Agenda 03/08/2016 Item #16E 4 3/8/2016 16.E.4.
EXECUTIVE SUMMARY
Recommendation to approve the administrative reports prepared by the Procurement
Services Division for modifications to work orders, change orders, surplus property and other
items as identified.
OBJECTIVE: To promote accountability and provide transparency to the public and gain
the Board's approval/ratification for various procurement-related transactions.
CONSIDERATIONS: In accordance with the Board's Procurement Ordinance 2013-69 as
amended by 2015-37 and the Procurement Manual (Section 19 Procedures), the Procurement
Services Division produces a regular Administrative Report which provides for Board approval of
the following transactions:
• Administratively approved work order modifications and/or contract change
orders/Amendments that do not exceed ten (10%) of the current Board approved aggregate
amount;
• Modifications to the current Board approved performance schedule (number of days);
• Surplus disposal and revenue disbursement; and,
• Other items as determined by the County Manager or designee.
The attached Change Orders report covers the period of January 21, 2016—February 11, 2016;the
Surplus Report covers the period of January 21, 2016-February 17, 2016.
FISCAL IMPACT: The net total for 3 changes to contracts is $6,071.00. The total number of
days added to contracts is 30. No revenue was received for the disposal of surplus items.
LEGAL CONSIDERATIONS: This item has been reviewed by the County Attorney,
is approved as to form and legality, and requires majority vote for approval. -
JAK
GROWTH MANAGEMENT IMPACT: There is no Growth Management Impact associated
with this action.
RECOMMENDATION: That the Board of County Commissioners ratifies/approves work order
modifications, change orders and/or Contract Amendments, surplus disposal and revenue
disbursement, and other items as determined by the County Manager or designee in accordance with
Procurement Ordinance 2013-69 as amended by 2015-37.
PREPARED BY: Diana De Leon, CPPB, Contracts Technician, Procurement Services Division
ATTACHMENTS:
1) Change Order Report
2) Change Orders (backup)
3) Surplus Disposal and Revenue Report
4) Philips Equipment Donation Request(backup)
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3/8/2016 16.E.4.
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.16.E.16.E.4.
Item Summary: Recommendation to approve the administrative reports prepared by the
Procurement Services Division for modifications to work orders, change orders, surplus
property and other items as identified.
Meeting Date: 3/8/2016
Prepared By
Name: DeLeonDiana
Title: Contracts Technician,Procurement Services
2/17/2016 3:32:29 PM
Submitted by
Title: Contracts Technician,Procurement Services
Name: DeLeonDiana
2/17/2016 3:32:30 PM
Approved By
Name:NorthrupAdam
Title:Procurement Specialist,Procurement Services
Date: 2/17/2016 4:09:11 PM
Name: pochopinpat
Title: Operations Coordinator,Administrative Services Department
Date: 2/17/2016 4:13:15 PM
Name: MarkiewiczJoanne
Title: Division Director-Procurement Services,Procurement Services
Date: 2/17/2016 4:38:14 PM
Name: PriceLen
Title: Department Head-Administrative Svc,Administrative Services Department
Date: 2/23/2016 5:15:01 PM
Packet Page -922-
3/8/2016 16.E.4.
Name: KlatzkowJeff
Title: County Attorney,
Date: 2/24/2016 8:23:56 AM
Name: WellsLaura
Title: Management/Budget Analyst, Senior, Office of Management&Budget
Date: 2/25/2016 9:27:32 AM
Name: CasalanguidaNick
Title: Deputy County Manager, County Managers Office
Date: 2/29/2016 8:41:38 AM
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3/8/2016 16.E.4.
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Packet Page -924-
3/8/2016 16.E.4.
-„
- ,,..n,
Public Utilities Department
January 28, 2016 Planning & Project Management Division
Jeff Janco,Vice President
Bonness, Inc.
1900 Seward Avenue
Naples, FL 34109
RE: Zero Dollar Contract Change Notification# 1
MPS 306 Force Main Phase II
Contract No. 15-6451
Purchase Order No. 4500160066
Collier County Project No. 70044.6
Dear Mr.Janco:
By copy of this letter, the above referenced work order is being issued a zero dollar($0.00) change as
indicated below:
The above referenced work order time is hereby extended by 30 calendar days. The previous total
number of project completion days was 225. The new substantial completion date shall be May 23,
2016. The new final completion date shall be on or before July 7,2016.Note:Time extensions cannot
exceed 20%
By extending this work order, the County is not relieving your firm of its obligations to perform work in
a timely and satisfactory manner or any consequences resulting from failing to do so. Collier County
hereby reserves all legal rights, including, but not limited to, rights to terminate, suspend or elect any
other appropriate course(s) of action should circumstances warrant with regard to the referenced work
order.
Draw against Allowance As detailed in Work Directive No. 1, provide concrete pads for plug valves.
