HomeMy WebLinkAboutContract 2025-054ADocusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
AGREEMENT No. 2025-054
BRUSH TRUCK, AMBULANCE, AND FIRE APPARATUS REPAIR, MAINTENANCE,
AND UPFITTING SERVICES
THIS AGREEMENT is made and entered into this 24th day of June 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 ON SCENE REPAIRS AND MAINTENANCE, LLC, whose address is: 1640 NE 32nd Ave.,
Suite A, Ocala, FL 34470, (hereinafter referred to as "CONTRACTOR").
WHEREAS, City of North Port, through the public procurement process, awarded an Agreement
for Brush Truck, Ambulance, and Fire Apparatus Repair, Maintenance, and Upfitting Services
Contract No. RFQ 2025-22;
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 North Port Contract Number RFQ 2025-22;
WITNESSETH: That the parties hereto, for the consideration hereinafter set forth, mutually agree
as follows:
1. SCOPE OF WORK
The CONTRACTOR shall furnish brush truck, ambulance, and fire apparatus repair, maintenance,
and upfitting services as described in the City of North Port Contract Number RFQ 2025-22, 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 Monday, September 30, 2030 unless terminated or renewed by City of
North Port.
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
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
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 two (2)
additional one (1) year terms.
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 North Port Contract Number RFQ 2025-
22 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. It is expressly understood and agreed that the passing, approval, and/or acceptance of any
gasoline, diesel, kerosene, LP gas, and bio-diesel herein by CITY or by any agent or
representative as in compliance with the terms of this Contract shall not operate as a
waiver by the CITY of strict compliance with the terms of this Contract and the CITY
may require the CONTRACTOR replace the accepted gasoline, diesel, kerosene, LP gas,
and bio-diesel so as to comply with the warranties and specifications hereof.
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Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
D. 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.
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 parry.
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:
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A. CONTRACTOR's Commercial General Liability, $1,000,000 Each ($2,000,000
aggregate). Liability Coverages, Bodily Injury Occurrence, & Property Damage
Combined Single Limit
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
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) is caused in whole or
in part 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, regardless of whether or not such acts are caused in part by a parry
indemnified hereunder. 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 sole acts of negligence, 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
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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:
On Scene Repairs and Maintenance, LLC
1640 NE 32nd Ave., Suite A, Ocala, FL 34470
Attn: George Scott, Owner
OWNER:
City of Clermont
685 W. Montrose Street, Clermont, FL 34711
Attn: Rick Van Wagner, Interim City Manager
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.
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Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
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.
9.5. Entire Agreement
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. Assignment
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.
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Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
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
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 / Notice To Proceed
C. An applicable Contractor Quote or Statement of Work
D. All documents contained in the City of North Port Contract Number RFQ 2025-22.
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Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
IN WITNESS WHEREOF, the parties hereto have executed this Agreement.
CITY OF CLERMONT ATTEST
E--
ETdA
igned by: DocuSigned by:
Ao�d Ho1vc
99CA96BEB98467... 3AD7F349056344A...
SIGNATURE
Tim Murry
FULL NAME
Mayor
TITLE
6/30/2025
DATE SIGNED
ON SCENE REPAIRS AND MAINTENANCE, LLC
DocuSigned by:
G��G SCAT'
CC3C586B6F9E445...
SIGNATURE
George Scott
FULL NAME
Owner
TITLE
6/30/2025
DATE SIGNED
SIGNATURE
Tracy Ackroyd Howe
FULL NAME
City Clerk
TITLE
7/8/2025
DATE SIGNED
nc
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
Exhibits List
A - City of North Port Agreement
B - Pricing
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
Exhibit A
City of North Port Agreement
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
Action History (UTC-05:00)
Submit by Bernice Moen 03-04-2025 01:46:59 PM (Start)
Reviewed by Alla Skipper 03-04-2025 04:35:14 PM (Initial PA Review)
• The task was assigned to Alla Skipper, Keith Raney 3/4/2025 1:47:00 PM
• Alla Skipper assigned the task to Alla Skipper 3/4/2025 4:34:17 PM
Submit by Barbara Wolf 03-04-2025 06:48:51 PM (Business Operations Completes)
• The task was assigned to Crystal Osborne, Lisa Guerreiro, Barbara Wolf 3/4/2025 4:35:15 PM
• Barbara Wolf assigned the task to Barbara Wolf 3/4/2025 6:33:54 PM
Submit by Garrett Woods 03-05-2025 01:29:06 PM (Pre -Director Approval)
• The task was assigned to Garrett Woods 3/4/2025 6:48:51 PM
Submit by Chelsea Buell 03-05-2025 04:43:02 PM (Pre -Director Approval)
• The task was assigned to Chelsea Buell 3/5/2025 1:29:07 PM
Approve by Chuck Speake 03-06-2025 09:51:37 AM (Director Approval)
• The task was assigned to Chuck Speake, Tricia Wisner 3/5/2025 4:43:03 PM
• Chuck Speake assigned the task to Chuck Speake 3/6/2025 9:50:31 AM
Approve by Lisa Herrmann 03-06-2025 09:52:27 AM (Budget Approval)
• The task was assigned to Heidi Hallas, Nicole Brown, Lisa Herrmann 3/6/2025 9:51:37 AM
• Lisa Herrmann assigned the task to Lisa Herrmann 3/6/2025 9:52:11 AM
Approve by Alla Skipper 03-06-2025 11:00:06 AM (Purchasing Approval)
• The task was assigned to Alla Skipper, Keith Raney 3/6/2025 9:52:28 AM
• Alla Skipper assigned the task to Alla Skipper 3/6/2025 10:59:45 AM
Approve by Irina Kukharenko 03-07-2025 09:08:35 AM (Finance Director Approval)
• The task was assigned to Kimberly Williams, Irina Kukharenko 3/6/2025 11:00:07 AM
• Irina Kukharenko assigned the task to Irina Kukharenko 3/7/2025 9:08:20 AM
Reviewed by Lori Hollingshead 03-07-2025 09:32:21 AM (CM Executive Assistant)
• The task was assigned to Lori Hollingshead, Anna Duffey 3/7/2025 9:08:37 AM
• Lori Hollingshead assigned the task to Lori Hollingshead 3/7/2025 9:31:59 AM
Approve by Jason Yarborough 03-07-2025 09:39:26 AM (DCM/ACM Approval)
• The task was assigned to Jason Yarborough, Julie Bellia 3/7/2025 9:32:22 AM
• Jason Yarborough assigned the task to Jason Yarborough 3/7/2025 9:39:20 AM
Approve by Jerome Fletcher 03-07-2025 10:09:15 AM (CM Approval)
• The task was assigned to Jason Yarborough, Julie Bellia, Jerome Fletcher 3/7/2025 9:39:26 AM
• Jerome Fletcher assigned the task to Jerome Fletcher 3/7/2025 10:09:06 AM
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
Title*
Brush Truck, Ambulance Apparatus Repair, Maintenance and Upfitting Services
Department* Division
PUBLIC WORKS FLEET
Submitter*
Bernice Moen
Pre-DirectorApprover(s) (?)
Include director from partnering department(s).
1
2
Garrett Woods
Chelsea Buell
Extension* Department Contact*
7114 BARBARA WOLF
Name
Assigned Number*
2025-22
Date *
03/04/2025
Requested Motion/Action *
Recommend the City Manager award RFQ 2025-22, Brush Truck, Ambulance Apparatus Repair, Maintenance and Upfitting Services, to On Scene
Repairs & Maintenance of Ocala, Florida at the unit prices listed on attached tabulation. Quote prices shall be from date of award through and
including September 30, 2030, with an option to renew for two (2) additional one (1) year terms, by mutual consent, at the same pricing with a no
more than a maximum annual increase of fifteen (15) percent on labor, parts, and travel. Requests for price increases must be documented with
written verifications of industry price increases and mutually agreed upon by the Quoter and the City. Terms and conditions will remain the same.
Renewal?* From * To.
O Yes O0 No 03/04/2025 09/30/2030
Is this item budgeted?*
If NO, state action required
OO Yes O No
Participating Departments
Fire Rescue
Accounts
..............................................
Account*
520-3035-519.46-70
Project
Comments to Budget
Current P.O. 51092 will be closed adding to the current account balance. See attached account balance.
Reason
Name Change Price Change City Manager Request
$50,000.00
Amount*
Background*
What and Why
It is the intent of the City of North Port to secure services of a qualified Contractor who can safely and efficiently provide for the repair services
and possible upfitting of emergency response "Brush Trucks, Ambulances and Fire Apparatus.
Formal Request for Quotation (RFQ) 2025-22 was issued on January 28, 2025. RFQ was posted on DemandStar to 206 suppliers plus 3
supplemental suppliers, GovDelivery and City's External File Sharing. The 3 supplemental suppliers were given a courtesy call a week prior to due
date of February 20, 2025, however, only one (1) response was received.
The award of this Quote is to the lowest overall responsive, responsible Quoter meeting or exceeding all the specifications contained within RFQ.
Therefore, it is requested that the City Manager award RFQ 2025-22, Brush Truck, Ambulance Apparatus Repair, Maintenance and Upfitting, to On
Scene Repairs & Maintenance.
Backup*
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
2025-22 Recommendation Memo rev.pdf
Submittal RFQ 2025-22 On Scence Repairs.pdf
RFQ 2025-22 Brush Truck Rescue and Apparatus Repairs FINAL ADA.pdf
Sunbiz - On Scene Repairs 2-20-25.pdf
46-70 Balance 3-4-25.pdf
421.95 KB
14.32M B
521.19KB
200.03KB
222.47 KB
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
,t_ CITY OF NORTH PORT
FINANCE DEPARTMENT/PURCHASING DIVISION
4970 CITY HALL BLVD, SUITE 337
NORTH PORT, FLORIDA 34286
F L O K I D A OFFICE: 941.429.7170
FAX: 941.429.7173
EMAIL: purchasing@northportfl.gov
MEMORANDUM
TO: Chuck Speake, Public Works Director
Thru: Garrett Woods, Senior Business Manager
FROM: Bernice Moen, Contract Administrator
DATE: February 21, 2025
SUBJECT: RFQ NO.2025-22 Brush Truck, Ambulance and Fire Apparatus Repair, Maintenance and
Upfitting Services
The above referenced solicitation was broadcasted to 206 suppliers plus 3 supplemental suppliers. The
3 supplemental suppliers were given a courtesy call a week prior to due date; however, only one (1)
response was received from the following firm:
FIRM:
On Scene Maintenance & Repairs
(Responsiveness: all requested documents submitted)
See attached tabulation for remarks.
Purchasing has reviewed the submittal and has determined the apparent low quoter to be responsive in
accordance with the specifications and addenda (see attached tabulation). A responsive submittal is one
which conforms in all material respects to the solicitation. This quote contains no exceptions or deviations
from the terms, conditions, and specifications.
CRITERIA FOR AWARD: The award of this Quote will be to the lowest overall responsive, responsible
Quoter meeting or exceeding all the specifications contained herein. The City reserves the right to award
this quote in whole or in part, or by line item, whichever is in the best interest of the City. Other
considerations of award may be references, experience of the quoter with accounts of this size or larger,
prior performance evaluations created by the City, and number of years in business.
The City reserves the right to reject the quote submittal of any Quoter who has previously failed to
perform properly, or on time, or who is not able to satisfactorily deliver the goods or perform the services
specified herein.
Public Works (Fleet) staff shall review the submittal to determine if the quoter is responsible. A
responsible person, company or entity is determined to have the capability in all respects to fully perform
the contract requirements and has the integrity and reliability which will assure good faith performance
1IPage
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
and the capacity and capability to perform in accordance with the specifications. Additionally,,/ verify the
references as applicable (Section II B & C, below) and make sure the qualifications which were specified in
the solicitation have been met. Please complete and sign this form and attach your recommendation along
with the recommendation of the Department for Finance Director's approval. Upon receipt of this form, I
will post Notice of Intent (NOI) and you may initiate the contract process.
11. Recommendation of Award to:
SUBMITTAL:
APPARENT LOW QUOTER
On Scene Maintenance & Repairs
SUBMITTAL
YES
NO
N/A or OTHER
A
Procurement reviewed and determined the apparent low quoter
to be responsive:
✓
B
Business Operations Manager reviewed and determined the
apparent low quoter to be responsible meeting or exceeding
specifications:
❑�
❑
C
Department Director recommendation of award: to the lowest
responsive, responsible quoter meeting or exceeding
specifications:
❑
Account Number* Project Number
520-3036-519.46-70
Estimator's Name
Barb Wolf
Estimated Cost Date of Estimate
$75,000.00 01 /14/2025
Digitally signed by Garrett Woods
Garrett Woods Date: 2025.02.24 07:59:48 -05'00'
----------------------------------------
Garrett Woods, Senior Business Manager
Chuck Speake-05 Digitally signed by Chuck -00
Date: 2025.02.27 09:29:21-0500'
----------------------------------------
Chuck Speaake, Public Works Director
Alla V. /. V kl p per Digitally signed by Skipper
V Date: 2025.03.04 09:39:32:4:43-0600'
Alla Skipper, Senior Contract Administrator
Digitally signed by Lisa Herrmann
Lisa Herrmann Date: 2025.03.0409:13:18
-05'00'
---------------------------------------
Lisa Herrmann, Budget Manager
0 Digitally signed by
Irina Kukharenk
Date: 2025.03.04 13:07:13-05'00'
Kimberly Williams, Finance Director
Available Amount*
$109,361.03
Estimator's Title
Administrative Services Specialist
2 1 P a g e
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
RFQ NO.2025-22 Brush Truck, Ambulance and Fire Apparatus Repair, Maintenance and Upfitting Services
QUOTE DUE: February 20, 2025 at 2:00 PM (EDT) VIA EMAIL
+ QUOTE TABULATION SUMMARY
QUOter Name:
On Scene Repair & Maintenance
N/A
N/A
Received:
2/19/2025
Line Item
No.
