WEST VILLAGES IMPROVEMENT DISTRICT

CONTRACTOR'S PREQUALIFICATION STATEMENT (CONSTRUCTION OF PUBLIC INFRASTRUCTURE IMPROVEMENTS AND
MAINTENANCE SERVICES)

Sunny Grove Landscaping & Nursery Inc.

Contractor

1

TABLE OF CONTENTS

REQUEST FOR QUALIFICATIONS ADVERTISEMENT NOTICE TO PROSPECTIVE BIDDERS
APPLICATION FOR CONTRACTOR PREQUALIFICATION SUPERVISORY PERSONNEL
COMPANY OWNED MAJOR EQUIPMENT STATUS OF CONTRACTS ON HAND
ALL PROJECTS APPLICANT COMPANY COMPLETED IN THE LAST TWO YEARS LIST OF ADDITIONAL DOCUMENTS FOR INCLUSION IN APPLICATION AFFIDAVIT FOR INDIVIDUAL
AFFIDAVIT FOR PARTNERSHIP AFFIDAVIT FOR CORPORATION
SWORN STATEMENT UNDER SECTION 287.133(3)(A), FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES

CONTRACTOR CLASSIFICATION LISTING DETERMINATION OF QUALIFIED PROSPECTIVE BIDDER

2

REQUEST FOR QUALIFICATIONS
FOR CONSTRUCTION AND MAINTENACE SERVICES WEST VILLAGES IMPROVEMENT DISTRICT

The West Villages Improvement District ("District") requests Applications for Qualification from firms interested in providing construction and maintenance services for public infrastructure improvements. Upcoming projects include the construction of various infrastructure improvements and maintenance services in and around the District including i) earthwork/excavation and construction of roadways, stormwater management facilities, water and sewer facilities, irrigation facilities, landscape, hardscape, street lighting, and other public improvements and ii) maintenance services including exotic vegetation removal, and canal/drainage, landscaping, lake and littoral maintenance, and streetlighting.

To be eligible to submit qualifications, firms must: i) hold all required applicable licenses in good standing and ii) be authorized to do business in the Sarasota County, and the State of Florida.

For construction services, any contractor pre-qualified and considered eligible by the Department of Transportation to bid to perform the type of work the project entails shall be presumed to be qualified to perform the project.

Applicants may request an Application for Qualification from Dewberry Engineers Inc. 2201 Cantu Court, Suite 107,
Sarasota, Florida 34232, or via email to rellis@dewberrv.com beginning April 14th, 2022, after 1:00 p.m. Applicants must submit one (1) electronic copy (PDF format on a USB flash drive), by 4:00 p.m. on May 16th, 2022. Address responses to:
Mr. Richard Ellis, District Engineer, 2201 Cantu Court, Suite 107, Sarasota, Florida 34232.

Qualified firms will be selected based on experience, qualifications of personnel, and ability to perform construction or maintenance services. Packages will be reviewed and rated by a committee appointed by the District Board of Supervisors promptly after receipt of the submittals, with final selections expected to be made at a publicly noticed Board of Supervisors meeting held shortly thereafter.

At that time, all qualified firms may be assigned a project qualification and aggregate dollar limit for work under District contracts. All applicants will be promptly notified after the construction and maintenance firms are selected. The pre­ qualification decisions of the Board of Supervisors shall be valid for a period of three (3) years, after which the Board of Supervisors may either extend the prequalification period for an additional two (2) years or open the prequalification process again, at its sole discretion. The District reserves the right to waive any informality in the qualifications submitted, to reject any and all qualifications submitted and to advertise for the services.

Pre-qualified firms will be eligible to bid on construction and maintenance projects subject to the applicants approved project classification and aggregate limit. Failure to pre-qualify may preclude the District from awarding contracts for construction and maintenance services to non-qualified firms.

Applicants may contact the District Engineer, Dewberry Engineers Inc., at 2201 Cantu Court, Suite 107, Sarasota, Florida 34232, or via email to rellis@dewberry.com, until the qualifications submittal deadline for further information. All requests for information shall be in writing.

Any contractor submitting a Contractor's Prequalification Statement, which in its judgment is adversely affected by the District's rating as to the contractor's qualifications and wishes to protest such decision must file with the District a notice of protest in writing within seventy-two (72) hours (excluding Saturdays, Sundays and state holidays) after receipt of the notice of the District's ranking, and shall file a formal written protest within seven (7) days (including Saturdays, Sundays and state holidays) after the date of filing of the notice of protest. The formal written protest shall state with particularity facts and law upon which the protest is based. Failure to timely file a notice of protest or failure to timely file a formal written protest shall constitute a waiver of all further proceedings under Florida law and the District's Rules of Procedure. You may obtain a copy of the District's Rules of Procedure by contacting the District Manager's Office at 250 IA Bums Road, Palm Beach Gardens, FL 33410.

William Crosley, District Manager

3

Publication Date:	, 2022

4

NOTICE TO PROSPECTIVE BIDDERS

The information required herein is for the purpose of fairly evaluating contractor qualifications to perform various construction and maintenance activities for the West Villages Improvement District (the "District").

APPLICANTS FOR PREQUALIFICATION AS BIDDERS FOR THE WEST VILLAGES IMPROVEMENT DISTRICT CONTRACTS ARE HEREBY NOTIFIED THAT INCLUSION OF FALSE, DECEPTIVE OR FRAUDULENT STATEMENTS ON THIS APPLICATION CONSTITUTES FRAUD. FURTHERMORE, YOU ARE HEREWITH NOTIFIED THAT THE WEST VILLAGES IMPROVEMENT DISTRICT CONSIDERS SUCH ACTION ON THE PART OF THE APPLICANT TO CONSTITUTE GOOD CAUSE FOR DENIAL, SUSPENSION, OR REVOCATION OF THE PROSPECTIVE BIDDER'S QUALIFICATION FOR BIDDING ON ITS PROJECTS.

Please be advised that this application must be complete within itself without reference to any other application or statement. All sections of the application shall be completed. If any of the requested information does not apply, it shall be indicated as "None" or "N.A." as applicable. Failure to make entries in every section of this application may result in a disqualification.

All financial information provided in this application and accompanying audited financial statements are exempt from public record laws pursuant to Section 119.071(1)(c), Florida Statutes, and will be kept confidential. District can request annual audits and annual resubmittal of any or all financial statements from any prequalified contractor.