Original Allowance Amount $50,000.00
Changes to Date $0.00
Current Allowance Amount _____ __ ' _____ __ ___ $50.000.00 1
Cost of this Revised ed Allowance Amount $46,575.00 9 -
Sincerely,
Ore ' ! / r
Wayne M. Karlovich, P.E.
Senior Project Manager
f
Swainson Hall/1 curemn Strategist, Purchasing Department
iyo
Approval: ? , ...,4 Date: /� '"
C: Robin Sheley, Clerk's Finance Division
Planning&Project ManagementDivison•3339 Tamiami Trail East,Suite 303 •Naples.Florida 34112-5351•239-252-4285•FAX 239-252-5378
Packet Page -925-
3/8/2016 16.E.4.
c\
Co ,er County
Public Utilities Department
Planning & Project Management Division
October 12, 2015
Jeff Janco, Vice President
Bonness, Inc.
1900 Seward Avenue
Naples, FL 34109
RE: NOTICE-TO-PROCEED FOR MPS 306 Force Main Phase II
Contract No. 15-6451
Purchase Order No. 4500160066
Collier County Project No. 70044.6.3.4wmk
Dear Mr. Janco:
This letter serves as Collier County's official NOTICE TO PROCEED (NTP) to your
Company to commence with the above referenced project. This NTP is issued pursuant
to Contract #15-6451. The purchase order number is shown above and a copy of the
P.O. is enclosed.
This NTP is limited to the scope of work for: MPS 306 Force Main Phase II for the
contract amount of $1,107,858.57. Please include the purchase order number, contract
number and project number on each application for payment to facilitate the payment
process.
Commencement date for the services associated herewith shall be considered to be
October 26, 2015. The substantial completion date shall be considered to be April 23,
2016,. Final completion of all work shall be considered to be June 7, 2016, a total of
225 days. No work is authorized after the final completion date herein unless the time
of the contract/work order is extended on or before the final completion date. Invoices
for unauthorized work will not be paid.
If you have any questions, please contact me.
Sincerely,
M/r;4, 4
Wayne M. Karlovich, P.E.
Senior Project Manager
cc: Swainson Hall, Procurement Strategist
Pia/mg&Prcect Managenent Dmston•3339 Tamiami Trail East,Suite 303 •Naples,Florida 34112-5361•239-252-4285•FAX 239-252-5378
Packet Page -926-
3/8/2016 16.E.4.
/ BONNESS INC.
Paving and S3ieworli Contractors
1900 Seward Avenue
Naples.FL•34109
www.Bonnesslnc.com
P(239)597.6221
f(239)597.7416
Florida CFICOCiv9444
Horioa CUCii122479
01.18.16
GOOD MORNING WAYNE.
WE WOULD LIKE TO REQUEST A 30 DAY EXTENSION TO OUR CONTRACT TIME DUE TO THE PLAN
REVISION AND FDOT REVIEW PROCESS.THANK YOU AND HAVE A GREAT DAY.
REGARDS,
AL DEMARTINO
ESTIMATOR/PROJECT MANAGER
1 900 SEWARD AVE I NAPLES, FL 34109
P: 239.597.6221 F:239.597.7416 I C: 239.398.1700
ADEMARTINO@BONNESSINC.COM
Packet Page -927-
3/8/2016 16.E.4.
' ES INC,
a
Ama s,„„a„1 Averme
Naples,Florida 311.451
(239)597-6:741•'NIX(237)5437-74 I I,
V 4ww.t Tonnes Sinc,ccirn
Proposal 1/18/2016
Submitted To: Public Utilities Division Planning &Project Estimate Number: 94942016
Management
Address: 3339 Tamiami Trail East, Suite 303 Bid Title: MPS 306 Force Main- Phase II# 15-
6451 -CO-Additional Time
Naples, FL 34112
Project Location: US-41
Contact: Wayne Karlovich Project City,State: Naples, FL
Phone: Fax: Engineer/Architect: AECOM
Thank You for Considering Bonness Inc.
Item# Item Description Estimated Quantity Unit Unit Price Total Price I
01 Additional Time 30.00 DY $0.00 $0.00
Total Price for above Items: $0.00
Total Bid Price: $0.00
Notes: •Subject to prompt acceptance within 30 days and to all conditions stipulated on the reverse side,we agree to furnish
materials and labor at the price(s)set forth above.
•Change order based on the request for 30 days of additional time be added to the contract for plan deisng changes and FDOT
review.
•Any deviation of contracted work will require a signed change order.Work related to the change order will not be completed
until signed by the project manager.
•The above proposal is for listed items only.
Payment Terms: Payment due within 30 days of date of invoice, regardless of when payment is made by Owner
ACCEPTED: CONFIRMED:
The above prices, specifications and conditions are satisfactory Bonness Inc.
and hereby accepted.
Buyer
Authorized
Signature: Signature:
Date of Acceptance: Estimator: AI DeMartino
1/18/2015 11:00:45 AM Page 1 of 1
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3/8/2016 16.E.4.