Est Quantity
Unit of Measure
Unit Price
Extended Price
Unit Price
Extended Price
Unit Price
Extended Price
1
Hourly Shop Labor Rate
1
HR
$150.00
$150.00
2
Hourly Field Labor Rate (if applicable)
1
HR
$150.00
$150.00
3
Travel Rate (Circle One)
TRIP/MILES-
$595.00
$595.00
TOTAL
$895.00
4
IParts Mark-up (if applicable)
PERCENTAGE
20%
20%
5
Parts Discount (if applicable)
PERCENTAGE
N/A
N/A
* Trip or Miles
per Trip
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
DUE DILIGENCE REVIEW
RFQ 2025-22 Brush Truck, Ambulance and Fire Apparatus Repair, Maintenance and Upfitting Services
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Notes: N/A
Reviewed by:
Bernice Moen
2/20/25
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
J OK
% Exit
E Cancel
2024
2026
Account Activity Listing
Budget Allocation
Images
N ext Accou nt
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C 520-3035-519.46-70
Account information
BREPAIR & MAINTENANCE / FLEET - OUTSOURCED
Fiscal year: 2025 Be
Budget: 642,920.00
Committed: 571, 084.86
BBalance: 71,835.14
Account Balance by Period
cumulative
Period/Month
Actuals
Totals
®0l October
2,120.59
2,120.59
M02 November
30,800.39
32,920.99
S!JRI December
22,673.92
55,594.90
504 Ianuary
72,335.99
127,930.89
S05 February
44,379.88
172,310.77
1906 March
12,447.39
184,758.16
Jg07 April
.00
194,758.16
Jg08 May
.00
184,758.16
509 Tune
.00
184,758.16
Ig10 July
.00
194,758.16
Jg11 August
.00
184,758.16
512 September
.00
184,758.16
Project Data
Project Entry Optional
li CV2020 CORONAVIRUS (CO
B IM22 HURRICANE IAN 2
B IDAL23 TS/HURRICANE ID
S IRMA17 HURRICANE IRMA
.00
.00
.00
.00
Payment information
vendor (* indicates pending)
Total
®TEN-8 FIRE & SAFETY, LLC
9,896.85
®LIGHTNING WIRELESS SOLUTIONS I
1,115.00
®RING POWER CORPORATION
21,399.70
®BANK OF AMERICA (P-CARD)
105,227.30
I®IACKIE'S AUTO BODY INC
14,800.59
®DOBBS EQUIPMENT LLC
1,878.08
®ON SCENE REPAIRS & MAINTENANCE
6,830.14
®MIKE'S AUTO GLASS
11,334.88
®BERT'S BLACK WIDOW HARLEY-DAVI
2,131.83
®CHARLOTTE COUNTY FORD INC
26,907.97
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
CITY OF NORTH PORT
REQUEST FOR QUOTATION 2025-22
BRUSH TRUCK, AMBULANCE AND FIRE APPARATUS REPAIR, MAINTENANCE AND UPFITTING SERVICES
THIS IS NOT AN ORDER
January 28, 2025
CITY OF NORTH PORT Contact Person: Bernice Moen, Contract Administrator I
Finance/Purchasing Division Contact Phone: 941-429-7114
4970 City Hall Blvd Contact Fax: 941-429-7173
North Port, Florida 34286 Contact Email: purchasing@northportfl.gov
I(Fv nATFC-
1. LAST DAY FOR QUESTIONS: February 13, 2025, AT 2:00, P.M. See the section below titled "Clarification and
Additional Information" for further details.
2. QUOTE DUE DATE: February 20, 2025 AT 2:00 P.M. Late responses will not be considered. Electronic questions and
submittals shall be made to the above -listed contact person.
SUBMIT ALL QUOTES TO: purchasing@ north portfl.gov
Please note: If you are unable or do not desire to quote, please indicate on the Statement of Non -Submittal Form and return
to the City's Purchasing Division.
PURPOSE: It is the intent of the City of North Port (hereafter "City") to secure services of a qualified Contractor who can
safely and efficiently provide for the repair services and possible upfitting of emergency response "Brush Trucks, Ambulances
and Fire Apparatus" as listed herein.
QUOTE PRICES/TERM: (For Annual Contracts) QUOTE PRICES/TERMS OF CONTRACT: Contractors shall quote unit prices,
F.O.B. Destination as specified herein, for the purchase and/or installation of the goods, or performance of the services
specified herein. Such prices shall include Vendor's cost in full for all transportation, labor, materials, consumables, and
equipment used in delivering said materials to the point of delivery, or performance of the services. The term of this contract
shall be from the date of award through and including September 30, 2030, with an option to renew for two (2) additional
one (1) year terms, by mutual consent, at the same pricing with a no more than a maximum annual increase of fifteen (15)
percent, on labor, parts, and travel, terms and conditions remain the same.
Page 1 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
SCOPE OF SERVICES/TECHNICAL SPECIFICATIONS:
Brush Trucks
Repair of Type 3, Type 4, and Type 6 engines are considered "wildland engines" or "brush trucks." These are the vehicles that
respond to wildfires and have the ability to drive in "off road terrain" to respond to a fire or rescue. Wildland engines are
specially designed for the technique of pump -and -roll. This is a tactic where the vehicle drives with the pump engaged while
a firefighter uses a hose to spray water on the fire. Repairs are not limited to only the repair of the engine repair but the
pumps as well. The City of North Port has the following makes of brush trucks but are not limited to these makes: LMTV,
Hummer and American General types of Brush trucks. The sizes of the trucks vary up to five (5) ton. It is possible that there
could be some installation of emergency lighting.
Ambulances
Repair of but not limited to Road Rescue and Braun ambulances as needed. Vendor must have knowledge of ambulance
maintenance standards to ensure compliance with safety and performance standards with strict adherence to manufacturer
guidelines, specialized training for technicians (EVT certification), focus on critical components like lights, sirens,
communication systems, and life-support equipment, along with a heavy emphasis on preventative maintenance to ensure
reliable operation during emergencies, in a timely manner. Life Support Equipment (Ambulances): Thorough checks and
repairs of medical devices like defibrillators, oxygen systems, and patient monitoring equipment. Regular checks of medical
equipment, patient securing systems, and stretcher mechanisms.
Fire Apparatus
Repair of Pierce tankers, engines, and aerials as needed. Vendor must have knowledge of apparatus maintenance standards
to ensure compliance with safety and performance standards in a timely manner. Fire Trucks: Maintenance of pumps, water
tanks, hose reels, and specialized firefighting equipment.
Technical Expertise:
EVT Certification: Technicians must possess Emergency Vehicle Technician (EVT) certification to properly diagnose and repair
specialized emergency vehicle systems.
Automotive and Electrical Knowledge:
Deep understanding of automotive mechanics combined with proficiency in complex electrical systems including wiring,
lighting, and control modules.
Hydraulics (for certain vehicles): Knowledge of hydraulic systems for operations like lifting mechanisms on fire trucks.
Specific Components:
Emergency Lighting: Regular inspections and maintenance of flashing lights, strobe lights, and light patterns to ensure proper
visibility.
Sirens and PA Systems: Testing and repair of sirens, public address systems, and associated controls.
Communication Systems: Maintenance of mobile radios, antennas, and communication relays.
Maintenance Procedures:
Preventative Maintenance Schedules: Regular inspections and servicing to identify potential issues before they become
critical.
Fluid Checks: Monitoring fluid levels for engine oil, coolant, brake fluid, and hydraulic fluids.
Battery Maintenance: Proper testing and maintenance of batteries to ensure reliable starting.
Page 2 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
NON -MANDATORY PRE -QUOTE MEETING: N/A
CLARIFICATION AND ADDITIONAL INFORMATION: Discrepancies, omissions, or questions about the intent of the documents
should be submitted to the City's Purchasing Division in written form as a request for interpretation no later than five (5)
business days prior to Quote due date (or shall be verbally addressed at the pre -quote conference, if applicable).
Interpretations made will be in the form of an addendum to the documents. The City will attempt to notify all prospective
quoters of addenda issued to the quote documents; however, it shall be the responsibility of the quoter, prior to submitting
their response, to either visit www.demandstar.com to view the solicitation and download all issued addenda or contact the
City's Purchasing Division to determine if addenda were issued, acknowledging and incorporating it into their quote. Receipt
of all addenda by each quoter should be acknowledged on the quote form, indicating the addendum number and date of
issue, therein becoming part of the Contract. No oral explanations shall be binding. The City is not responsible for quotes not
submitted on time.
If you have any questions, concerns, or problems accessing the quote package using the link, please contact Bernice Moen,
Contract Administrator I. Request for additional information or clarification regarding the specifications must be sent via
email to purchasing@northportfLgov. No verbal requests will be honored. All questions and clarifications must be
submitted via e-mail or facsimile by February 13, 2025 at 2:00 PM.
CRITERIA FOR AWARD: The award of this Quote will be to the lowest overall responsive, responsible Quoter meeting or
exceeding all the specifications contained herein. The City reserves the right to award this quote in whole or in part, or by
line item, whichever is in the best interest of the City. Other considerations of award may be references, experience of the
quoterwith accounts of this size or larger, prior performance evaluations created bythe City, and number of years in business.
The City reserves the right to reject the quote submittal of any Quoter who has previously failed to perform properly, or on
time, or who is not able to satisfactorily deliver the goods or perform the services specified herein.
It is expressly understood by the City and the Contractor that award of the Contract is contingent upon appropriation of funds
by the City Commissioners.
EXAMINATION OF REQUEST FOR QUOTE DOCUMENTS/SITE: Prior to submission of the quote form, quoters shall carefully
examine the terms and conditions in this document, special provisions, and all other related quote documents, including all
modifications thereof, incorporated in the quote package, plus fully informing themselves as to all existing conditions and
limitations that effect the work to be performed under this contract.
Examination of site: Prior to submitting the quote form, each quoter shall examine the site and all conditions thereon during
the pre -quote meeting, if applicable or as requested. All quote forms shall be presumed to include all such existing conditions
as may affect any work to be done on this project. Failure to familiarize himself/herself with such conditions will in no way
relieve the successful quoter from the necessity of furnishing any materials or performing any work that may be required to
complete the work in accordance with the Specifications and drawings (if applicable).
INSTRUCTIONS TO QUOTERS:
To be considered, your properly completed Quote Form must be received by the City's Purchasing division by the Due Date
above. Quotes must be received by the City via email. The Quote Form below must be used to submit a Quote. All other
quote documents submitted will be rejected.
Do not submit a Quote for $100,000 or more. In the event no responsive and responsible quotes are received under this
quote threshold, the City may elect to cancel this request for quote and re -solicit using another procurement method. If in
your opinion the goods specified herein cannot be delivered under this dollar threshold, please notify the City's Purchasing
Division via email.
Page 3 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
1. Refer to this Request for Quote (RFQ) Number on all correspondences related to this RFQ.
2. Your Quote MUST comply the with the Instructions, Terms and Conditions, and Specifications contained herein.
3. Prices quoted are to be freight included or firm freight amount is to be listed.
4. Material markup shall not exceed industry standard for a municipality.
5. Any applicable travel should be portal (the Contractor location) to portal (City of North Port — one travel, not to our
facility and then again to any individual location of work.)
DEFINITIONS:
• Addenda: a written change to a solicitation.
• Contract: The submitted Quote forms signed by the Contractor, together with the complete quote solicitation and
any Purchase Order(s) furnished by the City shall constitute a binding contract.
• Contractor or Vendor: A general reference to any entity responding to this solicitation or performing under any
resulting Contract.
• Quote or Submittal: Any offer submitted in response to this RFQ, including all applicable forms.
•Quoter: One that submits a quote in response to this request for quote.
• Responsible: Refers to a quoter that has the capacity and capability to perform the work required under a Request
for Quote and is otherwise eligible for award.
• Responsive: Refers to a quote that contains no exceptions or deviations from the terms, conditions, provisions,
specifications, and drawings (if applicable) as set forth in the Request for Quote.
• Request for Quote (RFQ): This solicitation document, including any and all addenda.
• Solicitation: This written document requesting quotes from the marketplace.
TERMS AND CONDITIONS:
In the event of any conflict between the Terms and Conditions of this RFQ and the City's Purchase Order Terms and Conditions
the following Terms and Conditions shall control:
FREIGHT: FOB Destination, 1100 N. Chamberlain Blvd., City of North Port, FL 34286
Unless otherwise specified herein, deliveries shall be made, and work shall be performed during normal business hours
Monday through Friday from 7:00am — 3:00pm.
ESTIMATED QUANTITIES: It is understood that the quantities contained herein are approximate only and are solely for the
purpose of facilitating the comparison of quotes, and that the Contractor's compensation will be computed upon the basis
of the actual quantities in the completed work, whether they be more or less than those shown.
DESCRIPTIVE INFORMATION: Unless otherwise specifically provided in the Scope of Work, Special Provisions or Technical
specifications, all equipment, materials and articles incorporated in the work covered by this Contract are to be new and of
the most suitable grade for the purpose intended. Unless otherwise specifically provided in the Technical specifications,
reference to any equipment, material, article or patented process, by trade name, make or catalog number, shall be regarded
as establishing a standard of quality and shall not be construed as limiting competition. If the Quoter wishes to make a
substitution to the specifications, the Quoter shall furnish the City the name of the manufacturer, the model number and
other identifying data and information necessary to aid in the City in evaluating the substitution. Such substitution shall be
subject to City approval. Substitutions shall be approved only if determined by the City to be equivalent to the specifications.
A quote containing substitution is subject to disqualification if the City does not approve the substitution.
ARITHMETIC DISCREPANCIES: For the purpose of initial evaluation of quotes, the following will be utilized in resolving
arithmetic discrepancies found on the face of the quote forms as submitted by quoters:
Page 4 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
A. Obviously misplaced decimal points will be corrected.
In case of discrepancy between unit price and extended price, the unit price will govern. Apparent errors in
extension will be corrected.