The properly completed Contractor's Prequalification Statement shall be submitted to the District Engineer, Richard Ellis at Dewberry Engineers Inc., 2201 Cantu Court, Suite 107, Sarasota, Florida 34232. Any questions with regard to the requests for information contained herein shall be addressed to the District Engineer, Dewberry Engineers Inc., at 2201 Cantu Court, Suite 107, Sarasota, Florida 34232, or via email to rellis@dewberry.com.

Schedule of Pertinent Dates

Descriotion	Date	
RFQ "Pickup" Date	Thursday, April 14th, 2022, after 1:00 p.m.	
RFQDueDate	Monday, Mav 16th, 2022, at 4:00 p.m.	
Committee Meeting Date to Evaluate
Qualifications Statements	Tuesday, May 17th at 11:00 a.m.	
Board Meeting to Formally Approve
Prequalified Contractors	Thursday, May 19th at 11:00 a.m.	

CONTRACTOR PREQUALIFICATION STATEMENT

Application for Contractor Pregualification (Attach Additional Sheets if Necessary)

5

DATE SUBMITTED 	

0-5 /1-3	

_,2022

Applicant 	

Sunny Grove Landscaping & Nursery Inc.	

/_j A Partnership

[Company Name]	/XI A Corporation
/_j A Subsidiary Corporation
Parent Company Name 	 _

Parent Company Address:

Street Address	15111 S. Mallard Lane Ft. Myers Florida 33913
P. 0. Box (ifany)_3_4_7	 _

City _ _,E=s=t=er'-=o	 State _F=-1=	Zip Code 33929	 _

Telephone 	_,2=3=9--"-9"""92=-=18=1=8	 Fax no.239 922 3564 	 _

1st Contact Name  Mark Williamson	Title	President/Owner

2nd Contact Name 		Title 	 _

Applicant Company Address (if different):
Street Address 	 _

P. 0. Box (if any)	 _

City 	 State 	 Zip Code 	 _

Telephone 	

Fax no. 	 _

1st Contact Name	 Title 	 _

2nd Contact Name 		Title 	 _

List the location of the office from which the applicant would perform work for the West Villages Improvement District work.

Street Address  	4=9'--'S=i=n=cl=a=ir'""D=ri""'v"'"e 	

City_--=S=ar=a=s=o=ta"'--		State	Florida	Zip Code 34240_

Telephone 

----'9 4 1----'3 7_4 3 9_40		

Fax no._N_/A	_

1st Contract Name	-------=M=a=rka.:......,,.W'-'i=ll=ia=m=s=o=n'---	 Title	President/Owner

6

Is the applicant Company incorporated in the State of Florida? yes (X ) no ( )

If yes, provide the following:

Is the Company in good standing with the Florida Department of State Division of Corporations? yes (X ) no (
)

Ifno, please explain 	

Date incorporated_08/19/1977	Charter No. 	 _

Ifno, provide the following:

The State with whom the applicant company is incorporated in?		

Is the company in good standing with the State? yes ( ) no ( )

In no, please explain 	

Date incorporated 	 Charter No. 	_

Is the applicant company authorized to do business in the State of Florida? yes ( ) no ( )

Is the applicant company a registered or licensed contractor with the State of Florida? yes ( ) no ( X)
Provide copies of all licenses listed. Not Required for Landscape & Irrigation

If yes, provide the following:

Type ofregistration (i.e. certified general contractor, certified electrical contractor, etc.) 	_

License No. 	 Expiration Date 	_

Qualifying individual 	 Title 	_

List company(s) currently qualified under this license 	 _

Is the applicant Company a registered or licensed Contractor with Sarasota County? yes (X ) no()
Amiel Villani License# RGLAN SL 35 Amiel Villani SIS #03 Contractor's Certificate
Has the applicant Company performed work for an independent special district previously? yes ) no (X )

Is the applicant company prequalified by the Florida Department of Transportation? yes ( ) no ( X)

If yes, provide the following:

Work Class Ratings 	 _

Maximum Capacity Rating		

7

Name of Applicant's Bonding Company 	N=/A=------------------
Address 				 Approved Bonding Capacities:	Aggregate Limit	$	 _
Single Project Limit	$	 _
Total Current Contracts Bonded	$	 _

Note: All bonds and insurance policies obtained by Applicant required herein shall be issued by companies authorized to do business in the State of Florida and shall have a financial strength rating of A or better, and a financial size category ofX or higher, as rated by A.M. Best Company.

Name of Applicant's Bonding Agency 	 _

Address
Contact Name 	Phone 	 _

List the Applicant's total annual dollar value of work completed for each of the last three (3) years starting with the latest year and ending with the most current year (2019) $ 57,168,304_	(2020) $58,602,706	(2021)	$68,154,000

List the classification(s) (refer to attached listing) of work the applicant is applying for prequalification based on the applicant company's ability to self perform the work (excluding general contracting).

Landscape Installation			 Irrigation Installation			

What are the applicant company's current insurance limits? If contractor does not have a certain category of coverage listed below, please note none. (provide a copy of applicant's certificate of insurance)

General Liability Automobile Liability Workers Compensation
Contractor's Pollution Liability Umbrella Liability/Excess Liability Contractors Additional Insured Status

$1 Mill/2 Mill-----
$1Mill		_
$1 Mill/lMill, 1 Mill	 _
$_None	_
$ 5 Mill-----

General Liability _Yes	_
Auto Liability	_Yes		_
Per Project Aggregate Limit
General Liability 	 _ Waiver of Subrogation in favor of District

General Liability
Auto Liability
Workers' Compensation

_Yes	_
Yes----
Yes-----

Expiration Date _03/30/2023	_

Note: Applicant must provide a certification that their insurance carrier is authorized to conduct business in Florida. Coverage must be provided on a primary, non-contributory basis.

Has the applicant company been cited by OSHA for any job site or company office/shop safety violations in the past two years? yes (X ) no ( )
If yes, please describe each violation, fine, and resolution ----=P--le=a=s-=-e--s.e.e."--=at=t.a....c....h. e.._d...ti.,.o..r....v....e...ar=2.0..21	_
13.l	What is the applicant's current worker compensation rating? 1.00	_

8

ACORD™	CERTIFICATE OF LIABILITY INSURANCE	DATE (MM/DDNYYY)
04/01/2022	
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
- EPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER•	
.IPORTANT:.lf the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.	
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s).	
PRODUCER
Acrisure dba Gulfshore Ins SWF 4100 Goodlette Road N
Naples, FL 34103
239 261-3646	x i cT Amanda Lisenbey	
	rt8Ntro Extl: 239 659 8867	I ,ffc No): 239 213 2803		
	ti  ss: alisenbey@gulfshoreinsurance.com	
	INSURER(SJ AFFORDING COVERAGE	NAIC#	
	INSURER A: Cincinnati Insurance Company	10677	
INSURED	Sunny Grove Landscaping & Nursery, Inc. Xeriscape Water Systems, Inc
PO Box 347
Estero, FL 33928	INSURER e : Travelers Property Casualty Company	25674	-	
		INSURER c : Builders Mutual Insurance Company	10844		
		INSURER D : CNA Insurance	20443	
		INSURERE:		
		INSURERF:		

Client#: 60740	SUNLA6	 I 

COVERAGES	CERTIFICATE NUMBER:	REVISION NUMBER:

=

THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.