PUBLIC UTILITIES
WORK DIRECTIVE CHANGE
PROJECT NAME: MPS 306 Force Main—Phase II CHANGE # 1
DATE OF ISSUANCE: 1/19/2016 EFFECTIVE DATE: 1/19/2016
OWNER: Collier County Board of Commissioners PROJECT#: 15-6451
CONTRACTOR: Bonness Inc. ENGINEER: AECOM
You are directed to proceed promptly with the following change(s):
Description: Provide concrete pads for plug valves.
Purpose of Work Directive Change: To provide additional support for buried plug valves.
Cost of Work Directive Change: $3,425.00 to be provided from project allowance, detailed as follows:
(5) 6"x42"x36" 3000psi w/ WWM reinforcement concrete pads @$685.00 each
Attachments: Bonness Inc. estimate No. 94922016, dated 1/18/2016
If a claim is made that the above change(s)have affected Contract Price or Contract Times any claim for a
Change Order based thereon will involve one or more of the following methods of determining the effect of the
changes(s).
-. ter
Method of determining change in Contract Price: Method of determining change in Contract Times:
❑ Unit Prices ❑ Contractor's records
❑ Lump Sum ❑ Engineer's record
® Other N/A Z Other N/A
Estimated increase (decrease) in Contract Price: Estimated change in Contract Time:
$ 0.00 ZERO calendar days.
RECOMMENDED: AUTHORIZED:
By: Don Bramlett,PE t "L' By: Wayne Kariovich
Engineer Owner's Representative
ter,
01/28/16 1:14 PM
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3/8/2016 16.E.4.
wit-
I ' DONNESS INC.
1
1-,,,,In,,"' .,,: , ". ,:,„,,,....,..„
1 t9CX1 Seward Avenue
Naples,Florida 3401
(33L)$g7-6221•Fax(239)5q37-74 Ifs
www.bon nessinc.com
Proposal 1/18/2016
Submitted To: Public Utilities Division Planning &Project Estimate Number: 94922016
Management
Address: 3339 Tamiami Trail East,Suite 303 Bid Title: MPS 306 Force Main-Phase II # 15-
6451 -CO Plug Valve Pads
Naples, FL 34112
Project Location: US-41
Contact: Wayne Karlovich Project City,State: Naples, FL
Phone: Fax: Engineer/Architect: AECOM
Thank You for Considering Bonness Inc.
Item# Item Description Estimated Quantity Unit Unit Price Total Price
01 06"Concrete Pad For Plug Valves (3000 PSI W/ 5.00 EACH $685.00 $3,425.00
WWM Reinforcement)
Total Price for above Items: $3,425.00
Total Bid Price: $3,425.00
Notes: •Subject to prompt acceptance within 30 days and to all conditions stipulated on the reverse side,we agree to furnish
materials and labor at the price(s)set forth above.
•Change order based on the request to pour five 06"x 42"x 36"concrete pads for proposed plug valves.
'Due to critical nature of escalating material costs; asphalt and concrete pricing is subject to change.Should this situation
arise, Bonness Inc.will provide documentation of material adjustment(s).
•Any deviation of contracted work will require a signed change order.Work related to the change order will not be completed
until signed by the project manager.
•The above proposal is for listed items only.
Payment Terms: Payment due within 30 days of date of invoice, regardless of when payment is made by Owner
ACCEPTED: CONFIRMED:
The above prices,specifications and conditions are satisfactory Bonness Inc.
and hereby accepted.
Buyer Authorized
Signature: Signature:
Date of Acceptance: Estimator: Al DeMartino
1/18/2016 10:20:51 AM Page 1 of 1
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tt4
Prc 3/8/2016 16.E.4.
Change Order Form
❑Contract Modification ❑Work Order Modification ❑Amendment
Contract#:I 15-6459 Change#:I/ S I Purchase Order#: 4500160202 I Project#: 55150
Contractor/Firm Name: DeAngelis Diamond Construction, Inc. Contract/Project: EMS 76
Project Manager Name: Robert Fuentes Facilities Management
J 9 Division Name:
Original Contract/Work Order Amount $ 1,545,626.00 6/23/15 11B Original BCC Approval Date; Agenda Item #
Current BCC Approved Amount $ 1,545,626.00 6/23/15 11B Last BCC Approval Date; Agenda Item #
Current Contract/Work Order Amount $ 1,545,626.00 3/29/2016 SAP Contract Expiration Date (Master)
Dollar Amount of this Change $ 6,071.00 0.39% Total Change from Original Amount
Revised Contract/Work Order Total $ 1,551,697.00 0.39% Change from Current BCC Approved Amount
Cumulative Changes $ 6,071.00 0.39% Change from Current Amount
Completion Date, Description of the Task(s)Change,and Rationale for the Change
Notice to Proceed 8/12/2015 Original 3/09/2016 Last Approved 3/29/2016 Revised Date 3/29/2016
Date Completion Date Date (Includes this change)
#of Days Added 0 Select Tasks ❑Add new task(s) ❑ Delete task(s) ❑ Change task(s) ❑ Other(see
below)
Provide a response to the following: 1.) detailed and specific explanation/rationale of the requested change(s)to the task(s) and/
or the additional days added (if requested); 2.) why this change was not included in the original contract; and, 3.) describe the
impact if this change is not processed. Attach additional information from the Design Professional and/or Contractor if needed.
