN INDIAN ( ) ASIAN ( ) BLACK ( ) HISPANIC ( ) WOMEN ( ) OTHER (specify) NOT APPLICABLE Do you possess a Certification qualifying your business as a Minority Owned Business? YES NO X If YES, Name the Organization from which this certification was obtained and date: Issuing Organization for Certification Date of Certification Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D Project Name Project No.: 1. Definitions: E-VERIFY FORM TO BE COMPLETED AND UPLOADED ONLINE Annual Supply of Pipe Supplies and Accessories WH22-048 "Contractor" means a person or entity that has entered or is attempting to enter into a contract with a public employer to provide labor, supplies, or services to such employer in exchange for salary, wages, or other remuneration. "Contractor" includes, but is not limited to, a vendor or consultant. "Subcontractor" means a person or entity that provides labor, supplies, or services to or for a contractor or another subcontractor in exchange for salary, wages, or other remuneration. "E-Verify system" means an Internet -based system operated by the United States Department of Homeland Security that allows participating employers to electronically verify the employment eligibility of newly hired employees. 2. Effective January 1, 2021, Contractors, shall register with and use the E-verify system in order to verify the work authorization status of all newly hired employees. Contractor shall register for and utilize the U.S. Department of Homeland Security's E-Verify System to verify the employment eligibility of: a) All persons employed by a Contractor to perform employment duties within Florida during the term of the contract; and b) All persons (including subvendors/subconsultants/subcontractors) assigned by Contractor to perform work pursuant to the contract with the City of Boynton Beach. The Contractor acknowledges and agrees that registration and use of the U.S. Department of Homeland Security's E-Verify System during the term of the contract is a condition of the contract with the City of Boynton Beach; and c) Should vendor become the successful Contractor awarded for the above -named project, by entering into the contract, the Contractor shall comply with the provisions of Section 448.095, Fla. Stat., "Employment Eligibility," as amended from time to time. This includes, but is not limited to registration and utilization of the E-Verify System to verify the work authorization status of all newly hired employees. Contractor shall also require all subcontractors to provide an affidavit attesting that the subcontractor does not employ, contract with, or subcontract with, an unauthorized alien. The Contractor shall maintain a copy of such affidavit for the duration of the contract. 3. Contract Termination a) If the City has a good faith belief that a person or entity with which it is contracting has knowingly violated s. 448.09 (1) Fla. Stat., the contract shall be terminated. b) If the City has a good faith belief that a subcontractor knowingly violated s. 448.095 (2), but the Contractor otherwise complied with s. 448.095 (2) Fla. Stat., shall promptly notify the Contractor and order the Contractor to immediately terminate the contract with the subcontractor. c) A contract terminated under subparagraph a) or b) is not a breach of contract and may not be considered as such. d) Any challenge to termination under this provision must be filed in the Circuit Court no later than 20 calendar days after the date of termination. e) If the contract is terminated for a violation of the statute by the Contractor, the Contractor may not be awarded a public contract for a period of 1 year after the date of termination. Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D Com an Name: Core & Main LP Authorized Signature: afaI( m—d Print Name: Susan Reed Title Municipal Sales Coordinator Date: July 22, 2022 Phone: 561-848-4396 STATE OF Florida COUNTY OF revar The foregoing instrument was acknowledged before me by means of 9 physical presence or ❑ online notarization, this 22nd day of July , 2022, by Susan Reed on behalf of Core &Main LP He/she is personallknown to me or has produced as identification. rd, BENJAMINSTRASSER *: MY COMMISSION # GG 953162 Po EXPIRES: May 1, 2024 �''?,os�°•�' BondedThruNota�yPubecundeiwrlters f NOTARY PUBLIC Benjamin Strasser (Name of Notary Typed, Printed or Stamped) Municipal Quotations Specialist Title or Rank GG 953162 Serial number, if any Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D NON COLLUSION AFFIDAVIT OF BIDDER . PLOADED , State of Florida County of Brevard ) Susan Reed , being first duly sworn, deposes and says that: 1) SHe is Municipal Sales Coordinatorof Core & Main LP , the proposer that (Title) (Name of Corporation or Integrator) has submitted the attached ITB: 2) He is fully informed respecting the preparation and contents