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Agenda 09/10/2024 Item #16B 7 (Invitation to Bid ("ITB") No. 24-8240, "Florikan CRF with Gal-Xe One Fertilizers,")16.B.7 09/10/2024 EXECUTIVE SUMMARY Recommendation to award Invitation to Bid ("ITB") No. 24-8240, "Florikan CRF with GAL-Xe One Fertilizers," to Howard Fertilizer & Chemical Company, LLC, and authorize staff to open standard County purchase orders. OBJECTIVE: Allow division staff to open purchase orders for Florikan fertilizer purchases, which provide essential nutrients for growing vigorous and healthy plants. CONSIDERATIONS: On March 15, 2024, the Procurement Division posted ITB No. 24-8240, "Florikan CRF with Gal-Xe One Fertilizers." Staff extended the bid submission due date by two weeks to conduct vendor outreach and promote competition. On April 22, 2024, the County received two bids by the extended bid submission deadline. Staff reviewed the bids received and found Howard Fertilizer & Chemical Company, LLC. ("Howard Fertilizer") responsive and responsible with minor irregularities. Staff determined the other bidder, Southern Agricultural Insecticides, non -responsive and non -responsible for failing to submit a bid schedule and the required bid documents. Respondents: Company Name City County State Bid Amount Responsive/Responsible Howard Fertilizer & Orlando Orange FL See Bid Yes/Yes Chemical Company, LLC. Tabulation Southern Agricultural Palmetto Manatee FL No Bid No/No Insecticides schedule provided Subject to Board of County Commissioners (the "Board") approving the ITB award, staff will purchase Florikan fertilizer blends, 180 day slow release formula, in 50 pound bags as follows: August/September 2024. 8-0-12 Palm Blend at 1,229 bags for $60,405.35 and 0-0-20B-PC-MR-GALX, 159 bags for $6,193.05; November 2024, 8-2-12 Palm Blend at 2,246 bags for $108,144.90; and December 2024, 0-0-20B-PC-MR-GALX at 159 bags for $6,193.05. Staff recommends that the Board award ITB No. 24-8240 to Howard Fertilizer and authorize staff to use a standard County purchase order to serve as the contract when making purchases. Staff requests that the Board authorize purchases in this fashion for a period of one year subject to the Board's approval. Howard Fertilizer was incorporated in Florida in 1995, has its main headquarters in Orlando, and has several offices located throughout the state. Howard Fertilizer has been doing business with Collier County for two years. This item is consistent with the Collier County strategic plan objective to optimize the useful life of all public infrastructure and resources through proper planning and preventative maintenance. FISCAL IMPACT: Funding is available within the Landscape Project Fund (1012), Operating Project No. 31112 and Transportation Capital Fund (3081), Median Maintenance Project No. 60265. Annual maintenance funding for these services is available in FY24 budgets, respectively. The source of funding is both general and unincorporated general funds. The anticipated spend to purchase the various fertilizer blends is $180,936.35. GROWTH MANAGEMENT IMPACT: This recommendation is consistent with the Growth Management Plan. Packet Pg. 607 16.B.7 09/ 10/2024 LEGAL CONSIDERATIONS: This item is approved as to form and legality and requires majority vote for Board approval. -SRT RECOMMENDATION: The Board award Invitation to Bid No. 24-8240, "Florikan CRF with GAL-Xe One Fertilizers," to Howard Fertilizer & Chemical Company, LLC, and authorize staff to open purchase orders using standard form County purchase orders for a period of one year from the date of Board's award. Prepared by: Melissa Pearson, Contract Administration Specialist, Transportation Management Services Department. ATTACHMENT(S) 1.24-8240 NORA.docx (PDF) 2.24-8240 Bid Tabulation (PDF) 3.24-8240 Solicitation (PDF) 4.24-8240 Howard Fertilizer -Bid Submittal (PDF) 5.24-8260 COI Howard (PDF) 6.24-8240 WC —Howard 8.16.24 (PDF) Packet Pg. 608 16.B.7 09/10/2024 COLLIER COUNTY Board of County Commissioners Item Number: 16.13.7 Doe ID: 29642 Item Summary: Recommendation to award Invitation to Bid ("ITB") No. 24-8240, "Florikan CRF with GAL-Xe One Fertilizers," to Howard Fertilizer & Chemical Company, LLC, and authorize staff to open standard County purchase orders. Meeting Date: 09/10/2024 Prepared by: Title: Contract Administration Specialist — Road Maintenance Name: Melissa Pearson 08/08/2024 3:51 PM Submitted by: Title: Transportation Management Services Superintendent — Road Maintenance Name: Marshal Miller 08/08/2024 3:51 PM Approved By: Review: Unknown Pamela Lulich TMSD Reviewer Transportation Management Services Department Jeanne Marcella Department Road Maintenance Ellen Sheffey TMSD Reviewer Road Maintenance Marshal Miller TMSD Reviewer Transportation Management Operations Support Tara Castillo Procurement Services Vanessa Miguel Level 1 Purchasing Gatekeeper Procurement Services Deidra DeLaCruz Other Reviewer Capital Project Planning, Impact Fees, and Program Management Leeann Charles Procurement Services Sandra Srnka Procurement Director Review County Attorney's Office Scott Teach Level 2 Attorney Review Transportation Management Services Department Trinity Scott Office of Management and Budget County Attorney's Office Office of Management and Budget County Manager's Office Board of County Commissioners Debra Windsor Level 3 OMB Gatekeeper Review Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Agnieszka Chudy OMB Reviewer Amy Patterson Level 4 County Manager Review Geoffrey Willig Meeting Pending Completed 08/09/2024 6:59 AM Transportation Management Services Completed 08/12/2024 10:45 AM Completed 08/13/2024 8:12 AM Completed 08/13/2024 10:54 AM TMSD Reviewer Completed 08/13/2024 