1) EMS 76 was originally designed in 2003 and the project was delayed several times. In 2007 the project was suspended due to the
economic downturn and insufficient funding sources. In fiscal year 2014/2015 the project was resurrected on June 23,2015.
Contract#15-6459,Agenda item 11 B,was approved by the BCC in the amount of$1,545,626.00 to DeAngelis Diamond
Construction, Inc.
PCO#4 is a replacement of mini blinds which are in the contract with black out shades, requested by EMS staff.
PCO#5 is the installation of additional circuits in the ceiling of the Apparatus Bay to accommodate retractable powers extension
cords to avoid having extension cords on the floor which will create trip hazards.These cords are for the refrigeration units in the
Ambulance that keep medicine and other pharmaceutical drugs at a constant temperature while the unit is parked. Additionally,
three(3) circuits were requested in the exterior parking area for emergency trailers that would be parked in case of an Emergency
situation.
PCO#6 is a deduction to the contract for the allowance of security systems. The original amount of the allowance in the
contract is for$47,766.00 and the actual cost of the security system is$38,977.00. A deduction of($8,789.00)will be applied.
PCO#7 is the installation 136'of 2"conduit with pull boxes and wiring for a preemption system that is located in the traffic signal
unit on the corner of Logan Blvd. and Vanderbilt Beach Rd. In the initial design (2003),Vanderbilt Beach Rd. had not started the
road widening to six lanes of traffic,this new system is required to stop traffic on Vanderbilt Beach Road to ensure Ambulances
can safely exit EMS 75 and head VVest.
PCO#8 is the installation of a gang box, conduit and a specialty button from Apparatus Bay to Room 100(Electrical control room
for the preemption system.
PCO#9 is the installation of two(2)parallel feeders in 2"conduit with three(3) 3/0 and(1) 1/0 THHN copper wires for the
connection of electrical service from the new utility pole with a transformer that FPL is providing at Vanderbilt Beach Road in place
of a new transformer and concrete pad which will save money and space by the driveway for better access to ambulance unit.
2) The changes were not included in the original contract because they are recent requests from the EMS Division,that they now find
are needed for the safe operation of the Station. These needs were not anticipated when the original design was completed
(2003).
3) If this request is not approved,the station will have inadequate electrical service for the upgraded equipment which wasn't
available in 2003. The new equipment could still be used, but it could be a health and safety risk to EMS staff if this equipment is
not powered by adequate electricity.
Revised: 10/28/2014 (Divisions who may require additional signatures may include on separate sheet.) PROCUR E T USE ONLY
Packet Page -931- Admin �t BCC es
3/8/2016 16.E.4.-
f
°. _. °, i
f 2
/7//�/Pre tared by: ( i Date: r
Robert Fuentes Project Man er,Facilities Management Division ,
Acceptance of this Change Order shalt constitute a modification to contract t work order identified above and will be subject to all the same
terms and conditions as contained in the contract!work order indicated above,as fully as if the same were stated in this acceptance. The
adjustment,if any,to the Contract shall constitute a full and final settlement of any and all claims of the Contractor 1 Vendor I Consultant/
Design Professional arising out of or related to the change set forth herein,including claims for impact and delay costs.
I
,{ \ � I
t
Accepted by: �i J; is Date: c c'-‘,-,' ,'t r
Chris Di11,"froject Manager, DeAngelis Diamond Construction, Inc. I
i
f
Approved by: .- '( 1, �,,/� .. Date: / �`
David Aieamesbergcr`,"AiA�-Bae€317 'Arc ierct , fic. I i
4
0
Approved by: t 't.� '.'i, , .,! t t f Date: r i0, Ss
rf hi:inda Cummings, Procurement Specialist, Putties g Division
i f
\s t
•
Revised:10/28/2014 (Divisions who may require additional signatures may include on separate sheet.) PROCURE.E 'USE ONLY 1
vit
AGmin BCC ES
_
Packet Page -932-
3/8/2016 16.E.4.