of the attached submittal and of all pertinent circumstances respecting such submittal; 3) Said ITB is genuine and is not a collusive or sham ITB; 4) Further, the said Bidder nor any of its officers, partners, owners, agents, representatives, employees or parties in interest, including this affiant, has in any way colluded, conspired, connived or agreed, directly or indirectly with any other Bidder, integrator or person to submit a collusive or sham ITB in connection with the Contract for which the attached ITB has been submitted or to refrain from bidding in connection with such Contract, or has in any manner, directly or indirectly, sought by agreement or collusion or communications or conference with any other Bidder, integrator or person to fix the price or prices in the attached ITB or of any other Bidder, or to fix any overhead, profit or cost element of the ITB price or the ITB price of any other Bidder, or to secure through any collusion, conspiracy, connivance or unlawful agreement any advantage against the City of Boynton Beach or any person interested in the proposed Contract; and 5) The price or prices quoted in the attached bid are fair and proper and are not tainted by any collusion, conspiracy, connivance or unlawful agreement on the part of the bidder or any of its agents, representatives, owners, employees, or parties in interest, including this affiant. (Signed) YUcPlty /, emd Subscribed and sworn to before me This 22nd day of July , 20 22 v BENJAMIN STRASSER *, MY CAMMISSION # GG Wi62 • o� EXPIRES: May 1, 2024 ''• of � Bonded TIm, rbt�ry Public Under'tws (Title) Municipal Sales Coordinator Notary Public (Signature) My Commission Expires: May 1, 2024 THIS PAGE MUST BE SUBMITTED ALONG WITH RESPONSE IN ORDER FOR PACKAGE TO BE CONSIDERED COMPLETE AND ACCEPTABLE Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D PALM BEACH COUNTY INSPECTOR GENERAL ACKNOWLEDGMENT The Contractor is aware that the Inspector General of Palm Beach County has the authority to investigate and audit matters relating to the negotiation and performance of this contract, and in furtherance thereof may demand and obtain records and testimony from the Contractor and its subcontractors and lower tier subcontractors. The contractor understands and agrees that in addition to all other remedies and consequences provided by law, the failure of the Contractor or its subcontractors or lower tier subcontractors to fully cooperate with the Inspector General when requested may be deemed by the municipality to be a material breach of this contract justifying its termination. Core & Main LP CONTRACTOR NAME By Yawa y Aced Title: Municipal Sales Coordinator Date: July 22, 2022 Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D WH22-048 - Annual Supply of Pipe Fittings and Accessories Opening Date: July 6, 2022 1:00 PM Closing Date: August 2, 2022 2:30 PM Vendor Details Company Name: Core & Main LP 1101 W 17th St Address: Riviera Beach, Florida 33404 Contact: Benjamin Strasser Email: benjamin.strasser@coreandmain.com Phone: 321-339-9340 HST#: 03-0550887 Submission Details Created On: Thursday July 28, 2022 13:45:22 Submitted On: Thursday July 28, 2022 14:38:53 Submitted By: Benjamin Strasser Email: benjamin.strasser@coreandmain.com Transaction #: 569d46b2-3d67-4aa1-b1e2-28897a00794e Submitter's IP Address: 165.225.223.68 Bid Number: WH22-048 Vendor Name: Core & Main LP Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D Exhibit B WH22-048 Pricing Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D Schedule of Prices The Bidder hereby Bids and offers to enter into the Contract referred to and to supply and do all or any part of the Work which is set out or called for in this Bid, at the unit prices, and/or lump sums, hereinafter stated. `Denotes a "MANDATORY" field Do not enter $0.00 dollars unless you are providing the line item at zero dollars to the Owner (unless otherwise specified). If the line item and/or table is "NON -MANDATORY" and you are not bidding on it, leave the table and/or line item blank.Do not enter a $0.00 dollar value. Bid Number: WH22-048 Vendor Name: Core & Main LP Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D Attachment B - Item 1 Item 1 is to determine the percentage discount or cost plus percentage offered on all materials from the manufacturers listed below that is offered by your company. Either percentage discount or cost plus percentage is acceptable, both are not required. Please state what the percentage discount or cost plus percentage is based on. If you do not offer any of the categories, please place a TV in the box. ***** You can submit multiple discounts with multiple item categories. It must be stated which discount goes with corresponding category. ***** Category Discount Percentage Off* Cost Plus Percentage * Ductile Iron Pipe, Ductile Iron Fittings