□

\R	TYPE OF INSURANCE
X COMMERCIAL GENERAL LIABILITY

W- l

POLICY NUMBER EPP0573712

04/01/2022 04/01/202 EACH OCCURRENCE

$1,000 000

CLAIMS-MADE	OCCUR

·1--;: :--= -c-:M--;cA ;:;-; ::--:J [?J:c-;E :c; ::c-tgE;:;:UJTe;::;D::--n-ce-,\-+-'-$..:..SOi..::O:..=..::O:.i;0::..:0=  1

X PD Ded:100,000

n

>		

POLICY [!]	:2-r		LOCR

GEN'L AGGREGATE LIMIT APPLIES PER:

OTHER: AUTOMOBILE LIABILITY

EPP0573712

04/01/2022 04/01/202:l

MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG

:  llNGLE LIMIT

$10 000
$1,000,000
$2,000,000
$2,000,000
$
$1,000,000

f--'-'=== ----¥---'----'-'	_.j

>--

X ANYAUTO OWNED AUTOS ONLY

-	SCHEDULED

BODILY INJURY (Per person)	$
BODILY INJURY (Per accident) $

_X HAIURTEODSONLY

,-	1<?JwNED
X  AUTOSONLY
$

n

X UMBRELLA LIAB	lxJ OCCUR
-	EXCESS LIAB	CLAIMS-MADE DED I XI RETENTION $10000
WORKERS COMPENSATION
AND EMPLOYERS" LIABILITY	y / N ANY PROPRIETOR/PARTNER/EXECUTIVEr-:-;7 OFFICER/MEMBER EXCLUDED?

NIA

CUP0T838645

WCP1076953

04/01/2022 04/01/202:J EACH OCCURRENCE
AGGREGATE

04/01/2022 04/01/2023 X l  fnrri:c	J	12JH-
E.L. EACH ACCIDENT

$5 000.000
$5 000 000
$

$1 000 000

(Mandalory In NH)
If yes, describe under

E.L. DISEASE - EA EMPLOYEE $1 000 000

DESCRIPTION OF OPERATIONS below
Leased/Rented Equipment

7012388125	K,4/01/2022 04/01/2023

E.L. DISEASE - POLICY LIMIT
$200,000
$2,500

$1 000,000

DESCRIPTION OF OPERATIONS I LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)

CERTIFICATE HOLDER	CANCELLATION

For Insurance Purposes Only	
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WIU BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.	

I	AUTHORIZED REPRESENTATIVE
	-$z.	-	
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03)	1 of 1	The ACORD name and logo are registered marks of ACORD
#S1797310/M1797131	TKM21

02/24/2021 Luis Miguel Pineda Morales  LANDSCAPE  Claim #894939

The employee was guiding a tree with both hands while the tree was strapped to the boom of the front-end loader. While doing this the employee slipped and lost his balance. His right leg and ankle were run over by the front tire of the front-end loader. Employee was transported to Naples Community Hospital by ambulance.

2/25/2021 Mary Ann Bohn spoke with Miguel's nurse at the hospital. She advised that the x-rays showed no breakage or damage to leg or ankle. The x-rays did show issue with three of his toes. His foot was swollen and they hoped the swelling would go down overnight. A Podiatrist was going to visit him today to evaluate injury to his toes. Report of this injury was called into OSHA last night upon being told the employee was being admitted to an overnight stay at the hospital. The OSHA report was left on voice mail.
I went in this morning and reported the case online to make sure OSHA received. An OSHA representative told me they may be sending someone to the hospital to interview
Luis Miguel.

06/09/2021 Received an email from Susan. Miguel is doing very well and is getting fitted for his prosthetic.
See full report in file of all hospitalizations, amputation, receipt of prosthetic leg, etc.

9/24/2021 Received email from Susan Pezzino that a settlement has been reached. $300,000 inclusive of fees/costs and a voluntary resignation and general release.

LANDSCAPE• NURSERY • IRRIGATfON

Inspection Number 1518241

Citation 1 and Item Number 1
Accident February 24, 2021

To Whom this may concern:

Please note the following: Abatement method to prevent accident or injury from happening when operating a Caterpillar front loader.

We referenced both page (8) and page (90) of operator's manual when implementing safety policy. Bill Cobb, our Safety Manager held a meeting with the operator Casildo Cruz and the entire crew to review all safety measures needed to be taken when operating this machine.

We addressed the issue of how the accident occurred, pointed out what Casildo and his crew should and should not have done on February 24th.  We went into great detail about safety
procedures that need to be taken when operating a Caterpillar front loader.

We reviewed and put in place a prevention program which includes the standards for safe distances employees must maintain when working around loaders.  The purpose of this policy is to ensure the safety of those individuals who operate front end loaders. It is the driver's responsibility to operate the equipment in a safe manner to prevent injuries and property damage. As such, Sunny Grove expects the driver to drive and operate his loader in a safe manner pursuant to the safety guidelines of the operation and maintenance manual. Manual is kept with machine at all times.

Our Safety Manager Bill went over the instructions and warnings in the Operations and Maintenance manual with Casildo. We feel Casildo and the entire crew are fully trained and understand the rules of operating the front loader.

15111 S. Mallard Lane• Fort Myers, Florida 33913 • (239) 992 - 1818 • Fax (239) 992 - 3564 Mailing Address• P.O. Box 347 • Estero, Florida 33929

U.S. DEPARTMENT OF LABOR OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION

In the Matter of: OSHA No.(s):

Sunny Grove Landscaping and Nursery, Inc. 1518241

INFORMAL SETTLEMENT AGREEMENT

The undersigned Employer and the undersigned Occupational Safety and Health Administration (OSHA) representative, in settlement of the above citation(s) and penalties which were issued on 03/05/2021, hereby agrees as follows:

The Employer agrees to correct the violations as cited in the above citations or as amended below.