C�
ITB #15-6459 - EMS 76 BID FORM 5/12/2015
SELECTED Nt/lr�
Item DIVISION OF WORK SUBCONTRACTOR ITEM AMOUNT g4
1 GENERAL CONDITIONS $ 192,850.00
2 SITE WORK&UNDERGROUND South Florida and Jensen $ 273,032.00
3 EXTERIOR PAVING South Florida Excavation $ 67,146.00
4 LANDSCAPE&IRRIGATION Renfroe and Jackson $ 56,378.00
5 CONCRETE West Coast Structural $ 73,100.00
6 MASONRY West Coast Structural $ 60,100.00
7 STUCCO American $ 94,272.00
8 MISC METALS Sunmaster $ 23,187.00
9 CARPENTRY Suncoast and Bradford $ 51,129.00
10 PAINTING Jamestown $ 32,285.00
11 WINDOWS Heritage $ 42,517.00 le+,1-3 0'"
12 DOORS Fields Door and Hardware $ 41,630.00
13 HARDWARE Fields Door and Hardware $ 15,400.00
14 RESIDENTIAL APPLIANCES Florida Builder $ 4,781.00
15 CABINETRY Sharp Interiors $ 30,854.00
16 FLOOR COVERING&WALLTILE Ciano $ 36,373.00
17 SIGNAGE(INT&EXTERIOR) 12 Visual $ 2,910.00
18 ROOF TRUSSES Southwest $ 13,250.00
19 ROOFING CFS $ 60,000.00
20 STORM PANELS Sunmaster $ 9,318.00
21 FIRE SUPPRESSION West Coast $ 14,995.00
22 MECHANICAL Tropical Plumbing and Lead Mech $ 77,540.00
23 ELECTRICAL Collier Electric Company $ 168,500.00 / I (04-7' -.
24 EMERGENCY GENERATOR Collier Electric Company $ 42,713.00
25 DATA&COMMUNICATIONS Collier Electric Company $ 6,250.00
TOTAL BASE BID(without Allowances) TOTAL $ 1,490,510.00
26 ALLOWANCE No.1 - Security Systems $47,766.00 3B,`37�•ao
27 ALLOWANCE No.2 - Additional Preserve Planting $5,000.00
TOTAL BASE BID LUMP SUM Including Allowance#1  TOTAL $1,543,276.00 1 z5 `,p 7'
ADD ALTERNATE COSTS
ALTERNATE No.1 - Substitution of HORIZONTALLY OPENING Apparatus Doors > $ 207,000.00
ALTERNATE No.2- 4 Color Epoxy Painted Floors in Apparatus Bay > $ 2,350.00
ALTERNATE No.3- Additional Contractor Lump Sum Cost for the expedited 180/210
Schedule in lieu of the 270/300 Non-accelerated Schedule. $ (`-0
COMBINATION BASE BIDS PLUS ADD ALTERNATES
BASE BID+ALTERNATE#1 $1,750,276.00
CONTINUED ON PAGE 2 OF 2 ,,.
Packet Page -933-
3/8/2016 16.E.4.
CONTINUED FROM PAGE 1 OF 2
BASE BID+ALTERNATE#2 $1,545,626.00
BASE BID+ALTERNATE#3 $1,543,276.00
BASE BID+ALTERNATE#1,#2, $1,752,626.00
If this Bid is accepted,the undersigned Bidder agrees,to enter into an agreement with Owner to perform and furnish the
Work described in the Bidding Documents for the Bid Price and within the Time of Completion indicated in this Bid and in
accordance with the other terms and conditions of the Contract Documents.
In submitting this Bid,Bidder represents that:
a. Bidder has carefully examined the Bidding Documents.
b. Bidder has had the opportunity to examine the site of the work,existing conditions,and all other conditions
affecting the work on the above-named Project.
c. Bidder has carefully correlated the information known to Bidder,information and observations obtained from
visits to the site,and other information identified in the Bidding Documents with the Bidding Documents.
d. Bidder is familiar with federal,state,and local laws and regulations applicable to Project.
e. This bid will remain subject to acceptance for 180 days after the bid opening.
f. Bidder has received and reviewed I da nu tiers_1_thru,_3_.
DeAngelis Diamond Co t ction
g 4 5
Company Name C/ ""
Norman Gentry- Executive Vice President 5/28/2015
Signature/Title " / ' Date
PAGE 2 OF 2
Packet Page -934-
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Packet Page -935-
3/8/2016 16.E.4.
1
Procurement Services
eO ic'r t..,.:Oui-tt`V Change Order Form
el Contract Modification O work Order Modification O Amendment
Contract#: 13-6180 Change#: 1 Purchase Order#:l N/A Project#: N/A
Contractor/Firm Name: Galls LLC ContractJProject: fee Shirts and Apparel —
rAlice Faye Franklin Collier County EMS I
Project Manager Name:i _ Division Name: �� _ I
Original Contract/Work Order Amount — N/A 6/10/14;16.E.8 Original BCC Approval Date; Agenda Item#
Current BCC Approved Amount N/A 6/10/14;16,E,8 Last BCC Approval Date; Agenda Item#
Current Contract/Work Order Amount N/A 6/9/2016 SAP Contract Expiration Date (Master)
Dollar Amount of this Change $ 0.00 #VALUE! Total Change from Original Amount
Revised Contract/Work Order Total $ 0.00 #VALUEI Change from Current BCC Approved Amount
Cumulative Changes #VALUE! #VALUE! Change from Current Amount
r Completion Date, Description of the Task(s)Change,and Rationale for the Change
Notice to Proceed N/A Original N/A Last Approved N/A Revised Date N/A
Date Completion Date Date (Includes this change)
#of Days Added ( N/A Select Tasks 0 Add new task(s) 0 Delete task(s) O Change task(s) ®Other(see below)
Provide a response to the following: 1.) detailed and specific explanation/rationale of the requested change(s)to the task(s) and/
or the additional days added (if requested); 2.) why this change was not included in the original contract; and, 3.) describe the
impact if this change is not processed. Attach additional information from the Design Professional and/or Contractor if needed.