C. Apparent errors in addition of lump sum and extended prices will be corrected.
For the purpose of quote evaluation, the City will proceed on the assumption that the quoter intends his/her quote be
evaluated on the basis of the unit prices, extensions, and totals arrived at by resolution of arithmetic discrepancies as provided
above, and the quote will be so reflected on the tabulation of quotes.
FORM OF CONTRACT: The submitted Quote Form signed by the Quoter, together with the complete quote package
furnished by the City and a purchase order, shall constitute a binding contract (hereinafter "contract documents"). The Quoter
shall be required to perform according to the Quoter's submitted Quote Form and the City's quote package when a purchase
order, signed by the Purchasing Manager, is transmitted to the Quoter. The transmitted purchase order shall serve as both a
Notice of Acceptance and Notice to Proceed to the Quoter. Failure to comply with the conditions set forth in the purchase
order shall be deemed a breach of contract subjecting the Quoter to forfeiture of the bid bond (if applicable) or other posted
security and other possible penalties.
NON-EXCLUSIVE CONTRACT: Quoter acknowledges and agrees that services under this Contract are to be requested by City
on an as -needed basis only, and no representation or guarantee is made by City to quoter that City will utilize quoter's services
exclusively or at all. No guarantee of services or volume of work is implied. This Contract does not entitle quoter to exclusive
rights to City contracts. The City reserves the right to acquire services from other companies if deemed appropriate.
CITY RESERVED RIGHTS: The City reserves the right to accept or reject any and/or all quotes, to waive irregularities and
technicalities, and to request resubmission of quotes. Also, the City reserves the right to accept all or any part of the quote
and to increase or decrease quantities to meet additional or reduced requirements of the City. Any sole response received
on the first submission date may be rejected by the City depending on available competition and timely needs of the City.
WARRANTY: All warranties express and implied, shall be made available to the City for goods, equipment, and services
covered by this solicitation. Contractor warrants that all workmanship, materials, and equipment will be new and in
accordance with industry standards for a period of one (1) year of completion of the work or delivery of the goods. Any
defective workmanship or nonconforming materials or equipment will be immediately removed and replaced by Contractor
at its expense. Failure on the part of the City to reject inferior workmanship or to note nonconforming materials or equipment
will not be construed to imply acceptance by the City. The terms and conditions of this solicitation may supersede the
manufacturer's standard warranty.
SUB -CONTRACTING: The Contractor shall not sell, transfer, assign or otherwise dispose of the Contract or any portion thereof
without written consent of the City. If the Contractor chooses to sublet any portion of the Contract, the Contractor must
provide a written request to sublet work to the City for approval. With the City's acceptance of the request, the Contractor
may sublet a portion of the work, but shall perform with its own organization work amounting to not less than 50% of the
total Contract amount. The request will be deemed acceptable by the City, for purposes of the City's consent, unless the City
notifies the Contractor within five (5) business days of receipt of the request that the City is not consenting to the requested
subletting.
ASSIGNMENT: This Contract, or any interest herein, shall not be assigned, transferred or otherwise encumbered, under any
circumstances by the Vendor without the prior written consent of the City Manager or designee.
TAXES: The City is exempt from Federal Excise and State Sales Taxes. The Contractor shall assume liability for Local, State,
or Federal Tax that is applicable to the work. The quote shall not include sales tax to be collected from the City. The City's
sales tax exemption is not available to Contractor for items Contractor purchases, regardless of whether these items will be
transferred to the City.
Page 5 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
PAYMENT: The City's Finance Department shall issue payments in accordance with the Florida Local Government Prompt
Payment Act, Florida Statutes, Chapter 218, upon receipt of the Contractor's invoice and approval of same by the City
indicating that the goods and services have been delivered and/or performed in conformity with this Request for Quote.
The City reserves the right to pay for purchases made under any Contract resulting from a solicitation through its Purchasing
Card Program which utilizes VISA credit cards. When payment is received utilizing the City credit card, an original invoice
should not be mailed to the City's Finance Department. Only the detailed/itemized credit card receipt is issued for this charge
with the original receipt being provided with the delivery to the individual cardholder placing the order. No surcharges will
be accepted for the use of purchasing cards.
CONTINUOUS PROSECUTION OF WORK: The Contractor shall continuously prosecute the work, or a designated portion of it
in accordance with the Contract Documents. Upon written direction from the City, the Contractor shall remove any personnel
for the duration of the Contract, who fails to comply with the Contract Documents.
Once commencing the work, the operation must be continuously prosecuted during normal hours to its completion. At no
time shall the Contractor suspend work for any reason, for more than seven (7) calendar days, excluding delays granted for
inclement weather.
Correction of safety concerns will be given priority and shall be corrected as soon as practicable, but not later than 24 hours
after discovery by the City and notification to the Contractor. Failure to comply with these Provision and/or Technical
Specification shall result in the Contractor being considered in default and subject to suspension of this contract.
Contractor shall furnish to the City, in such detail and as often as requested, full reports of the progress of Contractor's
Services irrespective of its location. The presence of an inspector shall in no way lessen the responsibilities of the Contractor.
TERMINATION OF CONTRACT:
Funding in Subsequent Fiscal Years: It is expressly understood by the City and the Contractor that funding for any successive
fiscal years of the Contract is contingent upon appropriation of funds by the City Commissioners. In the event that funds are
not available or appropriated, the City reserves the right to terminate the Contract. The City will be responsible for payment
of any outstanding invoices and work completed by the Contractor prior to such termination.
Termination With or Without Cause: The City shall have the right to unilaterally cancel, terminate or suspend this Contract,
in whole or in part, by providing the Contractor thirty (30) days written notice by certified mail.
The City reserves the right to terminate this Contract, in part or in whole, in the event the Contractor fails to perform in
accordance with the terms and conditions stated herein. The Contractor will be notified by letter of the City's intent to
terminate. In the event of termination for default, the City may procure the required goods and/or services from any source
and use any method deemed in its best interest. All re -procurement cost shall be borne by the Contractor.
Termination by Contractor: Contractor shall have the right to terminate services only in the event of the City failing to pay
Contractor's properly documented and submitted invoice within ninety (90) calendar days of the approval by the City's
Administrative Agent, or if the project is suspended by the City for a period greater than ninety (90) calendar days.
PERMITS AND REGULATIONS: Permits and licenses necessary for the prosecution of the work shall be secured and paid for
by the Contractor, unless otherwise specified. The Contractor shall give all notices and comply with all laws, ordinances, rules,
and regulations bearing on the conduct of the work as drawn and specified. If the Contractor observes that the specifications
and drawings are at variance therewith, he/she shall promptly notify the City in writing, and any necessary changes shall be
adjusted as provided in the Contract for changes in the work. If the Contractor performs any work knowing it to be contrary
to such laws, ordinances, rules, and regulations, and without such notice to the City, he/she shall bear all costs arising
therefrom. It shall be the responsibility of the Contractor to assure compliance with any FDOT specifications, OSHA, EPA,
and/or other Federal, State or City law(s), code(s) and ordinance(s), as each may apply.
Page 6 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
DAMAGES: The Contractor shall take all necessary precautions for the safety of and will provide the necessary protection as
deemed necessary by the City, and any of its personnel to prevent damage, injury or loss to the traveling public, employees
on the job and other persons who may be affected thereby, all the work and all materials or equipment to be incorporated
therein, whether in storage on or off the site, and other property at the site or adjacent thereto.
The Contractor shall be responsible for the protections of adjoining property which may include, but not be limited to
mailboxes, sprinkler systems, conduits, landscaping ornaments, trees, shrubs, lawns, walks, pavements, driveways,
sidewalks, roadways, structures and utilities, not designated for removal, relocation or replacement in the course of the
work. Areas adjacent to the work that are damaged shall be repaired at the Contractor's expense. Restoration of adjoining
areas shall be equal to or better than original condition and to the satisfaction of the City.
If applicable, mailboxes shall be kept in service to the satisfaction of the US Postal Service and the City, until they are
permanently restored to their proper location upon the completion of the work. Driveways and City roads impacted
during the work shall be temporarily restored as soon as possible and maintained on a continual basis to minimize the
impact on the homeowners' egress and access. These provisions apply to the warranty period after City approval of
completion of the contract. The work limits at each work zone area shall be agreed to by the Contractor and the City prior
to any work programs. Any damage outside the agreed work zone area shall be the responsibility of the Contractor to
restore.
DECLARATION OF EXEMPTION FROM PUBLIC RECORD: In accordance with Florida Statutes 119.0701, Contractor shall
comply with all public records laws, and shall specifically:
1. Keep and maintain public records required by the CITY to perform the service.
a. The timeframes and classifications for records retention requirements must be in accordance with the General
Records Schedule GS1-SL for State and Local Government Agencies.
(See http://dos.state.f1.us/library-archives/records-management/general-records-schedules/).
b. Public records" means and includes those items specified in Florida Statutes 119.011(12), as amended from time
to time, and currently defined as: All documents, papers, letters, maps, books, tapes, photographs, films, sound
recordings, data processing software, or other material, regardless of the physical form, characteristics, or means
of transmission, made or received pursuant to law or ordinance or in connection with the transaction of official
business with the City. Contractor's records under this Contract include but are not limited to,
supplier/subcontractor invoices and contracts, project documents, meeting notes, emails and all other
documentation generated during this Contract.
2. Upon request from the City's custodian of public records, provide the City, at no cost, with a copy of the requested
records or allow the records to be inspected or copied within a reasonable time at a cost that does not exceed the
cost provided for by law. All records kept electronically must be provided to the City, upon request from the City's
custodian of public records, in a format that is compatible with the information technology systems of the City.
3. Ensure that project records that are exempt or confidential and exempt from public records disclosure requirements
are not disclosed except as authorized by law for the duration of the contract term and, if the CONTRACTOR does not
transfer the records to City following completion of the contract, for the time period specified in General Records
Schedule GS1-SL for State and Local Government Agencies.
Page 7 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
4. Upon completion of the contract, transfer, at no cost, to the City all public records in Contractor's possession or keep
and maintain public records required by the City to perform the service. If the Contractor transfers all public records
to the City upon completion of the contract, the Contractor shall destroy any duplicate public records that are exempt
or confidential and exempt from public records disclosure requirements. If the Contractor keeps and maintains public
records upon the completion of the contract, the Contractor shall meet all applicable requirements for retaining
public records.
5. 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, CONTACT THE CUSTODIAN OF PUBLIC RECORDS AT
CUSTODIAN OF PUBLIC RECORDS, 4970 CITY HALL BOULEVARD, NORTH PORT, FLORIDA
34286, 941.429.7063 OR HOTLINE 941.429.7270; EMAIL:
Publicrecordsreguest@cityofnorthport.com.
6. Failure of the CONTRACTOR to comply with these requirements shall be a material breach of this Contract. Further,
Contractor may be subject to penalties under Florida Statutes 119.10.
STATE REGISTRATION REQUIREMENTS: Any Quoter required by Florida law to register to do business in this state shall either
be registered or have applied for registration with the Florida Department of State in accordance with the provisions of
Chapter 607, 608, 617, or 621, Florida Statutes, unless they are exempt. A copy of the registration/application may be
required prior to award of a contract. Any partnership submitting a quote in response to this Request for Quote shall have
complied with the applicable provisions of Chapter 620, Florida Statutes.
UNAUTHORIZED ALIEN WORKERS: The City will not intentionally award publicly -funded contracts to any Contractor who
knowingly employs unauthorized alien workers, constituting a violation of the employment provisions contained in U.S.C.
Section 1324a(e) [Section 274A(e) of the Immigration and Nationality Act ("INA")]. The City shall consider employment by
any Contractor of unauthorized aliens a violation of Section 274A(e) of the INA. Such violation by the Contractor of the
employment provisions contained in Section 274A(e) of the INA shall be grounds for termination of the Contract by the City.
EQUAL EMPLOYMENT OPPORTUNITY: City, Florida, in accordance with the provisions of Title VI of The Civil Rights Act of
1964 (78 Stat. 252) and the Regulations of the Department of Commerce (15 CFR, Part 8) issued pursuant to such Act, hereby
notifies all quoters that it will affirmatively ensure that in any contract entered into pursuant to this advertisement, minority
business enterprises will be afforded full opportunity to submit quotes in response to this advertisement and will not be
discriminated against on the grounds of race, color or national origin in consideration for an award.
All quoters are hereby notified that the successful quoter (Contractor) must and shall comply with the Civil Rights Act of 1964,
the Age Discrimination in Employment Act, the Rehabilitation Act of 1973, the Americans with Disabilities Act and the Florida
Civil Rights Act, all as amended. Specifically, Contractor agrees that:
• No person shall, on the grounds of race, color, sex, religion, age, disability, national origin or marital status, be
excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any
program, activity or service funded through this Contract.
• Contractor will not discriminate against any employee or applicant for employment because of race, color,
religion, sex, age, disability, national origin or marital status. Contractor agrees to post in a conspicuous place,
available to employees and applicants for employment, notices setting forth the provisions of this non-
discrimination clause.
• Contractor will, in all solicitations or advertisements regarding program activities, services provided or
applications for employment, state that all qualified applicants will receive consideration for services or
employment without regard to race, color, religion, sex, age, disability, national origin or marital status.
Page 8 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
• City may require Contractor to submit reports as may be necessary to indicate non-discrimination. City officials
will be permitted access to Contractor's books, records, accounts and other sources of information and its
facilities as may be pertinent to ascertain compliance with non-discrimination laws.
It is expressly understood that City shall have the right to terminate this Contract upon receipt of evidence of discrimination.