and 0% US Pipe DI Pipe: Market Cost plus 11% at time of Accessories shipment US Pipe Field lok gaskets: Market Cost plus 11% at time of shipment Tyler Union: Fittings and Accessories: Market Cost Plus 11% Tyler Union Restraints: Market Cost Plus 11% Tyler Union P401 lined fittings: Market Cost Plus 11% EBAA: Market Cost Plus 11% Fab DI Pipe: US & Custom Pipe & Fab: Market Cost Plus 11% at time of shipment All are market cost plus most current list price at time of order Star: DI Fittings and accessories: Market Cost Plus 11% Star MJ/FLB P401 fittings: Market Cost Plus 11% Star Restraints: Market Cost Plus 11% Saddles and Full Circle Clamps 0% Smith Blair Clamps style 226: Market Cost Plus 11% Smith Blair Saddles style 317 Market Cost Plus 11% Smith Blair Couplings style 421: Market Cost Plus 11% JCM Style 432: Market Cost Plus 11% Hymax: Market Cost Plus 11% Ford 202B style: Market Cost Plus 11% All are market cost plus current list price at time of order Hydrants, Hydrant Parts and Accessories 0% Clow Hydrant: Market Cost Plus 11% Clow Repair Parts: Market Cost Plus 11% Clow extension kits: Market Cost Plus 11% All are market cost plus most current list price Gate Valves and Check Valves 0% Clow: R/W 2-12" NRS: Market Cost Plus 11% Clow: RAN OS&Y 2"-12": Market Cost Plus 11% Clow RAN NRS 14"-24": Market Cost Plus 11% Clow Valve 4-12" Holiday Free: Market Cost Plus 11% Kennedy: RW Valves 2-12": Market Cost Plus 11% Kennedy Ken -Flex 4"-12" Check Valve Only: Market Cost Plus 11% Clow Check Valves 2-12" Horizontal Only: Market Cost Plus 11% Pratt BF Plug & Butterfly Valves: Market Cost Plus 11% at time of shipment Kennedy BF Valves: Market Cost Plus 11% Kennedy Swing Check Valve Only 2-12: Market Cost Plus 11% C900 Pipe, C900 Fittings and Ferncos 0% Harco C 900 Fittings: Market Cost Plus 11% Multi Fittings C900 Pressure Rated: Market Cost Plus 11% Non Pressure rated: Market Cost Plus 11% Fernco Cat 1 & 2: Market Cost Plus 11% Fernco Cat 3L: Market Cost Plus 11% Fernco Cat 3 & 4E: Market Cost Plus 11% ADS, JM, NAPCO, Endot, all are Market Cost Plus 11% at time of shipment Bid Number: WH22-048 Vendor Name: Core & Main LP Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D Attachment B - Item 2 Items 2 will be used for evaluation purposes only and are not sole items to be ordered. The bidder shall complete all spaces to include the current price list for the item, the percentage discount or cost plus percentage offered from ITEM 1, and the final item price after the discount is applied. Either percentage discount or cost plus percentage is acceptable, both are not required. Please state what the percentage discount or cost plus percentage is based on. Line Item Description Part Number* Current Price * Discount % from Item 1 * Cost Plus Percentage from Item * Final Item Price 1 6" DIP x 4" DIP Fernco 1055-64 $13.1100 N/A Market Cost Plus 11% $14.5500 2 4" Kennedy Check Valve 41`5382 $912.6300 N/A Market Cost Plus 11% $1,013.0200 with Lever 3 6" MJ Ductile Iron Elbow / 6M9401T $356.0700 N/A Market Cost Plus 11% $395.2400 Epoxy Lined and Epoxy Coated 4 4" x 15" Full Circle Clamp / 72226050015000 $147.9900 N/A Market Cost Plus 11% $164.2700 Range 4.95 - 5.35 5 54" Bury Hydrant / Red / 5 605546M3CLMEDL $2,381.2900 N/A Market Cost Plus 11% $2,643.2300 1/4" MAIN SEAT VALVE / A (2) 2 1/2" PORTS (1) 4 1/2" PORT / MECHANICAL JOINT Attachment B - Item 3 Additional discount(s) or cost plus percentage for all brands, manufacturers, categories offered by your company. This discount or cost plus percentage will be used to purchase any product offered by your company that is not listed on Attachment B - Item 1. ***** You can submit multiple discounts with multiple manufacturers/categories. It must be stated which discount goes with corresponding manufacturer/category. ***** Instructions Discount Percentage Off* Cost Plus Percentage * Additional discount(s) or cost plus percentage for all brands, manufacturers, N/A Due to the extensive scope categories offered by your company. This discount or cost plus percentage will be of our supply Core & Main used to purchase any product offered by your company that is not listed on would like to offer Market Attachment B - Item 1. ***** You can submit multiple discounts with multiple Cost Plus 11% (except manufacturers/categories. It must be stated which discount goes with corresponding those noted below). This manufacturer/category. ***** price encompasses any non listed manufacturers offered by our company. Please note that all packing, handling, shipping and delivery charges to the City of Boynton Beach are included. The following are offered at a different Market Cost Plus percentage: Charter Plastic 15%, Copper 12%, Buy Wholesale/EGW 20% After hours contact and warehouse location Contact information in the event of an after hours emergency where supplies are needed. Such as a water main break. Line Item Description Information * 1 Contact Name Javier Rezakhani 2 Contact Phone 561-472-4693 3 Email to place orders javier.rezakhani@coreandmain.com 4 Location of Warehouse (Must be located in Miami -Dade, Broward, Palm Beach, Martin or St. Lucie County) 1101 W. 17th Street Riviera Beach, FL 33404 Bid Number: WH22-048 Vendor Name: Core & Main LP Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D Specifications r We will not be submitting for Specifications Number New Column 1 All Bid prices are F.O.B. Boynton Beach, Warehouse, 222 N.E. 9TH Avenue, Boynton Beach, Florida — AND/OR — Warehouse 2, located at 124 E. Woolbright Road, Boynton Beach, Florida. 