1) These items need to be added to support the continued operations of EMS,providing uniforms and accessories for new and
current employees.
2) A non-bid line was used to pay for these items historically. Finance will no longer pay against a non-hid line, and are holding
invoices to be approved by the BCC before paying the vendor,which has not been the practice historically.
Items to add are:
SS Poly Cotton Dress Shirt in White or Light Blue,$13.50 ea
LS Poly Cotton Dress Shirt in White or Light Blue,$15.50 ea
Zipper Application, $6.00 ea
EMT Patch,$1.49 ea
Right Chest Polo Embroidery–1 or 2 lines of text-$3.50 ea
Paramedic Patch, $1 . 39 ea
3) Invoices are being held up for payment,as each non-bid item must go to BCC for approval.
,
Prepared by- Alice Faye Franklin t.i Li '"% Date: 2/11/2016
(Project Manager Name and Divi$r'on)
Acceptance of this Change Order shall constitute a modification to contract/work order identified above and will be subject to all the same
terms and conditions as contained in the contract/work order indicated above,as fully as if the same were stated in this acceptance. The
adjustment,if any,to the Contract shall constitute a full and final settlement of any and all claims of the Contractor/Vendor/Consultant/
Design Professional arising out of or related to the change set forth herein,including claims for impact and delay costs.
Accepted by:_______ _ Date:
(Contractor/Vendor/Consultant/Design Professional and Name of Firm,if project applicable)
Approved by: Date:
(Design Professional ansl Name of Firm, if project applicable) _ ,
pproved by: .;..2 i;�� Date:
(Procurement Profeessie alfi )
Revised. 10/28/2014 (Divisions who may require additional signatures may include on separate sheet.) PROCUREMENT USVONLY
Admin R C I BCC ES
Packet Page -936-
3/8/2016 16.E.4.
Gal/s,LLC
1340 Russell Cave Rd
+,k ro::y u„r,%K s„rely I,p4nn,.+rt n.re Anparo, Lexington,KY 40505
Tax ID Number 20.3545989 ...” ,..
Customer: Collier County EMS Date: January 7,2016
Attn: Karen Wood Customer#: 54
Fax# 904-630.1488
From: Chris Groham
Total writs
Item# Description Qty Veer Price Discount
$c1997 SS-Poly Cohort Dress Shirt in Wilde or Light Blue 1 $13.50 $13.50'
Sk996 LE Poly Cotton Dress Shirt in Wbda or Light Blue 1 015 50 515.50
UU011 Zipper.pplicaiion 1 $6.00 $6,00
EG0077 Paramedic Patch - 1 - $1.39 57.39,
----.-100078 _ EMT Patch 1 $'I 49 51.49
Amendment to Bid#13-6180
1
■
0i e It q d to none,'lax on all shipments all 4 a P7 d .5 r t 01alp una local TOT C;e n(Y.Cosiurners 110 trl'S Subtotal 537,88
retV.11/,i:.l uinexl tax enp.aut resale cell 1,Gale n hie stunt orlca_ yiu,wva last au lux.4.06.:un»nl un rtle:rbit uS el041r
tax nap o,bnualinuI„c erOr9 yawl lops account x to(859{;US-554 L Ohipputo I 5 14111 9 70.00
Total 577.88
'Thank r.l,l lot Inc.hpn lll only l r e:n,+y1101 Lnil Bess.
Packet Page -937-
3/8/2016 16.E.4.
^alls,uz
om Russell Cave Rd
*. ^,..1~4ykt~~rc»*+'g.p,°nt="^*.~ Lexington,x,^ues
Tax mNumber: 20-3545989
Customer: Collier Dourly oil u*^i February,,mm
Attn: Karen Wood Customer tr: •:•Suua
,""# 804'630.1,40#
'=". Chits Graham
Total with
»"°" | Description City ,°,p*" Discount
PECOI Rtnw Chest Polo embroidery-/",2.linos°'text ` 03.W p,m
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Packet Page -938
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c . County
P.dm:ns; Ser ices D,s∎0-
naa-..rer,,- Sern.w
Collier County
Surplus Donation Application
(Pursuant to Florida Statute Chapter 274)
Collier County reserves the right to change the status of the Surplus Property at any time,
including auctioning or selling items to the highest bidder, in an effort to seek the highest
return for the taxpayers.