11:13 AM Completed 08/20/2024 3:59 PM Completed 08/20/2024 4:02 PM Other Reviewer Completed 08/20/2024 4:09 PM Completed 08/21/2024 10:26 PM Completed 08/26/2024 8:33 AM Transportation Completed 08/27/2024 9:59 AM Completed 08/27/2024 10:24 AM Completed 08/27/2024 3:39 PM Completed 09/04/2024 8:45 AM Completed 09/04/2024 10:07 AM 09/10/2024 9:00 AM Packet Pg. 609 DocuSign Envelope ID: 2993C63D-58C4-4969-A7B2-A94971C83308 16.B.7.a Collier Count y Procurement Services Division Notice of Recommended Award Solicitation: 24-8240 Title: Florkian CRF with Gal -Xe One Fertilizers Due Date and Time: April 22, 2024, at 3:00 PM EST. Respondents: Company Name City County State Bid Amount Responsive/Responsible Howard Fertilizer and Orlando Orange FL See Bid Tab Yes/Yes Chemical Company, LLC Southern Agricultural Palmetto Manatee FL No Bid No/No Insecticides schedule provided Utilized Local Vendor Preference: Yes 0 No - Recommended Vendor(s) For Award: On March 15, 2024, the Procurement Services Division released notices of Invitation to Bid No. 24- 8240, Florkian CRF with Gal -Xe One Fertilizers, to two thousand, five hundred and nineteen vendors (2,519), and nineteen (19) bid packages were viewed. The due date was extended for an additional two (2) weeks. Staff performed additional vendor outreach to promote competition, and two (2) bids were received by the submission deadline of April 22, 2024. Staff reviewed the bids received. Howard Fertilizer and Chemical Company, LLC. was found to be responsive and responsible with minor irregularities. Southern Agricultural Insecticides was found to be non -responsive and non -responsible for not providing the Bid Schedule and all required bid documents. Awards have been established based on the lowest total bid per line item. Staff is recommending award to Howard Fertilizer and Chemical Company, LLC, the lowest -responsive and responsible vendor. Contract Driven 0 Purchase Order Driven Required Signatures Project Manager: n,�i::a Pew 6/14/2024 Procurement Strategist:6/14/2024 Procurement Services Director: Sandra Srnka 6/14/2024 Date Packet Pg. 610 Procurement Startegist : Leeann Charles Project manager: Melissa Pearson Invitations sent : 2,519 Vendors viewed: 19 24-8240 Tabulation Florikan CRF with GAL-Xe One Fertilizers Note: Fertilizer purchase months are June 2024, July 2024, November 2024, and December 2024 unless otherwise directed. Vendors can bid the Florikan fertilizer listed OR submit an equal. The equal fertilizer bids will require the fertilizer label and a laboratory analysis report from an accredited fertilizer laboratory with the bid submission to be responsive. The analysis must be in accordance with protocols by the AFPC, AOAC, and TFI; refer to solicitation document Section 2. Equal fertilizer for compliance. All Delivery costs are incorporated into the unit price. PURCHASE MONTH: JUNE 2024 Howard Fertilizer & Chemical Company, LLC. Item Florikan SKU Number / Fertilizer Description UOM Quantity Unit Price Extended Price 1 Florikan Custom Blend / 8-0-12 Palm Blend 180 Days, Micro Size Prill 50 LB Bag 2,246 $ 49.15 $ 110,390.90 Total Bid Item 1. $ 110,390.90 PURCHASE MONTH: JULY 2024 Item Florikan SKU Number / Fertilizer Description UOM Quantity Unit Price Extended Price 2 SKU: 0-0-20B-PC-MR-GALX / 0-0-20 Derived From Polymer Coated Sulfate of Potash Magnesia, Micro Size Prill 50 LB Bag 159 $ 38.95 $ 6,193.05 Total Bid Item 2. $ 6,193.05 PURCHASE MONTH: NOVEMBER 2024 Item IFlorikan SKU Number / Fertilizer Description I UOM Quantity I Unit Price Extended Price 3 SKU: 8-2-12-180-LND / 8-2-12 Palm Blend 180 Days, Micro Size Prill 50 LB Bag 2,246 1 $ 48.15 $ 108,144.90 Total Bid Item 3. $ 108,144.90 PURCHASE MONTH: DECEMBER 2024 Item IFlorikan SKU Number / Fertilizer Description UOM Quantity Unit Price Extended Price 4 SKU: 0-0-20B-PC-MR-GALX / 0-0-20 Derived From Polymer Coated Sulfate of Potash Magnesia, Micro Size Prill 50 LB Bag 159 $ 38.95 $ 6,193.05 Total Bid Item 4. $ 6,193.05 Delivery Address: Collier County Govemment Road Maintenance Division 4800 Davis Blvd Naples, Florida 34112 Delivery Hours: Monday - Friday 8:00 a.m. - 3:30 p.m. Note: No deliveries on weekends or County observed holidays. Required Documents Yes/No Form 1: Vendor Declaration Statement Yes* Form 2: Conflict of Interest Certification Af Yes Form 3: hnmigration Affidavit Certification Yes Form 4: Local Vendor Preference N/A Business Tax Receipt Yes W-9 1Yes* Sun Biz Yes E-VerifyYes Bid Schedule Yes AddendumsI Yes* *Minor Irregularities* Opened By Leeann Charles Witnessed By Barbara Lance Equivalent Fertilizer Equivalent Fertilizer Equivalent Fertilizer Equivalent Fertilizer Packet Pg. 611 16.B.7.c Collier Count y Procurement Services Division COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS INVITATION TO BID (ITB) FOR Florikan CRF with GAL-Xe One Fertilizers SOLICITATION NO.: 24-8240 KRISTOFER LOPEZ, PROCUREMENT STRATEGIST PROCUREMENT SERVICES DIVISION 3295 TAMIAMI TRAIL EAST, BLDG C-2 NAPLES, FLORIDA 34112 TELEPHONE: (239) 252-8375 Kristofer.Lopez@colliercountyfl.gov (Email) This solicitation document is prepared in a Microsoft Word format. Any alterations to this document made by the Bidder may be grounds for rejection of the bid, cancellation of any subsequent award, or any other legal remedies available to the Collier County Government. Packet Pg. 612 16.B.7.c SOLICITATION PUBLIC NOTICE INVITATION TO BID (ITB) NUMBER: 24-8240 PROJECT TITLE: Florikan CRF with GAL-Xe One Fertilizers DUE DATE: April 15, 2024 0) 3:00 PM EST PLACE OF BID OPENING: PROCUREMENT SERVICES DIVISION 3295 TAMIAMI TRAIL EAST, BLDG C-2 NAPLES, FL 34112 All bids shall be submitted online via the Collier County Procurement Services Division Online Bidding