2 Bidder should state the model numbers of all items and accessories specified in this proposal. 3 Bidder must be able to guarantee all deliveries, through out the duration of the Bid. All orders must be delivered within 15 days from date of the purchase order. Back orders exceeding the 15 day period are subject to cancellation. Exceptions will be made based on market conditions. 4 Any quantities indicated in the proposal represent approximate needs for the one (1) year period. There is no guarantee made or implied that the City will fulfill such purchases. 5 Award is anticipated to be on a primary, secondary, third and possibly fourth basis. 6 Bidder agrees that all items proposed are DOMESTIC manufactured. 7 Bidder agrees that the percent discount or cost plus percentage submitted applies to the Commodity Bid — Pipe Fittings and Accessories. In this instance, Pipe Fittings and Accessories encompass any and all similar and like items as individually listed. 8 The City reserves the right to purchase on the open market should lower market prices prevail at which time the successful bidder shall have the option of meeting the lower price or relieving the City of any obligation previously understood 9 Bidder agrees that all items proposed in this bid are domestically made. 10 Bidder agrees that all pipe fittings and accessories listed on the proposal form must be of domestic manufacturer and meet all criteria set forth by the A.W.W.A., A.S.T.M. and the trade industry. 11 Bidder agrees to designate personnel for after hour emergencies. The personnel must be available 24 hours per day / 7 days per week throughout the duration of this contract. 12 Bidder attest that it has a warehouse located in Miami -Dade, Broward, Palm Beach, Martin or St. Lucie Counties. Bidder acknowledges and understands that The City will only accept bids with vendors that have a warehouse located in these areas. References Line Item Company Name * Email 1 Seacoast Utility Authority Jessica Decker jdecker@sua.com 2 Loxahatchee River District Erin Kelty erin.kelty@lrecd.org 3 Village of Wellington Alan Friedman afriedman@wellingtonfl.gov Documents Ensure your submission document(s) conforms to the following: Documents should NOT have a security password, as City of Boynton Beach may not be able to open the file. It is your sole responsibility to ensure that the uploaded document(s) are not either defective, corrupted or blank and that the documents can be opened and viewed by City of Boynton Beach. If you need to upload more than one (1) document for a single item, you should combine the documents into one zipped file. If the zipped file contains more than one (1) document, ensure each document is named, in relation to the submission format item responding to. For example, if responding to the Marketing Plan category save the document as "Marketing Plan." If the attached file(s) cannot be opened or viewed, your Bid Call Document may be rejected. • Bidder Qualification Statement - Bidder Qualification Statement_ CoreMain2022.pdf - Thursday July 28, 2022 14:20:08 • Anti -Kickback Affidavit - Anti -Kickback Affidavit_ CoreMain2022.pdf - Thursday July 28, 2022 14:20:48 • Non -collusion Affidavit of Bidder - NON COLLUSION AFFIDAVIT OF BIDDER_ CoreMain2022.pdf - Thursday July 28, 2022 14:21:28 • Certification Pursuant to Florida Statute § 287.135 - CERTIFICATION PURSUANT TO FLORIDA_CoreMain2022.pdf - Thursday July 28, 2022 14:22:04 • Confirmation of Drug -Free Workplace - CONFIRMATION OF DRUG FREE WORKPLACE_ CoreMain2022.pdf - Thursday July 28, 2022 14:22:27 • Confirmation of Minority Owned Business - CONFIRMATION OF MINORITY OWNED BUSINESS_CoreMain2022.pdf - Thursday July 28, 2022 14:23:05 • E-Veri - E-Verify_CoreMain2022.pdf - Thursday July 28, 2022 14:23:17 • Bidder Acknowledgement - BIDDER ACKNOWLEDGEMENT _CoreMain2022.pdf - Thursday July 28, 2022 14:23:51 • Local Business - Riviera Beach, FL - Branch 39 - License 00696.1 - Exp 9.30.22.pdf - Thursday July 28, 2022 14:26:58 • Palm Beach County Inspector General - PALM BEACH COUNTY INSPECTOR GENERAL.pdf - Thursday July 28, 2022 14:24:52 Bid Number: WH22-048 Vendor Name: Core & Main LP Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D Addenda & Declarations The Bidder hereby acknowledges and agrees: 1. To provide all goods, services and construction, as more specifically set out and in accordance with the Owner's Bid Call Document, including but not limited to the scope of work, specifications, drawings, Addenda (if issued by the Owner), the terms and conditions, etc. stated therein, which are expressly acknowledged and made part of this Contract. 