The Employer agrees to pay the proposed penalties, if any, as issued with the above citation(s), or, if amended by this agreement, as amended below.

OSHA agrees that the following citations are being amended as shown below:

Cit ID	

STANDARD	
Abatement Status / Changes	Initial Proposed Penalty	Amended Penalty	
1-1	OSH Act of 1970 Section 5(a)(l)	a.  Penalty Reduction	$12,228.00	$7,336.80	
	Total Amended Penalty	$7,336.80	

The Employer, by signing this informal settlement agreement, hereby waives its right to contest for the above citation and penalty, as amended in paragraph 3 of this agreement.

The Employer agrees to immediately post a copy of this Settlement Agreement in a prominent place at or near the location of the violation(s) referred to in paragraph 3 above.

The Employer agrees to continue to comply with the applicable provisions of the Occupational Safety and Health Act of 1970, and the applicable safety and health standards promulgated pursuant to the Act.

Each party hereby agrees to bear its own fees (including attorney fees) and expenses incurred by such party in connection with this proceeding, including the implementation of the terms and conditions of this agreement.

None of the foregoing agreements and/ or statements are intended as an admission of the allegations contained within the Citation and Notification of Penalty. The agreements herin are not intended to be used for purposes other than actions or proceedings arising under the Occupational Safety and Health Act.

The employer agrees to pay the penalty of$ $7,336.80 by 8/18/2021. If not paid by this date, the full penalty as originally assessed shall become due and payable. Please make your checks or money orders payable to "DOL -OSHA", and submit to 5807 Breckenridge Parkway, Suite A, Tampa, FL 33610-4249. Please indicate the Inspection Number on your remittance. Payments may also be made electronically at http://www.pay.gov. See the enclosed announcement for more information.

ERIN

Digitally signed by
ERIN SANCHEZ
SANCHEZ Date:2021.08.03
----	15:44:06-04'00'	

For Occupational Safety And Health Administration Erin Sanchez
Assistant Area Director
(signature and date)

For The Employer
(signature and date)

13.2	Has the applicant company experienced any worker injuries resulting in a worker losing more than ten (10) working days as a result of the injury in the past two years? yes ( ) no ( )

If yes, please describe each incident 	P..._l=ea=.s.e..""'s'""e-=-e-"a=tt=a=c=h_ed 

---'Y'""e=a=r-=2=0=2=1.......a.N.a.ao'-o""'n""e'-o""u::..:t:....:1"-'0'-d=a=-yi.:s;..:iaa::n ::2:.::0c::2""0_ 

Please state whether or not your company or any of its affiliates are presently barred or suspended from
bidding or contracting on any state, local or federal-aid contracts in any state(s)? Yes	No X		If so, state the name(s) of
the company(ies) 	

the state(s) where barred or suspended 		 _ and the period(s) of debarment or suspension 	 _

INDIVIDUAL'S NAME	PRESENT POSITION OR OFFICE	MAGNITUDE AND TYPE OF WORK*	YEARS OF CONSTRUCTION
/MAINTENANCE
EXPERIENCE	YEARS WITH FIRM	IN WHAT CAPACITY?	

PLEASE SEE
Experience o
key management page						

						

						

						
				..		

						

What is the construction or maintenance experience of the principal supervisory construction or maintenance personnel of your organization? (Attach resumes here.)

'•

*Give in sufficient detail for the District to evaluate your experience in the classifications of work for which you are requesting prequalification.

Have you ever failed to complete any work awarded to you? Yes	No _X_	Ifso, where and why?

OSHA's Form 300
Log of Work-Related Injuries and Illnesses

Year	2021
U.S. Department of Labor
l-	IOccupatioInal Sa.f.ety aInd Heal_t Adrm·inistr.atioI

T

T

T

Attention: This form contains information relating to employee health and must be used in a manner that
protects the confidenltality or employees to the extent
possible while the information is being used for occupational safety and health purposes.

·Yourn.1s! reoord information about every Vr'OO(.relaled injury or illness lhat involves lo$S of consciousness, restricted work acbv1ty or job transfer, days 11Nay from work, or medical treatment beyond first aid. You must also record significant work--<e!ated injuries end illnesses that are diagnosed by a physician or licensed health care professional. You must also record WOl'lt-<elaled injuries and illnesses that meet any of the specific recording criteria listed in 29 CFR. 1904 8 through 1904.12. Feel free lo use two lines for a single case if you need to. You must complete an injury and illness incident report {OSHA Form 301) or equivalent form for each injury or illness recorded on this form. If you're not sure whether a case is recordable, call your local OSHA office for help

Form approved 0MB no. 1218-0176

Establishment name  Sunny Grove Landscaping and Nursery, Inc.
City	Estero/Fort Myers	State -'F-"loc.cr.c.cidcca'--	_

Identify the person

Describe the case

.  Classify the case

-

(A)
Case
No.

(B)
Employee's Name

Using It result re

Enter the number of days s, check ONLY the most serious the injured or ill v.orker
was:

Check the •injury_" .C.?!UfT_l or choa - --C? _!Yp of i!ln s :

·•  -- 

(M)

Days away from wolk

Remained at w::,,k
· Job transfer Other record- or restriction able cases

0

I

!

?:-

g,
.,,
0..

1

J

(H)

(1)

(J)

E
(1)

"U)'
(2)

C

g-"g

0:   u

0

0

(3)

141

0
;;:
(5)

Miauel Pineda Morales

Andres Pedro DieQo

Page totals

Be sure to transfer these totals to the Summary page (Form 300A) before you post it.

.

0

?:- C

g,

0

0

0

0

7

223

71

1

2

4

0

X

12

0

X

Employee injured his hand while hooking up foli<s to a strap on a tree boom.

Job site

12/28

Laborer

7 Humberto Santiaoo Looez

X

15

0

X

Emolovee was diaoino holes with shovel and strained his back.

Job site

9/22

Laborer

6 Christooher Prioa

X

14

54

X

Employee was standini:t on a trailer, lost his balance, iniured his knee.

Job site

7/12

Laborer

5 Jesus Sanchez

X

0

17

X

Employee fell when steppin out of a vehicle and injured his knee.

Job site

7/9

Laborer

4 Aoustin Chacon

X

2

0

X

Emt>fo'\IP.f>, strained his back 'Nhen loadinQ ramps onto a trailer.

Job site

6/2

Laborer

3 Walter Looez Perez

X

0

0

X

Employee was removing a tree from a grower's pot using a piece of wood. The wood slipped. Employee received 5 sutures.