FORCE MAJEURE: Should performance of any obligation created under this Agreement become illegal or impossible by reason
of:
a. A strike or work stoppage, unless caused by a negligent act or omission of either Party;
b. An act of God, tornado, hurricane, flood, sinkhole, fire, explosion, landslide, earthquake, epidemic, pandemic,
quarantine, pestilence, or extremely abnormal and excessively inclement weather;
C. An act of a public enemy, act of war, terrorism, effect of nuclear radiation, blockage, insurrection, riot, civil
disturbance, state of martial law, or national or international calamity;
d. A declared emergency of the federal, state, or local government; or
e. Any other like event that is beyond the reasonable control of the non -performing party;
then the performance of any such obligation is suspended during the period of, and only to the extent of, such prevention or
hindrance, provided that:
f. The non -performing party provides written notice within five (5) days of the event of force majeure, describing the
event in sufficient detail, including but not limited to: the nature of the occurrence, a good faith estimate of the duration of
the delay, proof of how the event has precluded the non -performing party from performing, and the means and methods for
correcting the delay; and continues to furnish timely reports of all actions required for it to commence or resume performance
of its obligations under this Agreement;
g. The excuse of performance is no greater in scope or duration than required by the event of force majeure;
h. No obligations of either party that arose before the force majeure are excused as a result of the event of force
majeure; and
i. The non -performing party uses all reasonable diligence to remedy its inability to perform.
Economic hardship of a party does not constitute an event of force majeure. A party will not be excused from performance
due to forces that it could have reasonably prevented, removed, or remediated prior to, during, or immediately after their
occurrence.
The non -performing party's affected obligations under this Agreement will be temporarily suspended during, but not longer
than, the continuance of the event of force majeure and a reasonable time thereafter as may be required to commence or
resume performance of its obligations. Notwithstanding the above, performance shall not be excused under this Section for
a period exceeding two (2) months, provided that in extenuating circumstances, the City may excuse performance for a longer
term.
REFERENCES: Contractor shall submit a minimum of three (3) recent (within the past three (3) years) references of projects
of similar size and scope on the attached Reference form. Each reference shall include a project description, project location,
name and phone number of a contact person, total project amount, and completion date. The City reserves the right to
contact references.
MODIFICATION OF CONTRACT: Any Contract resulting from this solicitation may be modified by mutual consent of duly
authorized parties, in writing through the issuance of a modification to the Contract and/or change order as appropriate. This
presumes the modification itself is in compliance with all applicable City procedures. The Contract Documents shall constitute
the sole and complete understanding between the parties and supersedes all agreements between them, whether oral or
written with respect to the subject matter. No amendment, change, or addendum to this Contract is enforceable unless
agreed to in writing by both parties and incorporated into this Contract. The City Manager or designee may agree to
amendments that do not increase compensation to Contractor. A Contract modification or change order is a written
instrument prepared by the City and signed by the Contractor stating their agreement upon the change in Contractor's
Services.
Page 9 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
UNKNOWN CONDITIONS: If in the performance of Contractor's Services, Contractor finds latent, concealed or subsurface
physical conditions which differ from the conditions Contractor reasonably anticipated, or if physical conditions are materially
different from those normally encountered and generally recognized as inherent in the kind of work provided for in this
Contract, then the Contract Price and/or the Schedule of Contractor's Services may be equitably adjusted by mutual
agreement by the Contractor and the City with the execution of a Change Order to the Contract within reasonable time after
the conditions are first observed.
CHANGES IN THE WORK: The City, without invalidating the Contract, may order extra work or make changes by altering,
adding to or deducting from the work, the Contract sum being adjusted accordingly. Such work shall be executed under the
conditions of the original Contract. The change and amount of compensation must be agreed upon in writing in a document
of equal dignity herewith prior to any deviation from the terms of this Contract.
In giving instructions, the City shall have authority to make minor changes in the work, not involving extra cost, and not
inconsistent with the purposes of the work. Except in an emergency endangering life or property, no extra work or change
shall be made unless in pursuance of a written order by the City; and no claim for an addition to the Contract sum shall be
valid, unless ordered. Value of any such extra work, unknown conditions, or change(s) shall be determined by the rate sheet
submitted with the quote, approved by the City, and incorporated into the Contract issued pursuant to this solicitation.
If the previous method is not agreed upon, the Contractor, provided he/she receives an order as above, shall proceed with
the work. In such case and also under case, he/she shall keep amendment in such form as the City may direct, a correct
amount of the net cost of labor and materials, together with vouchers. The City shall certify to the amount, including
reasonable allowance for overhead and profit, due to the Contractor. Pending final determination of value, no payment on
changes shall be made. When requiring a change in the scope of services the Contractor shall notify the City by written notice
that a change order is requested within five (5) days of any occurrence.
MISCELLANEOUS ITEMS: All other miscellaneous items not specifically provided for in the request for quote, but required
for completion of the project and considered pertinent to the work, shall be considered incidental to the project.
Please note: If you are unable or do not desire to quote, please indicate on the Statement of Non -Submittal Form and return
to Purchasing.
CONTACT PROHIBITION: All prospective quoter are hereby instructed NOT to contact any member of the City of North Port
Commission, the City Manager, or City of North Port staff member other than the Authorized Contact Persons identified in
this Solicitation regarding this solicitation package, quoter's submittal package, City's Intent to Award, or City's Intent to
Reject (if applicable) at any time prior to the AWARD for this project. Any such contact shall be cause for rejection of your
submittal.
E- VERIFY: The City, contractor and every subcontractor shall register with and use the E-Verify system of the United States
Department of Homeland Security to verify the work authorization status of all new employees as required by Section
448.095, Florida Statutes. A contractor who enters into a contract with a subcontractor, must require that the subcontractor
provides the contractor a certification by affidavit stating that at the time of such certification and during the term of the
contract, the subcontractor does not and will not employ, contract, or subcontract with an unauthorized alien, who is not
authorized under federal law to be employed in the United States, as described in 8 U.S.C. S. 1324A(H)(3). The Contractor
shall comply with all other federal laws pertaining to the subcontractor.
INSURANCE REQUIREMENTS:
WORKERS COMPENSATION: Coverage to apply for all employees for Statutory Limits in compliance with the applicable state
and federal laws. The policy must include Employers' Liability with a limit of $1,000,000 each accident; $1,000,000 each
employee; and $1,000,000 policy limit for disease.
Page 10 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
COMMERCIAL GENERAL LIABILITY: Occurrence form required. Aggregate must apply separately to this contract/job.
Minimum $1,000,000 each occurrence; $2,000,000 general aggregate; $1,000,000 products and completed ops; and
$100,000 damage to rented premises.
COMMERCIAL AUTOMOBILE LIABILITY: To include all vehicles owned, leased, hired and non -owned vehicles with limits of
not less than $1,000,000 per each accident and for property damage and bodily injury, with contractual liability coverage for
all work performed under this Contract.
SPECIAL REQUIREMENTS:
1. City of North Port is to be named additional insured on Comprehensive Commercial General Liability Policy.
2. Garage Keeper's Liability coverage in the amount of $1,000,000. May be endorsed on the General Liability
3. The Certificate of Insurance must include the following:
In the "Description of Operations/Special Provisions" section - "City of North Port is named as an additional insured, as
their interests may appear on Commercial General Liability and Commercial Auto Policy."
In the "Certificate Holder" section:
City of North Port
4970 City Hall Boulevard
North Port, FL 34286
All certificates of insurance Certificates must be on file with and approved by the City before commencement of any work
activities under this Contract.
Any and all deductibles to the above referenced policies are to be the responsibility of the successful quoter. Current valid
insurance policies meeting the requirements herein identified shall be maintained during the duration of the contract period.
Renewal certificates shall be sent to the City thirty (30) business days prior to any expiration date. There shall be a thirty (30)
business day notification to the City in the event of cancellation or modification of any stipulated insurance coverage. It shall
be the responsibility of the Contractor to ensure that all subcontractors comply with the same insurance requirements that
he/she is required to meet. All certificates of insurance meeting the required insurance provisions shall be forwarded to the
City of North Port Purchasing Office.
EMPLOYEE BACKGROUND CHECK: If an owner, except a stockholder in a publicly traded corporation, or an employee of the
Contractor has been convicted of any offenses requiring registration as a sexual offender or sexual predator, regardless of
the location of conviction, the Contractor shall ensure that the offender's or predator's work on the project is consistent with
the terms of his probation and registry requirements.
DRUG FREE WORKPLACE PREFERENCE: The City has adopted a policy in observation of the Drug Free Workplace Act of 1988.
Therefore, it is unlawful to manufacture, distribute, dispense, possess, or use any controlled substance in the City workplace.
The City requests that the attached Drug Free Workplace Affidavit accompany the quote response. This form has been
adopted by the City in accordance with the Drug Free Workplace Act. The City will not disqualify any quoter who does not
sign the affidavit. The Drug Free Workplace Affidavit is primarily used as a tie breaker when two or more separate entities
have submitted quotes at the same price, terms and conditions, with preference given to the quoter who has signed the
affidavit.
Page 11 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
PUBLIC ENTITY CRIMES: In accordance with Florida Statutes Sec. 287.133(2)(a), "A person or affiliate who has been placed
on the convicted Contractor list following a conviction for a public entity crime may not submit a quote on a contract to
provide any goods/services to a public entity, may not submit a quote on a contract with a public entity for construction or
repair of a public building or public work, may not submit quotes on leases of real property to a public entity, may not be
awarded or perform work as a contractor, supplier, subcontractor, or consultant under a contract with any public entity, and
may not transact business with any public entity in excess of the threshold amount provided in Section 287.017, for Category
Two, for a period of 36 months from the date of being placed on the convicted contractor list".
SCRUTINIZED COMPANIES:
A. As required by section 287.135(5), Florida Statutes, for contracts of $1,000,000.00 or less, when submitting a bid
or proposal, and prior to entering into a contract with the City, ever person or entity shall certify on a form provide
by the City, that it is not on the Scrutinized Companies that Boycott Israel List, created pursuant to section
215.4725, Florida Statutes, and that it is not engaged in a boycott of Israel.
B. As required by section 287.135(5), Florida Statutes, for contracts of $1,000,000.00 or more, when submitting a
bid or proposal, and prior to entering into a contract with the City, ever person or entity shall certify on a form
provided by the City, that all of the following are true:
It is not on the Scrutinized Companies that Boycott Israel List, created pursuant to section 215.4725, Florida
Statutes, and that it is not engaged in a boycott of Israel; and
It is not on the Scrutinized Companies with Activities in Sudan list or the Scrutinized Companies with Activities
in Iran Petroleum Energy Sector list, created pursuant to section 215.473, Florida Statutes; and
3. It is not engaged in business operations in Cuba or Syria.
C. PENALTY:
1. If a false certification is submitted or the person or entity has been placed on one of the above -noted Lists of
Scrutinized Companies or has engaged in business operations in Cuba or Syria, the person or entity will be in
breach of the Contract terms and the City may terminate the Contract.
2. A person or entity that has been found to have provided a false certification may be subject to a civil penalty
equal to the greater of $2 million or twice the amount of the Contract, plus all reasonable attorney's fees and
costs, including any costs for investigations that led to the finding of the false certification; and
A person or entity that has been found to have provided a false certification shall be ineligible to bid on any
contract with the City for three (3) years after the date the City determined that a false certification has been
submitted.
HUMAN TRAFFICKING - Florida Statutes Section 787.06(13)
(13) When a contract is executed, renewed, or extended between a nongovernmental entity and a governmental entity,
the nongovernmental entity must provide the governmental entity with an affidavit signed by an officer or a
representative of the nongovernmental entity under penalty of perjury attesting that the nongovernmental entity does
not use coercion for labor or services as defined in this section. For purposes of this subsection, the term "governmental
entity" has the same meaning as in s. 287.138(1).
Page 12 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
FOREIGN ENTITY OF CONCERN COMPLIANCE WITH FLORIDA STATUTE 287.138
(1) As used in this section, the term:
(a) "Controlling interest" means possession of the power to director cause the direction of the management or policies of
a company, whether through ownership of securities, by contract, or otherwise. A person or entity that directly or indirectly
has the right to vote 25 percent or more of the voting interests of the company or is entitled to 25 percent or more of its
profits is presumed to possess a controlling interest.
(b) "Department" means the Department of Management Services.
(c) "Foreign country of concern" means the People's Republic of China, the Russian Federation, the Islamic Republic of
Iran, the Democratic People's Republic of Korea, the Republic of Cuba, the Venezuelan regime of Nicolas Maduro, or the
Syrian Arab Republic, including any agency of or any other entity of significant control of such foreign country of concern.
(d) "Governmental entity" means any state, county, district, authority, or municipal officer, department, division, board,
bureau, commission, or other separate unit of government created or established by law including, but not limited to, the
Commission on Ethics, the Public Service Commission, the Office of Public Counsel, and any other public or private agency,
person, partnership, corporation, or business entity acting on behalf of any public agency.
(2) A governmental entity may not knowingly enter into a contract with an entity which would give access to an individual's
personal identifying information if:
(a)The entity is owned by the government of a foreign country of concern;
(b)The government of a foreign country of concern has a controlling interest in the entity; or
(c)The entity is organized under the laws of or has its principal place of business in a foreign country of concern.
(3) Beginning July 1, 2025, a governmental entity may not extend or renew a contract with an entity listed in paragraphs
(2)(a)-(c) if the contract would give such entity access to an individual's personal identifying information.
(4)(a) Beginning January 1, 2024, a governmental entity may not accept a bid on, a proposal for, or a reply to, or enter
into, a contract with an entity which would grant the entity access to an individual's personal identifying information
unless the entity provides the governmental entity with an affidavit signed by an officer or representative of the entity
under penalty of perjury attesting that the entity does not meet any of the criteria in paragraphs (2)(a)-(c).
(b) Beginning July 1, 2025, when an entity extends or renews a contract with a governmental entity which would grant the
entity access to an individual's personal identifying information, the entity must provide the governmental entity with an
affidavit signed by an officer or representative of the entity under penalty of perjury attesting that the entity does not
meet any of the criteria in paragraphs (2)(a)- (c).