System: https://www.bidsyne.com/bidsyne-cas/ INTRODUCTION As requested by the Road Maintenance Division (hereinafter, the "Division or Department"), the Collier County Board of County Commissioners Procurement Services Division (hereinafter, "County") has issued this Invitation to Bid (hereinafter, "ITB") with the intent of obtaining bid submittals from interested and qualified vendors in accordance with the terms, conditions and specifications stated or attached. The vendor, at a minimum, must achieve the requirements of the Specifications or Scope of Work stated. The Division has been purchasing fertilizer every six to eight months by requesting quotes through email notifications from authorized Florikan distributors due to the unstable fertilizer market from 2020 to 2023. BACKGROUND The Division purchases fertilizers several times throughout the fiscal year (October 1 st through September 30th) to provide essential nutrients for healthy plants with vigorous growth. TERM OF CONTRACT The contract term, if an award(s) is/are made is intended to be for current needs. Prices shall remain firm for the initial term of this contract. Surcharges will not be accepted in conjunction with this contract, and such charges should be incorporated into the pricing structure The County Manager, or designee, may, at his discretion, extend the Agreement under all of the terms and conditions contained in this Agreement for up to one hundred eighty (180) days. The County Manager, or designee, shall give the Contractor written notice of the County's intention to extend the Agreement term not less than ten (10) days prior to the end of the Agreement term then in effect. All goods are FOB destination and must be suitably packed and prepared to secure the lowest transportation rates and to comply with all carrier regulations. Risk of loss of any goods sold hereunder shall transfer to the COUNTY at the time and place of delivery; provided that risk of loss prior to actual receipt of the goods by the COUNTY nonetheless remain with VENDOR. AWARD CRITERIA ITB award criteria are as follows: ➢ The County's Procurement Services Division reserves the right to clarify a vendor's submittal prior to the award of the solicitation. ➢ It is the intent of Collier County to award to the lowest, responsive and responsible vendor(s) that represents the best value to the County. ➢ For the purposes of determining the winning bidder, the County will select the vendor with the lowest price as outlined below: • Lowest Total Bid Per Item. ➢ Collier County reserves the right to select one, or more than one suppliers, award on a line item basis, establish a pool for quoting, or other options that represents the best value to the County; however, it is the intent to: Multiple Awardees L d N d U. d c O X J Q O t .r 3 U. U c 0 �L 0 U. 0 le N 14 N 0 z m H N I* co o) N c 0 M .2 0 Cn 0 14 N le N c d E t 0 M Q ➢ The County reserves the right to issue a formal contract or standard County Purchase Order for the award of this solicitation. Packet Pg. 613 16.B.7.c DETAILED SCOPE OF WORK The awarded Vendor (s) will supply and deliver Florikan fertilizers to the Collier County Road Maintenance Facility as requested by the division. 1. Florikan Fertilizers: Fertilizer shall be packaged in 501b water resistant bags. 1.1. Florikan Custom Blend / 8-0-12 Pahn Blend, 180 days, Micro Size Prill. (Attachment A) 1.2. SKU Number: 0-0-20B-PC-MR-GALX / 0-0-20, Derived From Polymer Coated Sulfate of Potash Magnesia, Micro Size Prill. (Attachment B) 1.3. SKU Number: 8-2-12-180-LND / 8-2-12 Palm Blend, 180 days, Micro Size Prill. (Attachment C) L 2. Equal Fertilizer: An equal fertilizer may be bid, and for validity purposes, Vendors shall comply with the following: N 2.1. Submit the equal fertilizer label and the laboratory analysis report from an accredited fertilizer laboratory with bid submission. �i The analysis must be in accordance with protocols recognized by the Association of Fertilizer and Phosphate Chemists (AFPC), c the Association of Analytical Chemists (AOAC), and The Fertilizer Institute (TFI). The report shall list the Florikan fertilizer(s) p and the equal fertilizer(s) that were analyzed to validate it is an actual equal fertilizer to the Florikan fertilizer. X 2.2. If the County requires further evaluation of "equal" products throughout the contract term. The County will submit an equal X sample to the Florida Department of Agriculture and Consumer Services, Division of Agricultural Environmental Services, at the Vendor's expense and no cost to the County. FDACS Form: Florida Commercial Fertilizer Collection Form. 2.3. The County shall be the sole judge of equality or similarity, and its decision shall be final. 3 U. 3. Orders: The Division will place fertilizer orders for deliveries in June 2024, July 2024, November 2024, and December 2024 unless V otherwise directed. Refer to the bid schedule for the fertilizer SKU number and type, quantities, and delivery months. M 19 3.1. The Division staff will place orders via email. If the lowest Vendor cannot place the order within the timeline or for fertilizer o availability, the Division can place the order from the next lowest Vendor. The process will continue with each next lowest a: Vendor until an order can be placed. The Division may request quotes for fertilizer from Vendors off -contract if Vendors 00 under contract cannot place the order(s). N 3.2. The Vendor is to provide an order confirmation via email within two business days. le N 4. Delivery: All deliveries are FOB (Free on Board) Destination. Delivery Drivers shall be equipped with a hand truck, dolly, or pallet Z jack to offload shipments. pp H 4.1. The delivery hours are Monday through Friday from 8:00 a.m. to 3:30 p.m. EST. There will be no deliveries after 3:30 p.m. N or County observed holidays on which County offices are closed: New Year's Day, Martin Luther King Jr. Day, President's to Day, Memorial Day, Independence Day, Labor Day, Veteran's Day, Thanksgiving Day, Friday after Thanksgiving Day, N Christmas Eve, and Christmas day. 4.2. The Vendor is to provide a delivery date and time to the Division staff who placed the order within four business days. o 4.3. The delivery will be within 14 business days unless the Division staff approves another timeline. a 4.4. The Vendor shall contact the Division staff who placed the order to provide a delivery date 24 hours before the delivery. 