Our Nurse"!

5/11

Laborer

X

180

X

Employee was guiding a tree into position during installation when he slipped and his right leg was run over by a front end loader.

Customer's 10b site

2/24

Laborer

(L)

Away from woli< (days)

(K)

On job
transferor
,estriclion
(days)

(G)

Death

(F)
Describe injury or illness, parts of body affected, and object/substance that directly injured or made person ill (e.g. Second degree bums on right forearm from acetylene torch)

(E)
Where the event occurred (e.g. Loading dock north end)

(mo./day)

(D)
Date of Injury or onset of illness

(C)
Job Title (e.g., Welder)

E

it

g	.

1c	,g .g	-	;
.
0	u	0

t

C	0..
,a	0:
<f)
;\'

Page	1 of 1	(1)	(2)	(3)	(4)	(5)

Has any officer or partner of your organization ever been an officer, partner, or owner of some other organization that has
failed to complete a construction or maintenance contract? Yes	 NoX_

If so, state name of individual, other organization and reason therefore.

List any and all litigation with owners or major .subcontractors to which the Applicant has been a party in the last five (5) years and describe the outcome or resolution.

Has the Applicant or any of its affiliates ever been either disqualified or denied prequalification status by a governmental entity? _No_X_ If so, discuss the circumstances surrounding such denial or disqualification as well as the date thereof.

Within the past five (5) years, has the Applicant failed to complete a project within the scheduled contract time?

_NO_X	 thereof.

If so, discuss the circumstances surrounding such failure to complete a project on time as well as the date

Does the Applicant have adequate equipment to perform normal construction or maintenance operations for each class of work

for which prequalification is sought? Yes_X 

No	

Ifno, please explain:

SUPERVISORY PERSONNEL

Company Name Sunny Grove Landscaping & Nursery Inc.	Date 05/13/2022

What is the experience of the key management and supervisory personnel of the applicant company for both administration as well as operations? (Attach resumes of key
,-

INDIVIDUAL'S NAME	
PRESENT TITLE	DESCRIPTION OF DIRECT JOB RESPONSIBILITIES	YEARS OF
EXPERIENCE IN PRESENT POSITION	TOTAL YEARS OF
RELATED EXPERIENCE	

Mark Williamson	
President/Owner	
Working owner
Oversees the running of Landscape, Irrigation & Maintenance Companies	
50 years	
50 years	

William Cobb	
Landscape Operations Manager	Organize and oversee day to day landscape operations	
11 years	
20 years	

Morgan Halle	
Project Manager	
Sales & Project Coordinator
Manages Landscape & irrigation jobs from start to completion	
20 years	
25 years	

Penny Nicol	
Project Manager	
Sales & Project Coordinator Manages Landscape & Irrigation jobs
from start to completion	
30 years	
30 years	

Vincent Defini	
Project Manager	
Sales & Project Coordinator Manages Landscape & Irrigation jobs
from start to completion	
1 year	
25 years	

Michael Winkleman	
Landscape Supervisor	
Manages & oversees Landscape installation on projects assii:med to him	
4 years	
25 years	

Agapito Saldana	
Landscape Supervisor	
Manages & oversees Landscape Installation on projects assiwed to him	
17 years	
30 years	

Ignacio Gutierrez	
Landscape Supervisor	
Manages & oversees Landscape Installation on projects assigned to him	
8 years	
25 years	

Juan Alvarez	
Landscape Supervisor	
Manages & oversees Landscape Installation on project assigned to him	
28 years	
30 years	

Scott Piper	
Irrigation General Mana_ger	
Irrigation design - Manage & Oversee All Irrigation work for Company	
22 years	
30 years	

Jose Espinoza	
Irrigation Supervisor	
Manages & oversees Irrigation Installation on projects assigned to him	
20 years	
25years	

Oscar Bustos	
Irrigation Supervisor	
Manages & oversees Irrigation Installation on projects assigned to him	
20 years	
25 years	

Reynier Santos Lagos	
Irrigation Supervisor	
Manages & oversees Irrigation Installation on projects assigned to him	
6 years	
15 years	

Jorge Ruiz Gonzalez	
Irrigation Supervisor	
Manages & oversees Irrigation Installation on projects assiened to him	
7 years	
10 years	
Mary Ann Bohn	-	
Office Manager/Accounting	
Manages Accounting office Staff Assist Mark Williamson, President	
20 years	
30 years	

Jason Stafford	
Landscape Maintenance Manager	
Manages Landscape & Irrigation Maintenance Company	
8 years	
10 years	

John Becht	
Landscape Maintenance Manager	
Manages Landscape & Irrigation Maintenance Company	
5 years	
10 years	

COMPANY OWNED MAJOR EQUIPMENT
(Attach additional sheets if necessary)

Company Name Sunny Grove Landscaping & Nursery Inc	.Date 05/13/2022	 _

QUANTITY	

DESCRIPTION	

CAPACITY	NO. LOCATED IN	
			
FLORIDA	
OTHER	
	
Please see attached				

					

					

					

					

					

15

SUNNY GROVE VEH	
LISTED BY TYPE	

	

Kubota Wheel Loader (swinger per Mark) SARASOTA	

Kubota Wheel Loader R520S1	

Kubota Wheel Loader	

Kubota KX91 Mini Excavator with bucket	

Kubota Model V33009 Loader	

3 GENERATORS PURCHASED FROM Divosta	
Kubota Wheel Loader R520S1T3 with bucket & tree boom K9725, K9264, K9933	
Purchase Creel Tractor O % interest	
Kubota track loader creel tractor 60 m.	

Kubota Loader Creel tractor rent 2 mo	
	
Kubota UtIl1ty vehicle Creel Tractor	
	
Kubota tractor/backhoe Creel Tractor	
Kubota utility vehicle Creel Tractor Company	
Kubota loader Creel tractor rent 2 month	
rent December and January then purch	
Kubota loader	
rent December and January then purch	
Kubota Loader Creel Tractor	

Kubota Excavator Creel Tractorn	

Creel Kubota loader, fork & tree boom fin	
Creel Kubota loader, bucket,fork & tree boom financed	
Creel Used Kubota loader fork & tree boom paid cash $14,580.83 plus 3) repair invoices	

WCE Equipment Kubota w bucket	

WCE Equipment Kubota w bucket	

Creel Tractor Kubota Excavator	
https://sunnygrove-my.sharepoint.com/personal/maryann_sunn\{grove_com/Documents/Desktop/equip   list.xlsx	5/2/2022

SUNNY GROVE VEH	
LISTED BY TYPE	

	

Creel Tractor Kubota Excavator	

Kubota Utility Vehicle Creel Tractor	

Creel Kubota articulating loader lfin 48 ,mo.	