REMAINDER OF THIS PAGE INTENTIONALLY LEFT BLANK
Page 13 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
QUOTE PRICES FORM:
REQUEST FOR QUOTATION NO. 2025-22
BRUSH TRUCK, AMBULANCE, AND FIRE APPARATUS REPAIR, MAINTENANCE AND UPFITTING SERVICES
The signature below is a guarantee that the Quoter shall not withdraw, modify, or cancel this quote for a period of ninety
(90) days after the quote due date.
The undersigned further certifies that he/she has read the Request for Quotation, Terms and Conditions, and any other
documentation relating to this request, and this quotation is submitted with full knowledge and understanding of the
requirements and time constraints noted herein.
Line
Item
#
Specifications/Item Description/Service
Estimated
Quantity
Unit of
Measure
Unit
Price
Extended
Price
1
Hourly Shop Labor rate
1
Hour
2
Hourly Field labor rate (if applicable)
1
Hour
3
Travel rate (Circle one)
Trip/miles
4
Parts mark-up (if applicable)
Percentage
5
Parts discount (if applicable)
Percentage
Total Price
CONTACT PERSONNEL:
Contact Person:
Telephone Number:
Contact Email:
24 Hour Telephone Number:
License: EVT Certifications
Quoter Comments:
Company Name
Print Name & Title of Company Representative
Signature of person authorized to bind the company Date
THIS PAGE MUST BE COMPLETED AND RETURNED IF SUBMITTING A QUOTE.
Page 14 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
QUOTE SUBMITTAL SIGNATURE FORM
REQUEST FOR QUOTATION NO. 2025-22
BRUSH TRUCK, AMBULANCE AND FIRE APPARATUS REPAIR, MAINTENANCE AND UPFITTING SERVICES
The signature below is a guarantee that the Quoter shall not withdraw his/her quote for a period of ninety (90) days after
the scheduled quote due date. If notified of the acceptance of the quoter's submittal, the undersigned agrees to accept
the form of contract designated in this RFQ by the City for the stated compensation in the form as prescribed by the City.
The undersigned further certifies that he/she has read the Request for Quotation, Terms and Conditions, Insurance
Requirements and any other documentation relating to this request and this quotation is submitted with full knowledge and
understanding of the requirements and time constraints noted herein.
As addenda are considered binding as if contained in the original specifications, it is critical that the contractor acknowledge
receipt of same. The undersigned acknowledges receipt of the following addenda, and the cost, if any, of such revisions has
been included in the quote price.
Addendum No. Dated Addendum No. Dated
Addendum No. Dated Addendum No. Dated
Company Information
Type of Organization (Please Check One):
Individual Ownership Joint Venture LLC/LLP
Partnership Corporation OTHER _
Federal Identification Number:
Is this a Florida Corporation:
If not a Florida Corporation,
In what state was it created:
Name as spelled in that State:
What kind of corporation is it:
Is it in good standing:
Authorized to transact business
in Florida:
❑Yes or ❑No
❑"For Profit" or ❑"Not for Profit"
❑Yes or ❑No
❑Yes or ❑No
State of Florida Department of State Certificate of Authority Document No.:
Respondent shall submit proof that it is authorized to do business in the State of Florida unless registration is not required by
law.
Does it use a registered fictitious name:
DBA (if any):
❑Yes or ❑No
THIS PAGE MUST BE COMPLETED AND RETURNED IF SUBMITTING A QUOTE.
Page 15 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
QUOTE SUBMITTAL SIGNATURE FORM CONTINUED
REQUEST FOR QUOTATION NO. 2025-22
BRUSH TRUCK, AMBULANCE, AND FIRE APPARATUS REPAIR, MAINTENANCE AND UPFITTING SERVICES
Company Name
Telephone # E-Mail Fax #
Mailing Address
Location Address
City State Zip Code
Telephone # E-mail Fax #
Print Name & Title of Firm Representative
Signature of person authorized to bind the company Date
Do you accept Visa as payment for goods/services? ❑YES ❑ NO
STATE OF _
COUNTY OF
Sworn to and subscribed before me this day of , 20 , by
who ❑ is personally known to me or ❑ has produced his/her driver's license as
identification.
NOTARY SEAL:
Notary Public - State of
Print Name:
Commission No:
THIS PAGE MUST BE COMPLETED AND RETURNED IF SUBMITTING A QUOTE.
Page 16 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
ANTI -HUMAN TRAFFICKING AFFIDAVIT
Instructions: This form must be completed by an officer or representative of an entity registering as a vendor, entering into,
renewing, or extending, a contract with the City of North Port.
The undersigned, on behalf of
("Entity'), verifies the following:
A. I have read and understand that Florida Statutes Section 787.06(13), prohibits the City of North Port ("City") from
executing, renewing, or extending a contract to entities that use coercion for labor or services, with such terms defined
in Florida Statutes Section 787.06(2) as follows:
• "Coercion" means: (1) using or threatening to use physical force against any person; (2) restraining, isolating, or
confining or threatening to restrain, isolate, or confine any person without lawful authority and against her or his
will; (3) using lending or other credit methods to establish a debt by any person when labor or services are pledged
as a security for the debt, if the value of the labor or services as reasonably assessed is not applied toward the
liquidation of the debt, the length and nature of the labor or services are not respectively limited and defined; (4)
destroying, concealing, removing, confiscating, withholding, or possessing any actual or purported passport, visa, or
other immigration document, or any other actual or purported government identification document, of any person;
(5) causing or threatening to cause financial harm to any person; (6) enticing or luring any person by fraud or deceit;
or (7) providing a controlled substance as outlined in Schedule I or Schedule II of Section 893.03, Florida Statutes, to
any person for the purpose of exploitation of that person.
• "Labor" means work of economic or financial value.
• "Services" means any act committed at the behest of, under the supervision of, or for the benefit of another. The
term includes, but is not limited to, forced marriage, servitude, or the removal of organs.
B. I declare, under penalties of perjury, that Entity does not use coercion for labor or services as defined in Florida Statutes
Section 787.06(2).
C. I understand that this affidavit applies to any City contract executed, renewed, or extended for the duration of the
contract; and the Entity must execute and submit this affidavit at least annually in the vendor registration and renewal
process.
I, the undersigned, understand and affirm that the above statements are based upon personal knowledge; that I am over
the age of 18 years and otherwise competent to make the above statements; and am authorized to legally bind the Entity,
and make the above statements on behalf of Entity. Under penalties of perjury, I declare that I have read the forgoing
document and that the facts stated in it are true.
Authorized Signature: Date:
Printed Name: Title:
STATE OF
COUNTY OF
Sworn to (or affirmed) and subscribed before me by means of ❑ physical presence or ❑ online notarization, this day
of , 2025, by , as of
the Entity, and is ❑ personally known to me or ❑ produced identification. Type of
Identification produced
Signature of Notary Public
Name of Notary Typed, Printed or Stamped My Commission Expires:
THIS PAGE MUST BE COMPLETED AND RETURNED IF SUBMITTING A QUOTE.
Page 17 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
AFFIDAVIT OF COMPLIANCE REGARDING FOREIGN ENTITY OF CONCERN LAWS
The undersigned, on behalf of the entity listed below ("Entity'), hereby attests and declares as follows:
1. Entity is not owned by the government of a foreign country of concern as defined in Florida Statutes Section 287.138.
2. The government of a foreign country of concern does not have a controlling interest in Entity.
3. Entity is not organized under the laws of, and does not have a principal place of business in, a foreign country of concern.
4. Entity is not owned or controlled by the government of a foreign country of concern, as defined in Florida Statutes
Section 692.201.
5. Entity is not a partnership, association, corporation, organization, or other combination of persons organized under the
laws of or having its principal place of business in a foreign country of concern, as defined in Florida Statutes Section
692.201, or a subsidiary of such entity.
6. Entity is not a foreign principal, as defined in Florida Statutes Section 692.201.
7. Entity complies with all applicable requirements of Florida Statutes Sections 692.202, 692.203, and 692.204.
8. NOT APPLICABLE Entity is not a foreign principal prohibited from purchasing the subject real property. Entity is either
(1) not a person or entity described in Florida Statutes Section 692.204(1)(a) or (2) authorized under Florida Statutes
Section 692.204(2) to purchase the subject property. Entity complies with the requirements of Florida Statutes Section
692.204.
9. The undersigned is authorized to execute this affidavit on behalf of Entity.
Under penalties of perjury, I declare that I have read the foregoing document and that the facts stated in it are true.
ENTITY
LEGAL NAME
AUTHORIZED SIGNATURE
PRINT NAME AND TITLE
DATE
THIS PAGE MUST BE COMPLETED AND RETURNED IF SUBMITTING A QUOTE.
Page 18 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
DRUG FREE WORKPLACE FORM
The undersigned, in accordance with Florida Statutes Section 287.087, hereby certifies that the Contractor,
(Company Name):
1. Publishes 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. Informs 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. Gives 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), notifies employees that, as a condition of working on the commodities
or Contractual services that are under bid, the employee will abide by the terms of the statement and will notify the
employer of any conviction of, or plea of guilty or nolo contendere to, any violation 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. Imposes 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. Makes a good faith effort to continue to maintain a drug free workplace through implementation of this section.
Check one:
As the person authorized to sign this statement, I certify that this firm complies fully with above requirements.
As the person authorized to sign this statement, this firm does not comply fully with the above requirements.
Signature
Printed Name
Title
Date
THIS PAGE MAY BE COMPLETED AND RETURNED IF SUBMITTING A QUOTE.
Page 19 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
REFERENCES - CLIENT LIST
SUMMARY EXPERIENCE/QUALIFICATIONS/CLIENT LIST (List similar projects, with completion dates showing experience)
(At least three (3) in the past three (3) years).
1. Project Location:
Name of Contact Person:
Project Description:
Total Project Amount: $
2. Project Location:
Name of Contact Person:
Project Description:
Total Project Amount: $
3. Project Location:
Name of Contact Person:
Project Description:
Total Project Amount: $
Telephone #.
Start Date:
Telephone #
Completion Date:
Start Date: Completion Date:
Telephone #.
Start Date: Completion Date:
4. Project Location:
Name of Contact Person: Telephone #
Project Description:
Total Project Amount: $
Start Date: Completion Date:
THIS PAGE MUST BE COMPLETED AND RETURNED IF SUBMITTING A QUOTE.
Page 20 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
CONFLICT OF INTEREST FORM
F.S. §112.313 places limitations on public officers (including advisory board members) and employees' ability to contract with
the City either directly or indirectly. Therefore, please indicate if the following applies:
PART I.
❑ I am an employee, public officer or advisory board member of the City
(List Position or Board)
❑ I am the spouse or child of an employee, public officer or advisory board member of the City
Name:
❑ An employee, public officer or advisory board member of the City, or their spouse or child, is an officer,
partner, director, or proprietor of Respondent or has a material interest in Respondent. "Material interest" means
direct or indirect ownership of more than 5 percent of the total assets or capital stock of any business entity. For the
purposes of [§112.313], indirect ownership does not include ownership by a spouse or minor child.
Name:
❑ Respondent employs or contracts with an employee, public officer or advisory board member of the City
Name:
❑ None of The Above
PART II:
Are you going to request an advisory board member waiver?
❑ I will request an advisory board member waiver under §112.313(12)
❑ I will NOT request an advisory board member waiver under §112.313(12)
❑ N/A
The City shall review any relationships which may be prohibited under the Florida Ethics Code and will disqualify any
vendors whose conflicts are not waived or exempt.
BUSINESS NAME:
NAME (PERSON AUTHORIZED TO BIND THE COMPANY):
SIGNATURE: DATE:
THIS PAGE MUST BE COMPLETED AND RETURNED IF SUBMITTING A QUOTE.
Page 21 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
STANDARD INDEMNIFICATION AGREEMENT (NON CONSTRUCTION/NON DESIGN PROFESSIONAL)
The CONTRACTOR shall be fully liable for the actions of its directors, officers, members, partners, or subcontractors, and the
employees and agents of each of them, and shall fully indemnify, defend and hold harmless the CITY, its commissioners,
employees, agents and assigns from all demands, claims, suits, actions, judgments, damages, fines, fees, taxes, assessments,
penalties, losses, expenses, costs of every type and description, and reasonable attorneys' fees (at both trial and appellate
levels), of any nature or kind whatsoever caused by, or arising out of or related to the performance or breach of this Contract
by the CONTRACTOR, its officers, directors, members, partners, or subcontractors, and employees or agents of any of them;
provided, however, that the CONTRACTOR shall not indemnify for that portion of any loss or damages proximately caused by
the negligent act or omission of the CITY.
To the extent applicable, the CONTRACTOR shall fully indemnify, defend and hold harmless the CITY, and its commissioners,
agents, employees and assigns from any demands, claims, suits, actions, judgments, damages, fines, fees, taxes, assessments,
penalties, losses, expenses, costs of every type and description, and reasonable attorneys' fees (at both trial and appellate
level), arising from or relating to violation or infringement of a trademark, copyright, patent, trade secret or intellectual
property right; provided, however, that the foregoing obligation shall not apply to the misuse or modification of
CONTRACTOR's products by the CITY or any of its commissioners, agents, employees, and assigns, or to the operation or use
of CONTRACTOR's products by the CITY or any of its commissioners, agents, employees, and assigns in a manner not
contemplated by the Contract.
In the event of a claim, the CITY shall promptly notify the CONTRACTOR in writing by prepaid certified mail (return receipt
requested), or by delivery through any nationally recognized courier service (such as Federal Express or UPS) which provides
evidence of delivery to the address provided below. Notification may also be provided by fax transmission to the number
provided below.
The CITY shall provide all available information and assistance that the CONTRACTOR may reasonably require regarding any
claim. This agreement for indemnification shall survive termination or completion of this Contract. The insurance coverage
and limits required in this Contract may or may not be adequate to protect the CITY and such insurance coverage shall not
be deemed a limitation on the CONTRACTOR's liability under the indemnity provided in this section. In any proceedings
between the parties arising out of or related to this Indemnity provision, the prevailing party shall be reimbursed all costs, expenses
and reasonable attorney fees through all proceedings (at both trial and appellate levels).