2 4.5. For any fertilizer delivery found to be defective, incorrect, or having vendor order errors, the vendor shall pick up and return o at no cost to the County. The Vendor shall expedite the defective order replacements, incorrect orders, and order errors by c expediting corrected orders within five business days at no additional cost to the County. N 5. Delivery Location: Road Maintenance Division, 4800 Davis Blvd, Naples, FL 34112 N 6. Compliance: The Vendor shall comply with Chapter 576, Florida Statutes, Agricultural Fertilizers, and Rule 5E-1, Florida d Administrative Code. These laws and rules require that any company that distributes fertilizer with its name on the fertilizer label t must have a license. Fertilizer containers shall be labeled pursuant to the laws and rules listed below. M 6.1. Chapter 576: http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_ Statute&URL=0500- Q 0599/0576/Sections/0576.041.htm1 6.2. Rule 5E-1, Florida Administrative Code: hops://www.flrules.org/ ag tewa. /ChgpterHome.asp?Chapter=5e-1 7. Licensing: Any person or company who distributes fertilizer in Florida and whose name appears on the fertilizer label as the guarantor is responsible for obtaining a license from The Florida Department of Agriculture and Consumer Services (FDACS), https://www.fdacs. og v/Agriculture-Industry/Fertilizer-Licensing-and-Tonnage-Reporting. VENDOR CHECKLIST Packet Pg. 614 16.B.7.c ***Vendor should check off each of the following items as the necessary action is completed (please see, Vendor Check List)*** N �O M N C O r O Cn O 14 N O N �.i C d E t t� O r Q Packet Pg. 615 16.B.7.d Email: Kristofer.Lopcz@colliercountyfl.gov CU 7eY CO-i4V ty Telephone: (239) 252-8375 Procurement Services Division Addendum #1 Date: April 15, 2024 From: Kristofer Lopez, Procurement Strategist To: Interested Bidders Subject: Addendum #I Solicitation 24-8240 — Florikan CRF with GAL-Xe One Fertilizers The following clarifications are issued as an addendum: Now reads: Bid due date is April 22, 2024 a, 3:00 PM EST If you require additional infonnation, please post a question on our Bid Sync (www.bidsync_.com) bidding platform under the solicitation for this project. Please sign below and return a copy of this Addendum with your submittal for the above referenced solicitation. �bu� &O'b & / / Y/ (Signature) U H &Rf4 17�u' -J 0)� 11 01 (Name of Firm) Date Packet Pg. 616 COLLIER COUNTY BUSINESS TAX BUSINESS TAX NUMBER: COLLIER COUNTY TAX COLLECTOR - 2800 N. HORSESHOE DRIVE - NAPLES FLORIDA 34104 - (239) 252-2477 VISIT OUR WEBSITE AT: www.colliertaxcollector.com THIS RECEIPT EXPIRES SEPTEMBER 30, 2024 LOCATION: 283 JEFFERSON AVE E ZONED: C-5 BUSINESS PHONE: 941-867-5408 STATE OR COUNTY LIC #: C ci 1G V (_) i �r_ni FnRnn CLASSIFICATION: DISTRIBUTOR CLASSIFICATION CODE: 03609401 This document is a business tax only. This is not certification that licensee is qualified. �►� It does not permit the licensee to violate any existing regulatory zoning laws of the state, county, or cities nor does it exempt the licensee from any other taxes or permits that may be required by law. .19 16.B.7.d DISPLAY AT PLACE OF BUSINESS FOR PUBLIC INSPECTIC FAILURE TO DO SO IS CONTRARY TO LOCAL LAWS HOWARD FERTILIZER & CHEMICAL COMPP HOWARD FERTILIZER & CHEMICAL C PO BOX 628202 ORLANDO, FL 32862 -THIS TAX IS NON -REFUNDABLE - DATE 10/02/202: AMOUNT 30.01 RECEIPT 504-24-0016372: �Ioe �o*vei"en. Packet Pg. 617 5/1/23, 10:59 AM Detail by Entity Name 16.B.7.d DIVISION OF CORPORATIONS f' brinx)! ; Jl. /.Org [VI off ritd Slurs of Florida web'1!? Department of State / Division of Corporations / Search Records / Search by Entity Name / Detail by Entity Name Florida Limited Liability Company HOWARD FERTILIZER & CHEMICALS, LLC Filing Information Document Number L22000260794 FEI/EIN Number 88-4107785 Date Filed 06/10/2022 State FL Status ACTIVE Principal Address 8306 S ORANGE AVE ORLANDO, FL 32809 Mailing Address PO BOX 628202 ORLANDO, FL 32862-8202 Registered Agent Name & Address FISHER, TOUSEY, LEAS & BALL, P.A. 501 RIVERSIDE AVE STE 600 JACKSONVILLE, FL 32202 Authorized Person(s) Detail Name & Address Title MGR HOWARD, JR, ROBERT M PO BOX 628202 ORLANDO, FL 32862-8202 Annual Reports Report Year Filed Date 2023 04/27/2023 Document Images 04/27/2023 --ANNUAL REPORT View image in PDF format 06/10/2022 -- Florida Limited Liability View image in PDF format https://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=EntityName&directionType=Initial&searchNameOrd Packet Pg. 618 5/1/23, 10:59 AM Detail by Entity Name N L N r L d LL d 0 ILI a c� 3 LL w U c �L 0 LL 0 N op Iq N O Z m H N Iq tO CD N R r r E 3 m N N N LL L 3 0 x 0 v N N r C N E t V 2 r rr Q https://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=EntityName&directionType=Initial&searchNameOr Packet Pg. 619 16.B.7.d Request for Taxpayer Give Form to the Form Identification Number and Certification requester. Do not (Rev. October2018) Department of the Treasury send to the IRS. Internal Revenue Service ► Go to www.irs.gov/FormW9 for instructions