Complete the Surplus Donation Application form indicating name address and location of the
organization. In order to qualify County staff will require a description of the property and how
it will be used, along with a copy of the organization's IRS 501 C(3)status.
1. Name and permanent mailing address of applicant organization:
C�zRFa col... apL€ Pas- CIZAA`v xL L e sc,.- ►a-�tt�cT
t45`%5 Q t..LAEms_ -aokA ARJ) , 4f 4 FL 34‘‘9
2. Representative of applicant organization to whom inquires should be addressed:
Name and Title - '9 Gy i W
Telephone Number ,,29- J - 7s'/ Fax Number,739' 75'/
Email Address - h r s t1a, ? c7nJ -e . o r4p
3. Provide a brief background statement regarding the nature of activity and purpose for which
the applicant organization was formed.
.tk c■¢_ -00-0o R su « 5EVAJ LQ$
TO The- Qeltou1-+r-S i NCZSG3 , PdV° Gv-E3TS
oc Grccp-t FAQ s c.,Q.Asr
4. Provide a description of the project or purpose for which this equipment is being requested.
nclude specifics of why donating this equipment to your organization or program will
benefit the citizens of Collier County. C� p
P4v\L\t3 C Tart_ cro2
"C14 -o r T' 3E u...-r∎utz v) wC -ta GR 33 r.iwpuE3
c PttoAnoE 2v k '+a cA • n.u,.s
5. Attach an equipment list (from the current available Surplus Property List at
..1Auctions\FY16\Surplus Spreadsheet FY2016.xlsx and, identifying the organization's
priority order.
The person signing this application on the organization's behalf certifies that the information
presented in this application is correct and complete; that the applicant organization does not
discriminate in its programs or services on the basis of age, race, gender, sexual orientation,
Packet Page -941-
3/8/2016 16.E.4.
familial status or national origin; and that the equipment obtained through the County's donation
program will be used for public purposes only and not for the benefit of private individuals.
Attach the organization's IRS 501 (C) (3)tax status.
Applicant (Print) gter 6/S HO1) Title �?,;ct�l /...i1 re tt 12)
Applicant (Signature) '(.� 'JX"f ./ Date /0" /
This completed apptifc. ion, equipment request sheet and any additional supporting materials
should be submitted to the following:
Collier County Government
Procurement Services Department
Tracey Payne, Procurement Services Manager
3327 Tamiami Trail East
Naples, FL 34112
Email: traceypayne @colliergov.net
Packet Page -942-
3/8/2016 16.E.4.
0000073 07/03/15
r fiY'?A°
Consumer's Certificate of Exemption R 04;;;
DEPARTMENT issued Pursuant to Chapter 212,Florida Statutes
OF REVENUE
85-80166260310-8 01/16/2015 01/31/2020 MUNICIPAL GOVERNMENT
Certificate Number Effective Date Expiration Date Exemption Category
This certifies that
GREATER NAPLES FIRE RESCUE DISTRICT
14575 COLLIER BLVD
NAPLES FL 34119-9605
is exempt from the payment of Florida sales and use tax on real property rented,transient rental property rented,tangible
personal property purchased or rented,or services purchased.
1100113% DR-14
Important Information for EXempt Organizations R.04/11
.f \�
DEPARTMENT
OF REVENUE
1. You must provide all vendors and suppliers with an exemption certificate before making tax-exempt purchases.
See Rule 12A-1.038, Florida Administrative Code(F.A.C.).
2. Your Consumer's Certificate of Exemption is to be used solely by your organization for your organization's
customary nonprofit activities.
3. Purchases made by an individual on behalf of the organization are taxable,even if the individual will be
reimbursed by the organization.
4. This exemption applies only to purchases your organization makes. The sale or lease to others of tangible
personal property,sleeping accommodations, or other real property is taxable. Your organization must register,
and collect and remit sales and use tax on such taxable transactions. Note: Churches are exempt from this
requirement except when they are the lessor of real property(Rule 12A-1.070, F.A.C.).
5. It is a criminal offense to fraudulently present this certificate to evade the payment of sales tax. Under no
circumstances should this certificate be used for the personal benefit of any individual. Violators will be liable for
payment of the sales tax plus a penalty of 200% of the tax,and may be subject to conviction of a third-degree
felony. Any violation will require the revocation of this certificate.
6. If you have questions regarding your exemption certificate, please contact the Exemption Unit of Account
Management at 800-352-3671. From the available options,select"Registration of Taxes,"then "Registration
•
Information,"and finally"Exemption Certificates and Nonprofit Entities." The mailing address is PO Box 6480,
Tallahassee, FL 32314-6480.
Packet Page -943-
3/8/2016 16.E.4.