Creel Kubota articulating loader financed 48 mo	

WCE Equipment Kubota R5202 Loader for	

Creel Tractor Kubota loader track Mark purch day
after hurricane heavy dutry 80" bucket ,tree boom & pallet fork AP-HD80LLC - LAF2210 - Ap-PFL4548	
2018 KUBOTA #U25R1T4 March 1st pmt	
Creel Tractor Kubota Excavator finance thru Kubota made two payments than fin	

Kubota R630R41 wheel loader W/pallet forks and tree boom Creel tractor finance 48 months	
Kubota Creel Tractor rented (5) mo. Then pur
Model KX033-4R1A	

Kubota with tree boom Coupler plus (2) buckets	

Kubota financing Wheel loader/Canopy	

Kubota financing Wheel Loader/Canopy	

Creel Kubota R630R41 Model  Nursery	

Land pride Model AP-LB60	

Paladin--Bradco Model 106655	
CreelKub t.a.,8.6;3QB.4..1_Model.,,,N1-1rs..e,r,y,_-·. 	.._ ,r.-
,	.,.., -	., --	

https://sunnygrove-my.sharepoint.	,-

ktop/equip list.xlsx	5/2/2022

SUNNY GROVE VEH	
LISTED BY TYPE	

	

Landpride AP-Lb60	

Paladin-Bradco Model106655	

Attachment	

Ditch Witch RT40 w/attachment Jose	

Auger head Mcmillen	
DitchWitch Trencher XeriscapeSARASOTA Oliver	
DitchWitch Trencher Xeriscape Genaro	
SN attach CMWH314XA0002361 Romeo	

digging machine attachment for this trencher	

DitchWitch Trencher SG & attachment Desiderio	

Ditch Witch Trencher Regions & attach Martin B	

Ditch Witch Trencher Regions & attach	JoseG	
Ditche Witch Trencher Regions & attach	
Ditch Witch Trenchers Regions & attach	
	
Ditch Witch R45 5 64" Tilt Loader	
Ditch Witch R45 5 64" Tilt Loader	
	
Ditch Witch R45 rented 11 months then paid	
Diitch Witch R45 rented 08 months then paid	

Ditch Witch 2015 RT45 Ride on Trencher	

Ditch Witch RT45 Ride on Trencher with attachment paid off in Jan 2017 Paid off	
https://sunnygrove-my.sharepoint.com/personal/maryann_sunr&tgrove_com/Documents/Desktop/equip  list.xlsx	5/2/2022

SUNNY GROVE VEH	
LISTED BY TYPE	

	

Ditch Witch RT45 trencher purchase with trade in	

2017 RT45 Ride on Trencher set up folder 1st pmt Ditch Witch renting 6 months than purchase purchase date 12/19/2017	
Ditch Witch RT45 trencher 013955/013956 renting for (6) months - than purchase apply rental as down pmt $3577.50 X 6 mo equals=
$21,465.00	

Ditch Witch RT45 We are renting 6 mo than pure	

Ditch Witch DWR45 DWH314 rent (6) mo than pu	
Ditch Witch Attachment	

Creel Kubota Articulating Loader Mech SSL Coupler	
48 mo -0- interest	
Model# R630R41 Coupler K7170 Bucket K7175 treE	
Ditch W. Walk behind loader rent 6 mo than purchas	
Landscape item Trench attachment CM SK5TR	

Ditch Witch RT45 Sliding attachment 42x6' Shark	

DITCH WITCH RT45 WITH ATTACMENT DWH314	

Ditch Witch Rt45 6 payments than purchase	

Ditch Witch Yanmar 44 HP Gross EPA Fin 24 mo	
Ditch Witch Yanmar 24 HP 42 ' bucket trencher
attachment added in July	

Ditch Witch Kubota 25 Gross EPA Tier 4	

Ditch Witch Financed SK800 18321 trencher attachment SKSTR 19494 ATTACHMENT	

Ditch Witch SK1550 Tree boom attachment	

https://sunnygrove-my.sharepoint.com/personal/maryann_sun  grove_com/Documents/Desktop/equip  list.xlsx	5/2/2022

SUNNY GROVE VEH	
LISTED BY TYPE	

	

Ditch Witch Financed SK800 Stc#020824/019471	

Ditch Witch Mini SK800 SSL	

Kubota Creel tractor Model SVL95-2S	

80# HD bucket Model AP-HDS0LLC	

Tree Boom Model #AP-LB60	

Land Pride Pallet Forks Model#AP-PFL5548	

Kubota Auger Med Flow 36' Bit Model# AP-SA35	

Ditch Witch SKI 1550 MINI SSL	

Ditch Witch SKK1550 financed	

Ditch Witch USED CM SK800 Paid cash	
KUBOTA WHEEL LOADER W/ CANOPY R530R41 WITH LIGHT MATERIAL BUCKET- BOOM -
PALLET FORKS	

Ditch witch SK 800 with trencher attachment	

36 X6 Combo Chain	

https://sunnygrove-my.sharepoint.com/personal/maryann_sunr&,grove_com/Documents/Desktop/equip  list.xlsx	5/2/2022

SUNNY GROVE 1	
LISTED BYTI	

	RED ITEMS NOT ON INSURANCE POLICY	
	GREEN NOT ON INSURANCE OR TAGGED	

Year	

Make - Type - Model	
		
1992	lnt'I 4700 Van Freddies Flat Bed w/o box	

2000	
lnt'I Model 4700 4X2 Irrigation Desiderio	

2000	
International 4700 X2 Irrigation Sergio	
1999	International Irrigation truck Genaro	
MNT	Dodge Ram Jason 2009 Emilio now	

1990	FORD DUMP TRUCK	

2011	Dodge Ram purch Wheels Inc parked up front
MIGUEL JUAN - MAINTENANCE	
2014	sg Conch insurance	

2007	
HINO Used Truck Model 268  Wallace SARASOTA	

2006	HINO Used Truck Model 268 Wallace SARASOTA Oliverio	

2007	
HINO Used Truck Model 268 Wallace SARASOTA	

2008	HINO Used Truck Model 268 Wallace spray Jose
Anaya 2008	
MNT	Dodge Ram Crew Cab 4X4 Long Bed 2013	

2008	HINO USED TRUCK
WALLACE INTERNATIONAL	

2014	Dodge Ram 1500  Spare
Truck owned by SG used by Maint.	
MNT	Dodge Ram Long Bed SPARE	
2008	HINO Used Truck Wallace XER Jose H	
2012	Dodge Ram 1500 Fastenal pd casheir SCOTT	