Name of Quoting Firm:
Mailing Address:
Location Address:
City & State:
Telephone:
E-mail:
Signature of person authorized to bind the Company:
Print name and title of person above:
Date:
Zip:
Fax Number:
THIS PAGE MUST BE COMPLETED AND RETURNED IF SUBMITTING A QUOTE.
CERTIFICATION REGARDING LOBBYING
Page 22 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
The undersigned certifies, to the best of his or her knowledge, that:
1. No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for
influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of
Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of
any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension,
continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.
2. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or
attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or
an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the
undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its
instructions.
3. The undersigned shall require that the language of this certification be included in the award documents for all subawards
at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all
subrecipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was made or
entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by 31,
U.S.C. § 1352 (as amended by the Lobbying Disclosure Act of 1995). Any person who fails to file the required certification
shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
The Contractor certifies or affirms the truthfulness and accuracy of each statement of its certification and disclosure, if any.
In addition, the Contractor understands and agrees that the provisions of 31 U.S.C. § 3801 et seq., apply to this certification
and disclosure, if any.
Signature of Contractor's Authorized Representative
Name
Title
Date
THIS PAGE MUST BE COMPLETED AND RETURNED IF SUBMITTING A QUOTE.
Page 23 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
NON -COLLUSIVE AFFIDAVIT
Before me, the undersigned authority ("Affiant"), personally appeared:
who, being first duly sworn, deposes and says that:
1. Affiant is the
the attached reply;
[insert Owner, Partner, Officer, Representative or Agent] of
[insert name of Contractor] the Respondent that has submitted
2. Affiant is fully informed respecting the preparation and contents of the attached reply and of all pertinent circumstances
respecting such reply.
3. Such reply is genuine and is not a collusive or sham reply.
4. Neither the said Respondent nor any of its officers, partners, owners, agents, representatives, employees or parties in
interest, including this affiant, have in any way colluded, conspired, connived or agreed, directly or indirectly, with any
other respondent, firm, or person to submit a collusive or sham reply in connection with the work for which the attached
reply has been submitted: or have in any manner, directly or indirectly sought by agreement or collusion, or
communication or conference with any respondent, firm, or person to fix the price or prices in the attached reply or of
any other respondent, or to fix any overhead, profit, or cost elements of the reply price or the reply price of any other
respondent, or to secure through any collusion, conspiracy, connivance, or unlawful agreement any advantage against
(Recipient), or any person interested in the reply work.
Signed, sealed, and delivered on 20
Signature
Printed Name
Title
SWORN ACKNOWLEDGMENT
STATE OF
COUNTY OF
Sworn to (or affirmed) and subscribed before me by means of physical presence or online notarization, this
day of 2025, by
Notary Public
Personally Known OR Produced Identification
Type of Identification Produced
THIS PAGE MUST BE COMPLETED AND RETURNED IF SUBMITTING A QUOTE.
Page 24 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
PUBLIC ENTITY CRIME INFORMATION
As provided by F.S. §287.133, a person or affiliate who has been placed on the convicted vendor list following a conviction
for a public entity crime may not submit a bid on a Contract to provide any goods or services to a public entity, may not
submit a bid on a Contract with a public entity for the construction or repair of a public building or public work, may not
submit bids on leases of real property to a public entity, may not be awarded or perform work as a Contractor, supplier,
Subcontractor, or Consultant under a Contract with any public entity, and may not transact business with any public entity in
excess of the threshold amount provided in Section 287, for CATEGORY TWO for a period of 36 months from the date of being
placed on the convicted vendor list.
being an authorized representative of the Contractor,
have read and understand the contents above.
I certify that the Contractor is not disqualified from replying to this solicitation/contracting because of Florida Statutes Section
287.133.
Telephone #:
Federal ID #:
Fax #:
Email:
Signature of Contractor's Authorized Representative
Name and Title of Contractor's Authorized Representative
Date
SWORN ACKNOWLEDGMENT
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me by means of physical presence or online notarization, this
day of
2025, by
Notary Public — State of Florida
Personally Known OR Produced Identification
Type of Identification Produced
THIS PAGE MUST BE COMPLETED AND RETURNED IF SUBMITTING A QUOTE.
Page 25 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
SCRUTINIZED COMPANY CERTIFICATION FORM
Contractor Name:
Authorized Representative Name and Title:
Address
Phone Number:
City:
Email Address:
State: ZIP:
A company is ineligible to, and may not, bid on, submit a proposal for, or enter into or renew a Contract with the City of North
Port for goods or services of any amount if, at the time of bidding on, submitting a proposal for, or entering into or renewing
such Contract, the company is on the Scrutinized Companies that Boycott Israel List, created pursuant to Florida Statutes,
section 215.4725, or is engaged in a boycott of Israel.
A company is ineligible to, and may not, bid on, submit a proposal for, or enter into or renew a Contract with the City of North
Port for goods or services of $1 million or more if, at the time of bidding on, submitting a proposal for, or entering into or
renewing such Contract, the company is on the Scrutinized Companies with Activities in Sudan List, the Scrutinized Companies
with Activities in the Iran Petroleum Energy Sector List, created pursuant to Florida Statutes, section 215.473, or with
companies engaged in business operations in Cuba or Syria.
CHOOSE ONE OF THE FOLLOWING
This Contract or Contract renewal is for goods or services of less than $1 million. As the person authorized to sign on
behalf of the above -named company, and as required by Florida Statutes Section 287.135(5), 1 hereby certify that the
above -named company is not participating in a boycott of Israel.
This bid, proposal, Contract or Contract renewal is for goods or services of $1 million or more. As the person authorized
to sign on behalf of the above -named company, and as required by Florida Statutes Section 287.135(5), 1 hereby certify
that the above -named company is not participating in a boycott of Israel, is not on the Scrutinized Companies with
Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List, and it does
not have business operations in Cuba or Syria.
I understand that pursuant to Florida Statutes, section 287.135, the submission of a false certification may result in the
termination of the Contract if one is entered into, and may subject the above -named company to civil penalties, attorney's
fees and costs.
Certified By:
Signature of Contractor's Authorized Representative
Name
Title
Date
THIS PAGE MUST BE COMPLETED AND RETURNED IF SUBMITTING A QUOTE.
Page 26 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
VENDOR'S CERTIFICATION FOR E-VERIFY SYSTEM
The undersigned Vendor/Consultant/Contractor (Vendor), after being duly sworn, states the following:
1. Vendor is a person or entity that has entered into or is attempting to enter into a contract with the City of North Port (City)
to provide labor, supplies, or services to the City in exchange for salary, wages or other renumeration.
2. Vendor has registered with and will use the E-Verify System of the United States Department of Homeland Security to
verify the employment eligibility of:
a. All persons newly hired by the Vendor to perform employment duties within Florida during the term of the
contract; and
b. All persons, including sub -contractors, sub -vendors or sub -consultants, assigned by the Vendor to perform work
pursuant to the contract with the City.
3. If the Vendor becomes the successful Contractor who enters into a contract with the City, then the Vendor will comply
with the requirements of Section 448.095, Fla. Stat. "Employment Eligibility", as amended from time to time.
4. Vendor will obtain an affidavit from all subcontractors attesting that the subcontractor does not employ, contract with, or
subcontract with, an unauthorized alien as defined in 8 United States Code, Section 1324A(H)(3).
5. Vendor will maintain the original affidavit of all subcontractors for the duration of the contract.
6. Vendor affirms that failure to comply with the state law requirements can result in the City's termination of the contract
and other penalties as provided by law.
7. Vendor understands that pursuant to Florida Statutes, section 448.095, the submission of a false certification may result
in the termination of the contract if one is entered into and may subject the Vendor named in this certification to civil
penalties, attorney's fees and costs.
VENDOR:
Certified By:
(Vendor's Company Name)
AUTHORIZED REPRESENTATIVE SIGNATURE
Print Name and Title:
Date Certified:
THIS PAGE MUST BE COMPLETED AND RETURNED IF SUBMITTING A QUOTE.
Page 27 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
STATEMENT OF NON -SUBMITTAL
REQUEST FOR QUOTATION NO. 2025-22
BRUSH TRUCK REPAIR, MAINTENANCE AND UPFITTING SERVICES
Statement: This form may be used, in part, to assess the accuracy of this solicitations and vendor selection; its submission
does not restrict the recipient from future bids, proposals or quotes.
Please mark where applicable and return this form to purchasing@citvofnorthport.com or fax to Purchasing at 941-429-
7173.
We have declined to quote on the above mentioned solicitation for the following reasons:
Specifications too "restrictive"
No longer offer this product/service.
Unable to meet specifications.
Specifications are unclear.
Insufficient time to respond to this solicitation.
Our schedule would not permit us to perform.
Unable to meet bonding/and or insurance requirements.
Other (please specify).
Explanations regarding above:
Firm Name
Telephone and email address
Date Respondent (point of contact) Name
THIS PAGE TO BE COMPLETED AND RETURNED ONLY IF NOT SUBMITTING A QUOTE.
Page 28 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
QUOTE PRICES FORM:
REQUEST FOR QUOTATION NO.202S-22
BRUSH TRUCK, AMBULANCE, AND FIRE APPARATUS REPAIR, MAINTENANCE AND UPFITTING SERVICES
The signature below is a guarantee that the Quoter shall not withdraw, modify, or cancel this quote for a period of ninety
(90) days after the quote due date.
The undersigned further certifies that he/she has read the Request for Quotation, Terms and Conditions, and any other
documentation relating to this request, and this quotation is submitted with full knowledge and understanding of the
requirements and time constraints noted herein.
Line
Item
#
Specifications/Item Description/Service
Estimated
Quantity
Unit of
Measure
Unit
Price
Extended
Price
1
Hourly Shop Labor rate
1
Hour
150. On
2
Hourly Field labor rate (if applicable)
1
Hour
IS0.00
I So ,Do
3
Travel rate (Circle one)
Tri miles
4
Parts mark-up (if applicable)
Percentage
®,
0
5
Parts discount (if applicable)
Percentage
Total Price
CONTACT PERSONNEL:
Contact Person: C'- ��', S
Telephone Number: 55;A I-)2sCr - 4b2b j
Contact Email: �ia.,�� erk c i C_ c,prn
24 Hour Telephone Number:
License: EVT Certifications
Quoter Comments:
On Sce roe e_pr"r' i� ma "Iwaoce-
Company Name
e qe 5CC, � , (uy—w'—
Print NarAe & Title of Company Representative
Signa of person authorized to bind the company Date
THIS PAGE MUST BE COMPLETED AND RETURNED IF SUBMITTING A QUOTE.
Page 14 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
QUOTE SUBMITTAL SIGNATURE FORM
REQUEST FOR QUOTATION NO.2025-22
BRUSH TRUCK, AMBULANCE AND FIRE APPARATUS REPAIR, MAINTENANCE AND WITTING SERVICES
The signature below is a guarantee that the Quoter shall not withdraw his/her quote for a period of ninety (90) days after
the scheduled quote due date. If notified of the acceptance of the quoter's submittal, the undersigned agrees to accept
the form of contract designated in this RFQ by the City for the stated compensation in the form as prescribed by the City.
The undersigned further certifies that he/she has read the Request for Quotation, Terms and Conditions, Insurance
Requirements and any other documentation relating to this request and this quotation is submitted with full knowledge and
understanding of the requirements and time constraints noted herein.
As addenda are considered binding as if contained in the original specifications, it is critical that the contractor acknowledge
receipt of same. The undersigned acknowledges receipt of the following addenda, and the cost, if any, of such revisions has
been included in the quote price.
Addendum No. Dated Addendum No.
Addendum No. Dated Addendum No.
Company Information
Type of Organization (Please Check One):
Individual Ownership Joint Venture
Partnership
Corporation
Dated
Dated
LLC LP
HER
Federal Identification Number: Sj 2-9 �4 6 G1 ? S,S
Is this a Florida Corporation: ®Yes or
If not a Florida Corporation,
In what state was it created:
Name as spelled in that State:
What kind of corporation is it:
Is it in good standing:
Authorized to transact business
in Florida:
❑No
'IN Profit" or ❑"Not for Profit"
®Yes or ❑No
10Yes or ❑No
State of Florida Department of State Certificate of Authority Document No.:
Respondent shall submit proof that it is authorized to do business in the State of Florida unless registration is not required by
law.
Does it use a registered fictitious name: ❑Yes or ®No
DBA (if any):,
THIS PAGE MUST BE COMPLETED AND RETURNED IF SUBMITTING A QUOTE.
Page 15 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
QUOTE SUBMITTAL SIGNATURE FORM CONTINUED
REQUEST FOR QUOTATION NO.2025-22
BRUSH TRUCK, AMBULANCE, AND FIRE APPARATUS REPAIR, MAINTENANCE AND UPFITTING SERVICES
Company Name_ nn Sce-a� V V I :aat:fnq4C-t.-
6!52- 113,
Telephone #
Fax #
te 2-7V 5E `3 15V 0co,( a I L- 0 LI `fi?2-
Mailing Address
j (40 N(� ?a2ncd—
Location Address
City State Zip Code
3S -1s29
Telephone #
Print Namc'& Title of Firm Representative
Sig ture of -person authorized to bind the company
Do you accept Visa as payment for goods/services? [YES D NO
STATE OF Z= (iriGtGi
COUNTYOF�
Fax #
Q i -2
Date
S orn to and subscribed before me this10 day of I'r_=b i -i4 o r- , 201-� . by
-C OVqK, who ❑ is-oersonally known to me or as produced his/her driver's license as
identific ion.
NOTARY SEAL:
NMary Public State of Florida
Notary Public - State of I
A Shannon L. Morris Print Name: 3 UICA1l i wk l k 'L 5
HH
MyExpiresS9/19/2027 sion 6917 Commission No:
THIS PAGE MUST BE COMPLETED AND RETURNED IF SUBMITTING A QUOTE.