1, 777 C+DEPARTMENT OF THE TREASURY
lilL'INTERNAL REVENUE SERVICE
CINCINNATI OH 45999-0023
Date of this notice: 11-06-2014
Employer Identification Number:
47-2260647
Form: SS-4
Number of this notice: CP 575 A
GREATER NAPLES FIRE RESCUE DISTRICT
$
CHARLOITE JOHNSON
14575 COLLIER BLVD For assistance you may call us at:
NAPLES, FL 34119 1-800-829-4933
IF YOU WRITE, ATTACH THE
STUB AT THE END OF THIS NOTICE.
WE ASSIGNED YOU AN EMPLOYER IDENTIFICATION NUMBER
Thank you for applying for an Employer Identification Number (EIN) . We assigned you
EIN 47-2260647. This EIN will identify you, your business accounts, tax returns, and
documents, even if you have no employees. Please keep this notice in your permanent
records.
When filing tax documents, payments, and related correspondence, it is very important
that you use your EIN and complete name and address exactly as shown above. Any variation
may cause a delay in processing, result in incorrect information in your account, or even
cause you to be assigned more than one EIN. If the information is not correct as shown
above, please make the correction using the attached tear off stub and return it to us.
Based on the information received from you or your representative, you must file
the following form(s) by the date(s) shown.
Form 941 04/30/2015
Form 720 01/31/2015
Your Form 2290 becomes due the month after your vehicle is put into use.
If you have questions about the form(s) or the due date(s) shown, you can call us at
the phone number or write to us at the address shown at the top of this notice. If you
need help in determining your annual accounting period (tax year) , see Publication 538,
Accounting Periods and Methods.
We assigned you a tax classification based on information obtained from you or your
representative. It is not a legal determination of your tax classification, and is not
binding on the IRS. If you want a legal determination of your tax classification, you may
request a private letter ruling from the IRS under the guidelines in Revenue Procedure
2004-1, 2004-1 I.R.B. 1 (or superseding Revenue Procedure for the year at issue) . Note:
Certain tax classification elections can be requested by filing Form 8832, Entity
Classification Election. See Form 8832 and its instructions for additional information.
If you are required to deposit for employment taxes (Forms 941, 943, 940, 944, 945,
CT-1, or 1042) , excise taxes (Form 720) , or income taxes (Form 1120) , you will receive a
Welcome Package shortly, which includes instructions for making your deposits
electronically through the Electronic Federal Tax Payment System (EFTPS) . A Personal
Identification Number (PIN) for EFTPS will also be sent to you under separate cover.
Please activate the PIN once you receive it, even if you have requested the services of a
tax professional or representative. For more information about EFTPS, refer to
Publication 966, Electronic Choices to Pay All Your Federal Taxes. If you need to
make a deposit immediately, you will need to make arrangements with your Financial
Institution to complete a wire transfer.
Packet Page -944-
3/8/2016 16.E.4.
(IRS USE ONLY) 575A 11-06-2014 GREA B 9999999999 SS-4
The IRS is committed to helping all taxpayers comply with their tax filing
obligations. If you need help completing your returns or meeting your tax obligations,
Authorized e-file Providers, such as Reporting Agents (payroll service providers) are
available to assist you. Visit the IRS Web site at www.irs.gov for a list of companies
that offer IRS e-file for business products and services. The list provides addresses,
telephone numbers, and links to their Web sites.
To obtain tax forms and publications, including those referenced in this notice,
visit our Web site at www.irs.gov. If you do not have access to the Internet, call
1-800-829-3676 (TTY/TDD 1-800-829-4059) or visit your local IRS office.
IMPORTANT REMINDERS:
* Keep a copy of this notice in your permanent records. This notice is issued only
one time and the IRS will not be able to generate a duplicate copy for you. You
may give a copy of this document to anyone asking for proof of your EIN.
* Use this EIN and your name exactly as they appear at the top of this notice on all
your federal tax forms.
* Refer to this EIN on your tax-related correspondence and documents.
If you have questions about your EIN, you can call us at the phone number or write to
us at the address shown at the top of this notice. If you write, please tear off the stub
at the bottom of this notice and send it along with your letter. If you do not need to
write us, do not complete and return the stub.
Your name control associated with this EIN is GREA. You will need to provide this
information, along with your EIN, if you file your returns electronically.
Thank you for your cooperation.
Keep this part for your records. CP 575 A (Rev. 7-2007)
Return this part with any correspondence
so we may identify your account. Please CP 575 A
correct any errors in your name or address.
9999999999
Your Telephone Number Best Time to Call DATE OF THIS NOTICE: 11-06-2014
( ) EMPLOYER IDENTIFICATION NUMBER: 47-2260647
FORM: SS-4 NOBOD
INTERNAL REVENUE SERVICE GREATER NAPLES FIRE RESCUE DISTRICT
CINCINNATI OH 45999-0023 CHARLOTTE JOHNSON
nni 14575 COLLIER BLVD
NAPLES, FL 34119
Packet Page -945-