2007	Hino Used purchased from Wallace Xeriscape paid cash Esteban	

2007	Hino Used purchased from Wallace
Sunny Grove paid cash New engine 06/2019	
MNT	Used inter made into dump truck 2012	
	2014 Dodge Ram 2500 pur Naples D Fin 48 Mon Ally MAINT OWNS	

2012	Dodge Ram 1500 purch Fastenal pd cash
crew #8 maintenance	

2207	
2007 Hino Wallace Int. Paid cash Jose	

2014	
2014 Dodge Ram Truck Maint purch 05/15	
2008	2008 Hino pd cash Xer owns Jose M	

2015	WALLACE INTL HINO PAID CASH being used in Sarasota per Bill 06/21	
2008	Wallace int Xeriscape Ramon HINO	
	2015 Dodge Ram Naples Dodge Ally 48 Mo -	
2007	Hino Wallace int Landscape SARASOTA	
MNT	2012 International Terrastar Wallace	

lOOio-	Hino Wallace international XERISCAPE
$AR SOTA manuel Ii	

0:\ Vehicles 07-10-2017\Vehicle

5/3/2022

SUNNY GROVE '	
LISTED BYT't'	

	RED ITEMS NOT ON INSURANCE POLICY	
	GREEN NOT ON INSURANCE OR TAGGED	

2008	

Hino Wallace financed JUAN ALVAREZ	
2013	Int. Terrastar Wallace paid cash	
2008	Hino Wallace Int. paid cash	DANIEL MONROY	

2009	Hino Wallace Int paid cash Xeriscape Jose
Garcia	
2009	HINO Wallace paid cash	
2015	Ford truck transit Galloway financed	
2008	Hino Wallace paid cash	CRUZ	
2009	Hino Wallace paid cash Xeriscape	
	SARASOTA JuliAN	

2015	Fastanal Dodge Ram Xeriscape paid cash BEING USED to transport to blue	
2008	Wallace Hino 2008 Xer Pd cash Aquilina	
2008	Hino Landscape Wallace pd cash	SAMMY	
2013	Inter Terrastar Wallace pd cash Temp.	
2008	Hino Truck Landsape Wallace	
2012	2016 international terrastar Wallace Int Pd C	

2016	2016 DODGE RAM VAN SARASOTA-MAINT IRRIGATION	

2008	Hino Wallace Paid cash Landscaping	PAULINOS
VASQUEZ	
2014	International Terrastar Wallace pd cash	
2016	Naples Ddoge 2016 Dodge Ram Fin 48 mo	
2009	Wallace Int Hino Paid cash	ALFONSO	
2012	International Terrastar Wallce paid cash	
2010	Hino Wallace lnternatioal paid cash	
2009	Hino Wallace lnternatioal paid cash PONCIANO	
2017	Naples Dodge Ram financed Aggy	
2017	Naples Dodge Ram financed MICHAEL	

2010	Hino Wallace paid 1200. Dec pay off Jan 2
DARIO RODRIGUEZ	
2012	Int Wallace paid 1200. Dec pay off Jan 2	
2012	International Terrastar Wallce paid cash	

2017	
Dodge Ram purchased Naples Dodge financed Ally	
2010	Hino purchased Wallace paid cash	CESAR	

MNT	2013 Dodge 2WD Reg Cab paid cash Wheels Inc.
{Fastenal) JUANITO	

MNT	2010 Hino Wallace Paid cash make into spray
truck	
SG	2006 International Tree Plateau paid cash	
Xer	2010 Hino Wallace	
MNT	Wallace truck 2015 Intern. Terrastar	
2015	Wallace truck 2015 Intern. Terrastar	

2010	Hino 268A used with plant box Wallace Int
FLORIAN	
SG	2017 Ford Escape Penny	

O:\Vehicles 07-10-2017\Vehicle , U/-.LU-  / ......:) ....	L

5/3/2022

SUNNY GROVE 1	
LISTED BY T"	

	RED ITEMS NOT ON INSURANCE POLICY	
	GREEN NOT ON INSURANCE OR TAGGED	

2010	
HINO used 268 with plant box Wallace Int MIGUEL	
2017	Cocnut Point 2017 Ford Transit Van Pd Cash	
2018	Aim new Truck Coconut pt Ford financed Temp	
2010	temp tagWallace inter Hino paid cash	

2018	Coconut Point Ford 4 door F 250 financed model	
2016	Coconut Poiint Ford Tansit Wagon Paid cash	

2018	
Coconut Point Ford Tru Transit financed	

2018	
Ford 2018 F 150 finance 48 mo Coconut Point Ford	

2018	Ford 2018 F 150 finance 48 mo Coconut Point
Ford	DAVID NAVA	

2016	Ford Transit-350 Van-SARASOTA Scanlon pd cash	

2017	Scanlon Acura Ram promaster paid cash
500.00 DEPOSIT	

2010	
Wallace Int Used 2010 Hino 268 paid cash	

2010	
Wallace Int Used 2010 Hino 268 paid cash	

2018	Coconut Point Ford PK financed Ford Motor Juan Angel	
I
2018	Coconut Point Ford PK financed Ford Motor -
MARCUS	
2010	Wallace 2010 Hino Aggy will tell us who is driver	
2019	FORD F-250 COCONUT POINT JUNIOR	
2019	FORD F-250 COCONUT POINT Crew 11	

2019	
HINO	WALLACE Financed 48 months	

2018	FORD F150 - COCONUT PT. FINANCED
DONATO	
2018	FORD F150 - COCONUT PT. ABBY	
2018	Ford Escape (Shawna) Coconut Point Ford	
2015	Ford VAN Transit Wagon Coconut Pt Santana	

2018	Ford Truck F 150 Series Coconut Point Financed
spare	

2018	ISUZI NPR HD FINANCED- NEXTRAN
MAINTENANCE IS USING--RAMIRO LOPEZ	

2018	ISUZI NPR HD FINANCED- NEXTRAN MAINTENANCE IS USING-LUIS PENA	

2019	
HINO 155 WALLACE INTERNATIONAL	

2019	
HINO 155DC WALLACE INTERNATIONAL	

2018	2018 Isuzu (Nextram) is dealer Financed 36 mo thru Isuzu Finance.	
2019	2019 Hino Wallace financed Hitachi	
2020	2020 Hino Wallace financed Hitachi	
2018	2018 Ford F 150 Coconut Pt financed	