and the latest information. f Name (as shown on your Income tax return). Name is required on this lino; do not leave this line blank. Howard Fertilizer and Chemical, LLC 2 Business nameldisregarded entity name, if different from above `a) 3 Check appropriate box for federal tax classification of the person whose name Is entered on line 1. Check only one of the 4 Exemptions (codes apply only to following seven boxes. certain entities, not Individuals; see a instructions on page 3): o ❑ Individual/sole proprietor or ElC Corporation ❑ S Corporation ❑ Partnership ElTrust/estate N single -member LLC Exempt payee code (If any) 5 ui c ao ❑r Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership) ► C `p ;? Note: Check the appropriate box In the line above for the tax classification of the single -member owner. Do not check Exemption from FATCA reporting U) a LLC if the LLC is classified as a single -member LLC that is disregarded from the owner unless the owner of the LLC is code if an ( y) 'C another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single -member LLC that 0. is disregarded from the owner should check the appropriate box for the tax classification of its owner. :e=u y [] Other (see instructions) ► 1(Applies to accounts maintained oulslde the U.S.) rn 5 Address (number, street, and apt. or suite no.) See instructions. Requester's name and address (optional) (QD' PO Box 628202 U) 6 City, state, and ZIP code Orlando, FL 32862 7 List account number(s) here (optional) IMM Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid social security number backup withholding. For individuals, this is generally your social security number (SSNHowever, for a resident alien, sole proprietor, or disregarded entity, see the Instructions for Para I, later. For other — _ antitiac it is vnur emnlover identification number (EIN). If you do not have a number, see How to Aet a TIN, later. Note: If the account is in more than one name, see the instructions for line 1 Number To Give the Requester for guidelines on whose number to enter. or Also see What Name and I Employer identification number JIM Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and 2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. 1 am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, o ributions to an individual retirement arrangement (IRA), and generally, payments other than interest and divider)ds, you are 91 required to sign Icat n, but you must provide your correct TIN. See the instructions for Part 11, later. A Sign I U.S. pens of !�Y V 1J/"�/'��� I r T �^ 7_ Here U.S. arson ► ✓ Date ► General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. For the latest information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to www.irs.gov/FormW9. Purpose of Form An individual or entity (Form W-9 requester) who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following. • Form 1099-INT (interest earned or paid) • Form 1099-DIV (dividends, including those from stocks or mutual funds) • Form 1099-MISC (various types of income, prizes, awards, or gross proceeds) • Form 1099-B (stock or mutual fund sales and certain other transactions by brokers) • Form 1099-S (proceeds from real estate"transactions) • Form 1099-K (merchant card and third party network transactions) • Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition) • Form 1099-C (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN. If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding, later. Cat. No. 10231X Form W-9 (Rev. 10-2018) Packet Pg. 620 16.B.7.d col pzr county Procurement Services Division Form 1: Vendor Declaration Statement BOARD OF COUNTY COMMISSIONERS Collier County Government Complex Naples, Florida 34112 Dear Commissioners: The undersigned, as Vendor declares that this response is made without connection or arrangement with any other person and this proposal is in every respect fair and made in good faith, without collusion or fraud. The Vendor hereby declares the instructions, purchase order terms and conditions, requirements, and specifications/scope of work of this solicitation have been fully examined and accepted. The Vendor agrees, if this solicitation submittal is accepted by Collier County, to accept a Purchase Order as a form of a formal contract or to execute a Collier County formal contract for purposes of establishing a contractual relationship between the Vendor and Collier County, for the performance of all requirements to which this solicitation pertains. The Vendor states that the submitted is based upon the documents listed by the above referenced solicitation. The Vendor agrees to comply with the requirements in accordance with the terms, conditions and specifications denoted herein and according to the pricing submitted as a part of the Vendor's bids. Further, the Vendor agrees that if awarded a contract for these goods and/or services, the Vendor will not be eligible to compete, submit a proposal, be awarded, or perform as a sub -vendor for any future associated work that is a result of this awarded contract. IN WITNESS WHEREOF, WE have hereunto subscribed our names on this . in the State of Firm's Legal Name: H 0 wC J s Fu+ V zcr ( Address: City, State, Zip Code Florida Certificate of Authority Document Number Federal Tax Identification Number *CCR # or CAGE Code *Only if Grant Funded Telephone: Email: Signature by: (Typed and written) Title: day of , 20_ in the County of led �3c�o S. 0011c Ue. v Orlando , FL, ae-qi0­1--le5 L40`1- S 5S-1 C )L4 I Cr� Packet Pg. 621 16.B.7.d Send to: Additional Contact Information ,�jj p� ,,�� (} r l Q ���� Few+ I (-wr and �U a1 iLGI.J� � LG payments (required if different from Company name used as payee above) Contact name: Title: Address: P V BOX '' (� 1-j 1 � q 2k Lp City, State, ZIP QJ10Ls —F(f X QCa " -� --I 0l U Telephone: �-t 0� - )EJ- Email: Cre-d i � o I toward -�c� CaY) Office servicing Collier County to place orders (required if different from above) Contact name: n f 1Jrer jC� �� � L•�1 1 Title: Address: City, State, ZIP Telephone: Email: 1 l ti I�.0 1 11 �.