Page 16 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
ANTI -HUMAN TRAFFICICl1` G AFFG DAW
insWuctions. This form must be completed by an officer or representative of an entity registering as a vendor, entering into,
renewing, or extending, a contract with the City of North Port.
The undersigned, on behalf of U' 7) (S d-- 06y'i6dLiMntity"), verifies the following:
A. I have read and understand that Florida Statutes Section 787.06(13), prohibits the City of North Port ("City") from
executing, renewing, or extending a contract to entities that use coercion for labor or services, with such terms defined
in Florida Statutes Section 787.06(2) as follows:
o "Coercion" means: (1) using or threatening to use physical force against any person; (2) restraining, isolating, or
confining or threatening to restrain, isolate, or confine any person without lawful authority and against her or his
will; (3) using lending or other credit methods to establish a debt by any person when labor or services are pledged
as a security for the debt, if the value of the labor or services as reasonably assessed is not applied toward the
liquidation of the debt, the length and nature of the labor or services are not respectively limited and defined; (4)
destroying, concealing, removing, confiscating, withholding, or possessing any actual or purported passport, visa, or
other immigration document, or any other actual or purported government identification document, of any person;
(5) causing or threatening to cause financial harm to any person; (6) enticing or luring any person by fraud or deceit;
or (7) providing a controlled substance as outlined in Schedule I or Schedule II of Section £5 , Florida Statutes, to
any person for the purpose of exploitation of that person.
o "Labor" means work of economic or financial value.
® "Services" means any act committed at the behest of, under the supervision of, or for the benefit of another. The
term includes, but is not limited to, forced marriage, servitude, or the removal of organs.
B. I declare, under penalties of perjury, that Entity does not use coercion for labor or services as defined in Florida Statutes
Section 787.06(2).
C. I understand that this affidavit applies to any City contract executed, renewed, or extended for the duration of the
contract; and the Entity must execute and submit this affidavit at least annually in the vendor registration and renewal
process.
I, the undersigned, understand and affirm that the above statements are based upon personal knowledge; that I am over
the age of 18 years and otherwise competent to make the above statements; and am authorized to legally bind the Entity,
and make the above statements on behalf of Entity. Under penalties of perjury, I declare that I have read the forgoing
document and that the facts stated in it are true.
Authorized Signature: �� � Date: 2 ,
Printed Name: Title:
STATE OF I; 'P,rf,-ej ra_
COUNTY OF M r--4'-R £,P-u
Sworn to (or affirmed) and subscribed before me by means of C-151�ysical presence or ❑ online notarization, this l z day
of 2025, by (" �-r ; �-ir as =t - E ,rt' r ` of
the En lty, and is ersonally known to me or ❑ produced identification. Type of
Identification produced
Signature of Notary Public
EMMI
Public State of Florida
hannon L. Morris
ma Commission HH 426917
xpires 9/19/2027
:;; P
Name of Notary Typed, Printed or Stamped My Commission Expires: i 2�
THIS PAGE MUST BE COMPLETED AND RETURNED IF SUBMITTING A QUOTE.
Page 17 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
AFFIDAVIT OF COMPLIANCE REGARDING FOREIGN EN u 0 u V OF C ONCEU1 LAWS
The undersigned, on behalf of the entity listed below ("Entity"), hereby attests and declares as follows:
1. Entity is not owned by the government of a foreign country of concern as defined in Florida Statutes Section 287.138.
2. The government of a foreign country of concern does not have a controlling interest in Entity.
3. Entity is not organized under the laws of, and does not have a principal place of business in, a foreign country of concern.
4. Entity is not owned or controlled by the government of a foreign country of concern, as defined in Florida Statutes
Section 692.201.
5. Entity is not a partnership, association, corporation, organization, or other combination of persons organized under the
laws of or having its principal place of business in a foreign country of concern, as defined in Florida Statutes Section
692.201, or a subsidiary of such entity.
6. Entity is not a foreign principal, as defined in Florida Statutes Section 692.201.
7. Entity complies with all applicable requirements of Florida Statutes Sections 692.202, 692.203, and 692.204.
8. NOT APPLICABLE Entity is not a foreign principal prohibited from purchasing the subject real property. Entity is either
(1) not a person or entity described in Florida Statutes Section 692.204(1)(a) or (2) authorized under Florida Statutes
Section 692.204(2) to purchase the subject property. Entity complies with the requirements of Florida Statutes Section
692.204.
9. The undersigned is authorized to execute this affidavit on behalf of Entity.
Under penalties of perjury, I declare that I have read the foregoing document and that the facts stated in it are true.
ENTITY �n
St"'ec& 1 (-s LEGAL NAME
e
AUTHORIZED SIGNATURE
r•
c� 5CC,4 izWy,,— PRINT NAME AND TITLE
DATE
THIS PAGE MUST BE COMPLETED AND RETURNED IF SUBMITTING A QUOTE.
Page 18 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
DRUG FREE WORKPLACE FORM
The undersigned, in accordance with Florida Statutes Section 287.087, hereby certifies that the Contractor,
l�� epic' �-'c� f: i� c��"3®� aCS a'� /��Y> �c �� (Company Name):
1. Publishes 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.
Informs 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. Gives 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), notifies employees that, as a condition of working on the commodities
or Contractual services that are under bid, the employee will abide by the terms of the statement and will notify the
employer of any conviction of, or plea of guilty or nolo contendere to, any violation 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.
Imposes 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. Makes a good faith effort to continue to maintain a drug free workplace through implementation of this section.
Check one:
�—
As the person authorized to sign this statement, I certify that this firm complies fully with above requirements.
As the person authorized to sign this statement, this firm does not comply fully with the above requirements.
Signature
Printed Name
Title
Date -
7M5 PAGE MAY RE COMPLETED AND RETURNED IF SUBRM-17MG A QUOTE.
Page 19 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
REFERENCES - CLIENT LIST
SUMMARY EXPERIENCE/QUALIFICATIONS/CLIENT LIST (List similar projects, with completion dates showing experience)
(At least three (3) in the past three (3) years).
Z. Project Location: 640 LAC �2-►?�, ��- t�� 14' 1�
1
Name of Contact Person: l n .,tAA,-� Telephone # .? 5�2
Project Description: f-2 -�, Ar h weGtrW-U --2 V & \0-e\ \G jj4- 19-^a-h9 0
Total Project Amount
Start Date: Completion Date:
2. Project Location: i (f-40 J i ; 32 n & Eve, :�— L u 7'f)
Name of Contact Person: �� c- `_7i� �JP��7►'-rrr��� Telephone#
Project Description: ' 1�(1y��rl �Sr� 1h�` li'` V
Total Project Amount: $
Start Date: Completion Date:
3. Project Location: J.% o J �:/e a e A � { " e �- I W4 14 ( C",r i , yi , I
Name of Contact Person: 76 ,'1 1 e • Cx , Telephone #
Project Description: 5erykC4 _� e-pe'- 'I'rs
Total Project Amount: $ Start Date: Completion Date:
4. Project Location: �,o Nzz, na �� eC`ccin
Name of Contact Person::1C jn �' 6-1'e,3 Telephone #
Project Description: LO re C _ G � TJ if �1� ►c -tc' �t (� +� t Olc;
Total Project Amount: $
Start Date: Completion Date:
THIS PAGE MUST BE COMPLETED AND RETURNED IF SUBMITTING A QUOTE.
Page 20 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
CONFUC—Lr OF INTEREST FO Wd
F.S. §112.313 places limitations on public officers (including advisory board members) and employees' ability to contract with
the City either directly or indirectly. Therefore, please indicate if the following applies:
PART I.
❑ I am an employee, public officer or advisory board member of the City
(List Position or Board)
❑ I am the spouse or child of an employee, public officer or advisory board member of the City
Name:
❑ An employee, public officer or advisory board member of the City, or their spouse or child, is an officer,
partner, director, or proprietor of Respondent or has a material interest in Respondent. "Material interest" means
direct or indirect ownership of more than 5 percent of the total assets or capital stock of any business entity. For the
purposes of [§112.313], indirect ownership does not include ownership by a spouse or minor child.
Name:
❑ Respondent employs or contracts with an employee, public officer or advisory board member of the City
Name:
❑ None of The Above
l
Are you going to request an advisory board member waiver?
❑ 1 will request an advisory board member waiver under §112.313(12)
❑ I will NOT request an advisory board member waiver under §112.313(12)
D" N/A
The atrV shail review any relationships which may/ be prohibited under the Florida Bhiics Code and MR disqualify any
vendors whose conflicts are not waived or exempt,
BUWkIESS NAME:
NAME (PERSON AUTHORIZED TO BIND THE COMPANY):
SIGNATURE:�'� -�'�- DATE: �_
THIS PAGE MUST BE COMPLETED AND RETURNED IF SUBMITTING Gal QUOTE.
Page 21 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
The CONTRACTOR shall be fully liable for the actions of its directors, officers, members, partners, or subcontractors, and the
employees and agents of each of them, and shall fully indemnify, defend and hold harmless the CITY, its commissioners,
employees, agents and assigns from all demands, claims, suits, actions, judgments, damages, fines, fees, taxes, assessments,
penalties, losses, expenses, costs of every type and description, and reasonable attorneys' fees (at both trial and appellate
levels), of any nature or kind whatsoever caused by, or arising out of or related to the performance or breach of this Contract
by the CONTRACTOR, its officers, directors, members, partners, or subcontractors, and employees or agents of any of them;
provided, however, that the CONTRACTOR shall not indemnify for that portion of any loss or damages proximately caused by
the negligent act or omission of the CITY.
To the extent applicable, the CONTRACTOR shall fully indemnify, defend and hold harmless the CITY, and its commissioners,
agents, employees and assigns from any demands, claims, suits, actions, judgments, damages, fines, fees, taxes, assessments,
penalties, losses, expenses, costs of every type and description, and reasonable attorneys' fees (at both trial and appellate
level), arising from or relating to violation or infringement of a trademark, copyright, patent, trade secret or intellectual
property right; provided, however, that the foregoing obligation shall not apply to the misuse or modification of
CONTRACTOR's products by the CITY or any of its commissioners, agents, employees, and assigns, or to the operation or use
of CONTRACTOR's products by the CIrV or any of its commissioners, agents, employees, and assigns in a manner not
contemplated by the Contract.
In the event of a claim, the CITY shall promptly notify the CONTRACTOR in writing by prepaid certified mail (return receipt
requested), or by delivery through any nationally recognized courier service (such as Federal Express or UPS) which provides
evidence of delivery to the address provided below. Notification may also be provided by fax transmission to the number
provided below.
The CITY shall provide all available information and assistance that the CONTRACTOR may reasonably require regarding any
claim. This agreement for indemnification shall survive termination or completion of this Contract. The insurance coverage
and limits required in this Contract may or may not be adequate to protect the CITY and such insurance coverage shall not
be deemed a limitation on the CONTRACTOR's liability under the indemnity provided in this section. In any proceedings
between the parties arising out of or related to this Indemnity provision, the prevailing party shall be reimbursed all costs, expenses
and reasonable attorney fees through all proceedings (at both trial and appellate levels).
Name of Quoting Firm: r5 a- yT)az o 'L yi a f1 L-C
Mailing Address: tp ;10(,j
Location Address: L540 �JC> Ai Je. 22)::�g
City & State: ! C--c- E Gy �— �— Zip: ` t}� l Z
i`
Telephone: �>5 2 - L40 l-3S Fags Number:
E-mail: �r e,.
Signature of person authorized to bind the Company:
Print name and title of person above:
Date: E �
THIS PAGE MUST BE COMPLETED AND RETURNED IF SUSV\,ffl I U Mf G A QUOTE.
CERTIFICATOOH REGARDI[I S L01313YONG
Page 22 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
The undersigned certifies, to the best of his or her knowledge, that:
1. No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for
influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of
Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of
any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension,
continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.
2. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or
attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or
an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the
undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its
instructions.
3. The undersigned shall require that the language of this certification be included in the award documents for all subawards
at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all
subrecipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was made or
entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by 31,
U.S.C. § 1352 (as amended by the Lobbying Disclosure Act of 1995). Any person who fails to file the required certification
shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
The Contractor certifies or affirms the truthfulness and accuracy of each statement of its certification and disclosure, if any.
In addition, the Contractor understands and agrees that the provisions of 31 U.S.C. § 3801 et seq., apply to this certification
and disclosure, if any.
i
Signature of Contractor's Authorized Representative
Name
Ou ,,"'
Title
Z - i - 2
Date
THIS PAGE MUST BE COMPLETED AND RETURNED IF SUBMITTING A QUOTE.
Page 23 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
Before me, the undersigned authority ("Affiant"), personally appeared:
who, being first duly sworn, deposes and says that;
1. Affiant is the 0i,,,,.-y ne-,— [insert Owner, Partner, Officer, Representative or Agent] of
(Y l (jA „kAk'j7r'<[insert name of Contractor] the Respondent that has submitted
the attached reply;
2. Affiant is fully informed respecting the preparation and contents of the attached reply and of all pertinent circumstances
respecting such reply.
3. Such reply is genuine and is not a collusive or sham reply.
4. Neither the said Respondent nor any of its officers, partners, owners, agents, representatives, employees or parties in
interest, including this affiant, have in any way colluded, conspired, connived or agreed, directly or indirectly, with any
other respondent, firm, or person to submit a collusive or sham reply in connection with the work for which the attached
reply has been submitted: or have in any manner, directly or indirectly sought by agreement or collusion, or
communication or conference with any respondent, firm, or person to fix the price or prices in the attached reply or of
any other respondent, or to fix any overhead, profit, or cost elements of the reply price or the reply price of any other
respondent, or to secure through any collusion, conspiracy, connivance, or unlawful agreement any advantage against
(Recipient), or any person interested in the reply work.