2. This Bid is made without any connections, knowledge, comparison of figures or arrangements with any other company, firm or person making a Bid for the same Work and is in all respects fair and without collusion or fraud. 3. I/WE do hereby Bid and offer to enter into a Contract to do all the Work as specified in the Bid Call Document(s) which shall include all costs but not limited to; freight, duty, currency, etc. in accordance with the prices and terms as submitted by the Bidder herein. 4. If IIWE withdraw this Bid before the formal Contract is executed by the Awarded Bidder for the said Work or One Hundred Twenty (120) Calendar Days, whichever event first occurs, the amount of the Bid Deposit accompanying this Bid (if applicable to this bid) shall be forfeited to the Owner. 5. I/WE acknowledge and agree that any issued Addendum/Addenda forms part of the Bid Call Document. 6. I/WE (including any related or affiliated entities and any principal thereof) have no unresolved litigation with the Owner. Palm Beach County Inspector General Acknowledgement The Consultant is aware that the Inspector General of Palm Beach County has the authority to investigate and audit matters relating to the negotiation and performance of this Consultant Agreement, and in furtherance thereof may demand and obtain records and testimony from the Consultant and its sub -consultants and lower tier sub -consultants. The Consultant understands and agrees that in addition to all other remedies and consequences provided by law, the failure of the Consultant or its subconsultants or lower tier sub -consultants to fully cooperate with the Inspector General when requested may be deemed by the municipality to be a material breach of this contract justifying its termination. Confirmation of Drug Free Workplace Preference shall be given to businesses with drug -free workplace programs. Whenever two or more submittals which are equal with respect to price, quality, and service are received by the City of Boynton Beach or by any political subdivision for the procurement of commodities or contractual services, a submittal received from a business that certifies that it has implemented a drug -free workplace program shall be given preference in the award process. Established procedures for processing tie submittals will be followed if none of the tied vendors have a drug -free workplace program. In order to have a drug -free workplace program, a business shall: 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. 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. Give each employee engaged in providing the commodities or contractual services that are under submittal a copy of the statement specified in subsection (1). In the statement specified in subsection (1), notify the employee that, as a condition of working on the commodities or contractual services that are under submittal, 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 of Chapter 893 or of any controlled substance law of the United States or any state, for a violation occurring in the workplace no later than 5 days after such conviction. Impose a sanction on, or require the satisfactory participation in a drug abuse assistance or rehabilitation program if such is available in the employee's community by, any employee who is so convicted. Make a good faith effort to continue to maintain a drug -free workplace through implementation of this section. As the person authorized to sign the statement, I certify that this firm complies fully with the above requirements. I,, I/We have the authority to bind the Company and submit this Bid on behalf of the Bidder. - Susan Reed, Municipal Sales Coordinator, Core & Main LP The bidder shall declare any potential or actual conflict of interest that could arise from Bidding on this Bid. Do you have a conflict of interest? r Yes s No The Bidder acknowledges and agrees that the addendum/addenda below form part of the Bid Document Bid Number: WH22-048 Vendor Name: Core & Main LP Docusign Envelope ID: 6A4AFCAB-3BF4-4BA8-803A-F7218062BB5D Please check the box in the column "I have reviewed this addendum" below to acknowledge each of the addenda. I have reviewed the File Name below addendum and Pages attachments (if applicable) There have not been any addenda issued for this bid. Bid Number: WH22-048 Vendor Name: Core & Main LP