� � M Cam Packet Pg. 622 16.B.7.d C O 7eY COurity Procurement Services Division Form 2: Conflict of Interest Certification Affidavit The Vendor certifies that, to the best of its knowledge and belief, the past and current work on any Collier County project affiliated with this solicitation does not pose an organizational conflict as described by one of the three categories below: Biased ground rules — The firm has not set the "ground rules" for affiliated past or current Collier County project identified above (e.g., writing a procurement's statement of work, specifications, or performing systems engineering and technical direction for the procurement) which appears to skew the competition in favor of my firm. Impaired objectivity — The firm has not performed work on an affiliated past or current Collier County project identified above to evaluate proposals / past performance of itself or a competitor, which calls into question the contractor's ability to render impartial advice to the government. Unequal access to information — The firm has not had access to nonpublic information as part of its performance of a Collier County project identified above which may have provided the contractor (or an affiliate) with an unfair competitive advantage in current or future solicitations and contracts. In addition to this signed affidavit, the contractor / vendor must provide the following: 1. All documents produced as a result of the work completed in the past or currently being worked on for the above -mentioned project; and, 2. Indicate if the information produced was obtained as a matter of public record (in the "sunshine") or through non-public (not in the "sunshine") conversation (s), meeting(s), document(s) and/or other means. Failure to disclose all material or having an organizational conflict in one or more of the three categories above be identified, may result in the disqualification for future solicitations affiliated with the above referenced project(s). By the signature below, the firm (employees, officers and/or agents) certifies, and hereby discloses, that, to the best of their knowledge and belief, all relevant facts concerning past, present, or currently planned interest or activity (financial, contractual, organizational, or otherwise) which relates to the project identified above has been fully disclosed and does not pose an organizational conflict. ri �! =d FQA Ner 4 6V_11�( Gild+ Company Name /.a fie ` T Signature Print Name and Title State of Hor Jo County of DcA I) c The foregoing instrument was acknowledged before a by means of [A physical presence or ❑ online notarization, this day of J U n { (month),Q4(year), by nbO i R► eri N e,1.1 (name of person acknowledging). r 1_ (Signature otary Public) (Print, Type, or ersonally Know OR Produced Identification Type of Identification Produced issioned Name of Notary Public) Notary P011o State of Florida Robin Leahy FwA My CommlS$Ion HH 503563 E m L N m LL M 3 0 x 0 It N 00 4 N C d E t cts w Q Packet Pg. 623 16.B.7.d Co Ter County Procurement Services Division Form 3: Immigration Affidavit Certification This Affidavit is required and should be signed, by an authorized principal of the firm and submitted with formal solicitation submittals. Further, Vendors are required to be enrolled in the E-Verify program (https://www.e-veri ov/), at the time of the submission of the Vendor's proposal/bid. Acceptable evidence of your enrollment consists of a copy of the properly completed E- Verify Company Profile page or a copy of the fully executed E-Verify Memorandum of Understanding for the company which will be produced at the time of the submission of the Vendor's proposal/bid or within five (S) day of the County's Notice of Recommend Award. FAILURE TO EXECUTE THIS AFFIDAVIT CERTIFICATION AND SUBMIT WITH VENDOR'S PROPOSAL/BID MAY DEEM THE VENDOR'S AS NON -RESPONSIVE. Collier County will not intentionally award County contracts to any Vendor who knowingly employs unauthorized alien workers, constituting a violation of the employment provision contained in 8 U.S.C. Section 1324 a(e) Section 274A(e) of the Immigration and Nationality Act ("INA"). Collier County may consider the employment by any Vendor of unauthorized aliens a violation of Section 274A (e) of the INA. Such Violation by the recipient of the Employment Provisions contained in Section 274A (e) of the INA shall be grounds for unilateral termination of the contract by Collier County. Vendor attests that they are fully compliant with all applicable immigration laws (specifically to the 1986 Immigration Act and subsequent Amendment(s), that it is aware of and in compliance with the requirements set forth in Florida Statutes §448.095, and agrees to comply with the provisions of the Memorandum of Understanding with E-Verify and to provide proof of enrollment in The Employment Eligibility Verification System (E-Verify), operated by the Department of Homeland Security in partnership with the Social Security Administration at the time of submission of the Vendor's proposal/bid, Company Name Signature c1{�s-��iy Print Name and Title State of Ply i c)q Countyof r The foregoing instrument was, acknowledged before me by means of Oil ysical presence or ❑ online notarization, this day of �'-- (month), �L�(year), by in%b pilttt'r!yP (name of person acknowledging). G (Sig 'e of Notary Public) EnaE Know OR Produced