Signed, sealed, and delivered on Ic 6 tom- , 20 `.2,>
a
Signature
61e of t; L
Printed Name-
0 Cr1
11MR,
SWORN ACKNOWLEDGMENT
STATE OF H t-V- ie--=)r
COUNTYOF'l<_f'I<�t'"1
Sworn to (or affirmed) and subscribed before me by means of '`--physical presence or online notarization, this r
day of 2025, by C`'c,vc.• ry.
i..
Notary Public
Personally Known OR Produced Identification
Type of Identification Produced — — -
Notary Public State of Florida
Shannon L. Morris
II!! My Commission HH 426917
Expires 91191202
11912027
THIS PAGE MUST RE COMPLETED AND RETURNED IF S1L9Bi�liITTIG`�9G A QUOTE.
Page 24 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
PUBLIC ENTITY CRIME INFORMATION
As provided by F.S. §287.133, a person or affiliate who has been placed on the convicted vendor list following a conviction
for a public entity crime may not submit a bid on a Contract to provide any goods or services to a public entity, may not
submit a bid on a Contract with a public entity for the construction or repair of a public building or public work, may not
submit bids on leases of real property to a public entity, may not be awarded or perform work as a Contractor, supplier,
Subcontractor, or Consultant under a Contract with any public entity, and may not transact business with any public entity in
excess of the threshold amount provided in Section 287, for CATEGORY TWO for a period of 36 months from the date of being
placed on the convicted vendor list.
I, � �! C N , being an authorized representative of the Contractor,
have read and understand the contents above.
I certify that the Contractor is not disqualified from replying to this solicitation/contracting because of Florida Statutes Section
287.133.
Telephone #: 352-- qU- S Fax #:
Federal ID #: Email: Qfirf-neA&L
Signature of Contractor's Authorized Representative
Name and Title of Contractor's Authorized Representative
7-1A 21-3
Date
SWORN ACKNOWLEDGMENT
STATE OF FLORIDA
COUNTY OF hid C(
Sworn to,,.or affirmed) and subscribed before me by means of V"physical presence or
day of I'Z - G t, 2025, byeV-!fZ"t..
Personally Known &"'� OR Produced Identification
Type of Identification Produced
Notary Public — State of Florida
online notarization, this I IS,
Notary Public State of Florida
Shannon L. Morris
�i�� My Commission HH 426917
Expires 9/19/2027
THIS PAGE MUST BE COMPLETED AND RETURNED IF SUBMITTING A QUOTE.
Page 25 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
SCRUTINIZED COMPANY CERTIFICATION FORM
Contractor Name: on
Authorized Representative Name and Title:l�_
Address:, Ci (' �s ' City: State: r� zip:
Phone Number: z `S - '� Email Address: tfoae,
U
A company is ineligible to, and may not, bid on, submit a proposal for, or enter into or renew a Contract with the City of North
Port for goods or services of any amount if, at the time of bidding on, submitting a proposal for, or entering into or renewing
such Contract, the company is on the Scrutinized Companies that Boycott Israel List, created pursuant to Florida Statutes,
section 215.4725, or is engaged in a boycott of Israel.
A company is ineligible to, and may not, bid on, submit a proposal for, or enter into or renew a Contract with the City of North
Port for goods or services of $1 million or more if, at the time of bidding on, submitting a proposal for, or entering into or
renewing such Contract, the company is on the Scrutinized Companies with Activities in Sudan List, the Scrutinized Companies
with Activities in the Iran Petroleum Energy Sector List, created pursuant to Florida Statutes, section 215.473, or with
companies engaged in business operations in Cuba or Syria.
CHOOSE ONE OF THE FOLLOWING
V/This Contract or Contract renewal is for goods or services of less than $1 million. As the person authorized to sign on
behalf of the above -named company, and as required by Florida Statutes Section 287.135(5), 1 hereby certify that the
above -named company is not participating in a boycott of Israel.
This bid, proposal, Contract or Contract renewal is for goods or services of $1 million or more. As the person authorized
to sign on behalf of the above -named company, and as required by Florida Statutes Section 287.135(5), 1 hereby certify
that the above -named company is not participating in a boycott of Israel, is not on the Scrutinized Companies with
Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List, and it does
not have business operations in Cuba or Syria.
I understand that pursuant to Florida Statutes, section 287.135, the submission of a false certification may result in the
termination of the Contract if one is entered into, and may subject the above -named company to civil penalties, attorney's
fees and costs.
Certified By:
Signature of Contractor's Authorized Representative
Name
Title
Date
THIS PAGE MUST RE COMPLETED AND RETURNED IF SUB dri`TIb` G A QUOTE
Page 26 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
VENDOR'S CERTIFEAiilON FOR E-VERIIFY SYSTEM
The undersigned Vendor/Consultant/Contractor (Vendor), after being duly sworn, states the following:
Vendor is a person or entity that has entered into or is attempting to enter into a contract with the City of North Port (City)
to provide labor, supplies, or services to the City in exchange for salary, wages or other renumeration.
2. Vendor has registered with and will use the E-Verify System of the United States Department of Homeland Security to
verify the employment eligibility of:
a. All persons newly hired by the Vendor to perform employment duties within Florida during the term of the
contract; and
b. All persons, including sub -contractors, sub -vendors or sub -consultants, assigned by the Vendor to perform work
pursuant to the contract with the City.
3. If the Vendor becomes the successful Contractor who enters into a contract with the City, then the Vendor will comply
with the requirements of Section 448.095, Fla. Stat. "Employment Eligibility", as amended from time to time.
4. Vendor will obtain an affidavit from all subcontractors attesting that the subcontractor does not employ, contract with, or
subcontract with, an unauthorized alien as defined in 8 United States Code, Section 1324A(H)(3).
5. Vendor will maintain the original affidavit of all subcontractors for the duration of the contract.
6. Vendor affirms that failure to comply with the state law requirements can result in the City's termination of the contract
and other penalties as provided by law.
7. Vendor understands that pursuant to Florida Statutes, section 448.095, the submission of a false certification may result
in the termination of the contract if one is entered into and may subject the Vendor named in this certification to civil
penalties, attorney's fees and costs.
VENDOR: r 1 r / , /° 4endor's Company Name)
Certified By:�
AUTHORIZED REPRESENTATIVE SIGNATURE
Print Name and Title:' , ����1ti�b,,!
Date Certified:
THIS PAGE MUST BE COMPLETED AND RETURNED IF SUBMITTING A QUOTE.
Page 27 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5 -- r Ivl Detail by Entity Name
G/GV/GJ
DIVISION OF CORPORATIONS
r Drio rwi
%fJ.t.�i�JJ F[—
rf) FC
Lai ofjritd 3fu« of Lori lu websire
Department of State / Division of Corporations / Search Records / Search by Entity Name /
Detail by Entity Name
Florida Limited Liability Company
ON SCENE REPAIRS & MAINTENANCE, LLC
Filing Information
Document Number
L21000117613
FEI/EIN Number
86-2849988
Date Filed
03/11/2021
Effective Date
04/01 /2021
State
FL
Status
ACTIVE
Principal Address
6270 SE 88TH STREET
OCALA, FL 34472
Mailing Address
6270 SE 88TH STREET
OCALA, FL 34472
Registered Agent Name & Address
SCOTT, GEORGE W
6270 SE 88TH STREET
OCALA, FL 34472
Authorized Persons) Detail
Name & Address
Title MGR
SCOTT, GEORGE W
6270 SE 88TH STREET
OCALA, FL 34472
Annual Reports
Report Year
Filed Date
2022
02/01 /2022
2023
03/13/2023
2024
01 /31 /2024
Document Images
https://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=EntityName&directionType=Initial&searchNameOrder=ONSCEN... 1 /2
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5 -- r Ivl Detail by Entity Name
G/GV/GJ
01/31/2024 --ANNUAL REPORT
03/13/2023 --ANNUAL REPORT
02/01/2022 --ANNUAL REPORT
03/11/2021 -- Florida Limited Liability.
View image in PDF format
View image in PDF format
View image in PDF format
View image in PDF format
Florida Department of State, Division of Corporations
https://search.sun biz.org/Inquiry/CorporationSearch/Search ResultDetai I?inqu irytype=EntityName&directionType=l nitial&searchNameOrder=ONSCEN ... 2/2
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
Exhibit B
Pricing
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
QUOTE PRICES FORM:
REQUEST FOR QUOTATION NO.202S-22
BRUSH TRUCK, AMBULANCE, AND FIRE APPARATUS REPAIR, MAINTENANCE AND UPFITTING SERVICES
The signature below is a guarantee that the Quoter shall not withdraw, modify, or cancel this quote for a period of ninety
(90) days after the quote due date.
The undersigned further certifies that he/she has read the Request for Quotation, Terms and Conditions, and any other
documentation relating to this request, and this quotation is submitted with full knowledge and understanding of the
requirements and time constraints noted herein.
Line
Item
#
Specifications/Item Description/Service
Estimated
Quantity
Unit of
Measure
Unit
Price
Extended
Price
1
Hourly Shop Labor rate
1
Hour
150. On
2
Hourly Field labor rate (if applicable)
1
Hour
IS0.00
I So ,Do
3
Travel rate (Circle one)
Tri miles
4
Parts mark-up (if applicable)
Percentage
®,
0
5
Parts discount (if applicable)
Percentage
Total Price
CONTACT PERSONNEL:
Contact Person: C'- ��', S
Telephone Number: 55;A I-)2sCr - 4b2b j
Contact Email: �ia.,�� erk c i C_ c,prn
24 Hour Telephone Number:
License: EVT Certifications
Quoter Comments:
On Sce roe e_pr"r' i� ma "Iwaoce-
Company Name
e qe 5CC, � , (uy—w'—
Print NarAe & Title of Company Representative
Signa of person authorized to bind the company Date
THIS PAGE MUST BE COMPLETED AND RETURNED IF SUBMITTING A QUOTE.
Page 14 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
QUOTE SUBMITTAL SIGNATURE FORM
REQUEST FOR QUOTATION NO.2025-22
BRUSH TRUCK, AMBULANCE AND FIRE APPARATUS REPAIR, MAINTENANCE AND WITTING SERVICES
The signature below is a guarantee that the Quoter shall not withdraw his/her quote for a period of ninety (90) days after
the scheduled quote due date. If notified of the acceptance of the quoter's submittal, the undersigned agrees to accept
the form of contract designated in this RFQ by the City for the stated compensation in the form as prescribed by the City.
The undersigned further certifies that he/she has read the Request for Quotation, Terms and Conditions, Insurance
Requirements and any other documentation relating to this request and this quotation is submitted with full knowledge and
understanding of the requirements and time constraints noted herein.
As addenda are considered binding as if contained in the original specifications, it is critical that the contractor acknowledge
receipt of same. The undersigned acknowledges receipt of the following addenda, and the cost, if any, of such revisions has
been included in the quote price.
Addendum No. Dated Addendum No.
Addendum No. Dated Addendum No.
Company Information
Type of Organization (Please Check One):
Individual Ownership Joint Venture
Partnership
Corporation
Dated
Dated
LLC LP
HER
Federal Identification Number: Sj 2-9 �4 6 G1 ? S,S
Is this a Florida Corporation: ®Yes or
If not a Florida Corporation,
In what state was it created:
Name as spelled in that State:
What kind of corporation is it:
Is it in good standing:
Authorized to transact business
in Florida:
❑No
'IN Profit" or ❑"Not for Profit"
®Yes or ❑No
10Yes or ❑No
State of Florida Department of State Certificate of Authority Document No.:
Respondent shall submit proof that it is authorized to do business in the State of Florida unless registration is not required by
law.
Does it use a registered fictitious name: ❑Yes or ®No
DBA (if any):,
THIS PAGE MUST BE COMPLETED AND RETURNED IF SUBMITTING A QUOTE.
Page 15 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
QUOTE SUBMITTAL SIGNATURE FORM CONTINUED
REQUEST FOR QUOTATION NO.2025-22
BRUSH TRUCK, AMBULANCE, AND FIRE APPARATUS REPAIR, MAINTENANCE AND UPFITTING SERVICES
Company Name_ nn Sce-a� V V I :aat:fnq4C-t.-
6!52- 113,
Telephone #
Fax #
te 2-7V 5E `3 15V 0co,( a I L- 0 LI `fi?2-
Mailing Address
j (40 N(� ?a2ncd—
Location Address
City State Zip Code
3S -1s29
Telephone #
Print Namc'& Title of Firm Representative
Sig ture of -person authorized to bind the company
Do you accept Visa as payment for goods/services? [YES D NO
STATE OF Z= (iriGtGi
COUNTYOF�
Fax #
Q i -2
Date
S orn to and subscribed before me this10 day of I'r_=b i -i4 o r- , 201-� . by
-C OVqK, who ❑ is-oersonally known to me or as produced his/her driver's license as
identific ion.
NOTARY SEAL:
NMary Public State of Florida
Notary Public - State of I
A Shannon L. Morris Print Name: 3 UICA1l i wk l k 'L 5
HH
MyExpiresS9/19/2027 sion 6917 Commission No:
THIS PAGE MUST BE COMPLETED AND RETURNED IF SUBMITTING A QUOTE.
Page 16 of 28
Request for Quote No. 2025-22
Docusign Envelope ID: 8447EA9E-72F1-4A29-83BF-9F5A43DOE9C5
On Scene repairs & Maintenance
1640 NE 32nd Ave Bldg A
Ocala, FL 34470
352-789-4035
kSERVICE ESTIMATE
FEIN: 86-2849988
MV-105979
onscenerepairs(@grnai1.com
Customer
DATE: 61912025
City of Clermont
Requested By
S/O Number
Customer Unit number
Terms
Payable Upon Receipt
Contact Person Contact Number TERMS:
Payable Upon Receipt
Qty.
Brand
Part No.
Description
Cost
Total
Travel rate per piggy back of North Port contract
$85.00
$
per hour
$ -
Labor rate
$125.00
$ -
$ -
$ -
$ -
Sub -Total: $ -
Pricing on above items valid for 30 days Misc $ -
Freight: $ -
Total: $ -
Page 1