Identification Type of Identification Produced 1�pb,n L-ft k)o (Print, Type, or Stamp ommissioned Name of Notary Public) Notary Public State of Florida i Robin Leahy ARM t My Commission HH 503563 gaffExpires 8/16/2027 rn L N m LL Q O m X J Q 0 t r 3 LL U �L 0 LL 0 N CD 4 N 6 z m H N It Packet Pg. 624 16.B.7.d 10/19/22, 2:06 PM An official website of the United States government Here's how you know My Company Profile I E-Verify E-Verify My Company Account My Company Profile Company Information Company Name Howard Fertilizer and Chemical Co, Inc. Doing Business As (DBA) Name Howard Fertilizer Company ID 1685330 Enrollment Date May 10, 2021 Employer Identification Number (EIN) 590788131 Unique Entity Identifier (UEI) DUNS Number 004056651 Total Number of Employees 100 to 499 NAICS Code https:Heverify.uscis.gov/account/company/profile Menu - Packet Pg. 625 16.B.7.d 24-8240 Bid Schedule Florikan CRF with GAL-Xe One Fertilizers Note: Fertilizer purchase months are June 2024, July 2024, November 2024, and December 2024 unless otherwise directed. Vendors can bid the Florikan fertilizer listed OR submit an equal. The equal fertilizer bids will require the fertilizer label and a laboratory analysis report from an accredit fertilizer laboratory with the bid submission to be responsive. The analysis must be in accordance with protocols by the AFPC, AOAC, and TFI; refer to solicitation documc Section 2. Equal Fertilizer for compliance. PURCHASE MONTH: JUNE 2024 Item Florikan SKU Number / Fertilizer Description UOM Quantity Unit Price Extended Price Equivalent Fertilizer 1 Florikan Custom Blend / 8-0-12 Palm Blend 180 Days, Micro Size Prill 50 LB Bag 2,246 $ 49.15 $ 110,390.90 Delivery Costs, Not to Exceed / FOB Destination Total Bid Item 1. $ 110,390.90 PURCHASE MONTH: JULY 2024 Item Florikan SKU Number / Fertilizer Description UOM Quantity Unit Price Extended Price Equivalent Fertilizer 2 SKU: 0-0-20B-PC-MR-GALX / 0-0-20 Derived From Polymer Coated Sulfate of Potash Magnesia, Micro Size Prill 50 LB Bag 159 $ 38.95 $ 6,193.05 Delivery Costs, Not to Exceed / FOB Destination Total Bid Item 2. $ 6,193.05 PURCHASE MONTH: NOVEMBER 2024 Item Florikan SKU Number / Fertilizer Description UOM Quantity Unit Price Extended Price Equivalent Fertilizer 3 SKU: 8-2-12-180-LND / 8-2-12 Palm Blend 180 Days, Micro Size Prill 50 LB Bag 2,246 $ 48.15 $ 108,144.90 Delivery Costs, Not to Exceed / FOB Destination Total Bid Item 3. $ 108,144.90 PURCHASE MONTH: DECEMBER 2024 Item Florikan SKU Number / Fertilizer Description UOM Quantity Unit Price Extended Price Equivalent Fertilizer 4 SKU: 0-0-20B-PC-MR-GALX / 0-0-20 Derived From Polymer Coated Sulfate of Potash Magnesia, Micro Size Prill 50 LB Bag 159 $ 38.95 $ 6,193.05 Delivery Costs, Not to Exceed / FOB Destination Total Bid Item 4. $ 6,193.05 Delivery Address: Collier County Government Road Maintenance Division 4800 Davis Blvd Naples, Florida 34112 Delivery Hours: Monday - Friday 8:00 a.m. - 3:30 p.m. Note: No deliveries on weekends or County observed holidays. Packet Pg. 626 16.B.7.d 10/19/22, 2:06 PM My Company Profile I E-Verify 325 Sector Manufacturing Subsector Chemical Manufacturing Edit Company Information Employer Category Employer Category None of these categories apply Edit Employer Category Company Addresses Physical Address 8603 S. Orange Ave. Orlando, FL 32809 Mailing Address Same as Physical Address Edit Company Addresses https:/Ieverify.uscis.gov/account/company/profile 9/1 Packet Pg. 627 16.B.7.d 10/19/22, 2:06 PM My Company Profile I E-Verify Hiring Sites We have implemented a new policy and require more information for existing and future hiring sites. Number of Sites 10 Edit Hiring Sites Company Access and MOU My Company is Configured to: Verify Its Own Employees Use Web Services Memorandum of Understanding View Current MOU U.S. Department of Homeland Security_ U.S. Citizenship and Immigration Services Accessibility_ P ug-ins hftps://everify.uscis.gov/accounVcompany/profile Packet Pg. 628 16.B.7.e I ACORO CERTIFICATE OF LIABILITY INSURANCE DATE IN 3/31/2025 1 7/1/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THI: CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIE; BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZE[ REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement of this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER Lockton Companies NAME: 3280 Peachtree Road NE, Suite #1000 PHONE FAX Atlanta GA 30305 E-MAILo Ext : A/C No (404)460-3600 ADDRESS: INSURER A: Ascot Specialty Insurance Comnanv 1 4505 INSURED Howard Fertilizer & Chemical Company, Inc. INSURER B : 1425231 8306 S. Orange Avenue INSURER C : Orlando FL 32809-7853 INSURER D : INSURER E : COVERAGES CERTIFICATE NUMBER: 20719923 REVISION NUMBER: XXXXXXX THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIO[ INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THI: CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP W MM/DD/YY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F_X1 OCCUR Y N ENPL2410001262-01 3/31/2024 3/31/2025 EACH OCCURRENCE $ 1000 000 PREM SES Ea occu ence $ 500,000 X MED EXP (Any one person) $ 25,000 Pollution Legal Liab PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000000 POLICY JECOT- LOC X PRODUCTS - COMP/OP AGG $ 2,000,000 X $ OTHER: Ded - $50000 B AUTOMOBILE LIABILITY N N 73APB008406 3/31/2024 3/31/2025 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ XXXXXXX ANY AUTO OWNED SCHEDULED AUTOS ONLY X AUTOS BODILY INJURY (Per accident) $ XXXXXXX X PROPERTY DAMAGE Per accident $ XXXXXXX HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY $XXXXXXX A UMBRELLA LIAB X OCCUR N N ENXL2410001263-01 3/31/2024 3/31/2025 EACH OCCURRENCE $ 5,000,000 X AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ XXXXXXX WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE NOT APPLICABLE PER OTH- STATUTE ER E.L. EACH ACCIDENT $ X)C=XX OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N / A E.L. DISEASE - EA EMPLOYEE $ XXXXXXX If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT I $ XXXXXXX DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) THIS CERTIFICATE SUPERSEDES ALL PREVIOUSLY ISSUED CERTIFICATES FOR THIS HOLDER, APPLICABLE TO THE CARRIERS LISTED AND THE POLICY TERM(S) REFERENCED. Insured is self insuring physical damage [Comp/Coll] as of 3/31/2024. Howard Fertilizer retains $1 million of Auto Liability limit between the primary and excess policies for a total of $7 million (Auto/Howard/Excess) RE: Bid 24-8240 Florikan CRF with GAL-Xe One Fertilizers Collier County Board of County Commissioners is included as an Additional Insured as respects to General Liability where required by written contract subject to policy terms, conditions and exclusions. 30 Day Notice of Cancellation/Non-renewal, except 10 days for nonpayment of premium, to the certificate holder when required by written agreement. CERTIFICATE HOLDER CANCELLATION See Attachments 20718823 Collier County Board of County Commissioners 3295 Tamiami Trail East, Naples FL 34112 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORI THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED II ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED m L d N d LL m c Q N J Q t �3 LL U c tv O LL O N O 4 N O Z m F_ N qq co Gn N O �.i O co N O le N r+ C N E t U O r Q © 1988-2048 ACORD CORPORAATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Packet Pg. 629 Attachment Code: D570249 Master ID: 1425231, Certificate ID: 20718823 16.B.7.e WAR Evidence of Coverage To whom it may concern: In our continuing effort to provide timely certificate delivery, Lockton Companies is transitioning to paperless delivery of Certificates of Insurance. To ensure electronic delivery for future renewals of this certificate, we need your email address Please contact us via the method listed below, referencing Certificate ID 20718823. Email: SE-EDelivery@lockton.com • - Please include the above Certificate ID number and "Email Address for E-Deliver" in the subject line. In the event your mailing address has changed, will change in the future, or you no longer 6 require this certificate, please let us know using the method above. z m The above inbox is for automating electronic deliver of certificates only. Please do NOT N send future certificate requests to this inbox. N Thank you for your cooperation and willingness in reducing our environmental footprint. Lockton Companies Lockton Companies 3280 Peachtree Road NE, Ste. 250 Atlanta, GA 30305 Packet Pg. 630 Standard Attachment: S614373 Master ID: 1425231, Certificate ID: 20718823 16.B.7.e 2024 Liability Certificate Addendum Howard Fertilizer & Chemical Company, Inc. Automobile Liability —Additional Coverages: ➢ Personal Injury Protection — Symbol 7 [Owned Autos - Subject to No Fault] See Specific Endorsement ➢ Auto Medical Payments — Symbol 7 [Owned Autos only] $5,000 Limit ➢ UM — BI Only — Symbol 7 [Owned Autos only] $100,000 Limit 2024 Contractor's Equipment Carriers are as follows: .o AMR-36873-70 Certain UWs @ Lloyds ORAMPR000543-07 Old Republic Union Ins Co GVS-11424-03 Geo Vera Specialty Ins Co Transverse Specialty TSAMPR0000896-03 Ins Co National Fire & 72AMR306643-07 Marine InsCo SPI-75832-07 Spinnaker Specialty Ins Co AME1007208-24-00 Everest Indemnity Ins Co Contractor's Equipment Deductibles: $1,000 All Equipment valued under $100,000 $5,000 All Equipment valued $100,000 and over Page 1 LOCWrOK Packet Pg. 631 CERTIFICATE OF LIABILITY INSURANCE DATE( �16.B.7.1 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THI: CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIE! BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZE[ REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement of this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: RICK NOSS SUNZ Insurance Solutions, LLC ID:(InSource) PHONE FAX C/o InSource Employer Solutions, Inc. A/c Na E:t: 470-891-4147 A/c No: 204 37th Ave N. #318 ADDRESS: rickn@insourcees.com St Petersburg, FL 33704 INSURER(S) AFFORDING COVERAGE NAIC# INSURERA: SUNZ Insurance Comoanv 34762 INSURED InSource Employer Solutions, Inc 204 37th Ave N. #318 St Petersburg FL 33704 INSURER B : INSURER C : INSURER D : INSURER E : COVERAGES CERTIFICATE NUMBER: Rnl;4a79R REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIO1 INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THI; CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ OCCUR DAMAGE TCLAIMS-MADE1:1 PREM SESOEa occur REITEante $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY ❑ PRO- JECT ❑ LOC PRODUCTS - COMP/OP AGG $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N WC053-00001-024 6/1/2024 6/1/2025 �/ STATUTE OERH ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1 ,000,000 OFFICER/MEMBER EXCLUDED? ❑ N/A E.L. DISEASE - EA EMPLOYEE $ 1 000 000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1 ,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Howard F&C Management Group, LLC locations: All employees. Eff Date: 3/31/2024 Bid 24-8240 "Florikan CRF with GAL-Xe One Fertilizers CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORI Collier County Board of County Commissioners THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED It 3295 Tamiaml Trail East ACCORDANCE WITH THE POLICY PROVISIONS. Naples FL 34112 AUTHORIZED REPRESENTATIVE Rick Leonard a ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Packet Pg. 632 80649726 1 8827072 1 Master Policy I InSource I Rick Noss 1 6/25/2024 3:39:29 PM (EDT) I Page 1 of 1