O:\Vehicles 07-10-2017\Vehicles 07-10-17.xlsx	3	5/3/2022

SUNNY GROVE 1	
LISTED BYTY	

	RED ITEMS NOT ON INSURANCE POLICY	
	GREEN NOT ON INSURANCE OR TAGGED	

2018	
2018 FORD TRU F-150 SE COCONUT POINT
FINANCE 6/12/2019 JOHN BECHT Truck being driven by John B in Maintenance Maintenance will make payments, it is their truck but Mark purchased in SG name	

2019	2019 ISUZU
Nextran Isuzu financed	
	2019 Isuzu NPR HD Purch from Nextram	
2019	2019 ISUZU NPR HD PURCHASED FROM NEXTRAM	
2019	2019 Isuzu NPRHD Model Purch Nextran Fin.	
2018	Ford Transit passenger van Coconut Pt pd cash	
2019	Coconut Pt Ford van Paid cash	
2013	Ram Marcus sold truck to SG for spare not assett	
2019	Nextram 2019 Isuzu NRR paid cash Tom Scott	
2019	Isuzu Nextran financed TIAA bank fin.	
2019	Isuzu Nextran financed TIAA bank fin.	
2013	Palm RV Dodge Ram paid cash Model 3500	

2019	
Coconut Point Ford financed Trade in #	

2019	Coconut Point Ford 2019 Ford Transit PAID CASH	
	Isuzu Nextran Model NRR	
2010	Hine purchased from Wallace per Mark	

2019	
Nextran isuzu Model NPRHD	
2019	Nextram Isuzu Model NPR HD	
2020	Ford 150 XL 4X2 Super Cab	
2019	Ford Transit Van 350 Coconut Pt Paid Cash	
2019	Isuzu Model NRR Sarasota for Junior crew	
2019	Isuzu Model NPR HD purchase from Nextran	
2021	ISUZU NRR	PURCHASE FROM NEXTRAN	

2016	
Hino purchase from Nextran	

2020	2020 FORD TRUCK F150
COCONUT POINT - FINANCED	ADAN	

2020	2020 FORD VAN TRANSIT CONECT
COCONUT POINT - FINANCED	

2020	2020 FORD VAN TRANSIT CONECT COCONUT POINT - FINANCED	

2020	FORD F150 PURCHASED FROM MATTHEWS- CURRIE FORD - FINANCE THRU FORD CREDIT	

2020	FORD F150 PURCHASED FROM MATTHEWS- CURRIE FORD - FINANCE THRU FORD CREDIT	

2020	FORD F150 PURCHASED FROM MATTHEWS- CURRIE FORD - FINANCE THRU FORD CREDIT	
2021	2021 ISUZU NPR HD	

2022	

ISUZU NPR HD  PURCHSED FROM NEXTRAN	
O:\Vehicles 07-10-2017\Vehicles 07-10-17.xlsx	4	5/3/2022

	SUNNY GROVE '	
LISTED BYTI	

	RED ITEMS NOT ON INSURANCE POLICY	
	GREEN NOT ON INSURANCE OR TAGGED	

2021	
ISUZU NPR HD  PURCHSED FROM NEXTRAN	

2016	USED VOLVO VNL PURCHASED FROM NEXTRAN	
2021	ISUZU NPR HD  PURCHASED FROM NEXTRAN	
2022	ISUZU NRR PURCHASE FROM NEXTRAN	
2021	FORD TRANSIT VAN	

2021	2021 ISUZU NPR HD
PURCHASED FROM NEXTRAN	
2021	2021 FORD F150	CURRY FORD	JOHN	

2021	2021 FORD SUPER DUTY CURRY FORD MARK'S TRUCK	

2021	
2021 FORD F150	CURRY FORD	BILL	

2021	2021 ISUZU NPR HD PURCHASED FROM NEXTRAN	

2021	2021 ISUZU NPR HD PURCHASED FROM NEXTRAN	

2021	2021 ISUZU NPR HD MODEL NEXTRAM trans tag
from accident truck 489	

2021	2021 ISUZU NPR HD PURCHASED FROM NEXTRAN
TRANSFERRED PLATE FROM #537	

2021	2021 ISUZU NPR HD
PURCHASED FROM NEXTRAN	

2021	
2021 Ford 150 Coconut Point Ford	

2022	
ISUZU NRR PURCHASE FROM TRUCKMAX	

2022	
ISUZU NRR PURCHASE FROM TRUCKMAX	

2021	FORD RANGER Xl 2WD
PURCHASED FROM MATTHEW CURRY FORD	

2021	FORD TRUCK
PURCHASED FROM COCONUT FORD	

2013	HONDA PILOT PURCHASED FROM COCONUT
POINT	Pd cash	CHEYENNE	

arban	
MATTHEWS CURRIE FORD 2022 FORD 150	
	MATTHEWS CURRIE 2022 FORD 150
ARBANDO	

2022	ISUZU NPR HD
PURCHASED FROM NEXTRAN	

2022	ISUZU NPR HD
PURCHASED FROM NEXTRAN	

:>:\Vehicles 07-10-2017\Vehicles 07-10-17.xlsx	5	5/3/2022

STATUS OF CONTRACTS ON HAND
(Attach additional sheets if necessary)

Company Name Sunny Grove Landscaping & Nursery Inc	.Date 05/13/2022	 _

Furnish requested information about all of applicant's active contracts, whether as prime or subcontracts; whether in progress or awarded but not yet started; and regardless of with whom contracted. All amounts to be shown to nearest $1,000. Contractor may consolidate and list as a single item all contracts which individually do not exceed 3% of total active contracts and in total do not exceed 20% of the active total contracts.
	
Applicant's Uncompleted Amount as of this Date	

Completion Date	

Owner, Location and Description of Project	Current
Contract Amount as Prime	Current
Contract Amount as Subcontractor	
Current Amount Sublet
to Others	

As Prime Contractor	

As Subcontractor	
Original
Contract Date	
Approved
Revised Date	
Current
Estimate Date	

Babcock National	
$9.5 Mill	
$	
$	
$4.8 Mill	
$	
AUR 4, 2018		
2026	

Ave National	
$11 Mill	
$	
$	
$5 Mill	
$	
Julv 15, 2018		
2025	

Vista Blue	
$9 Mill	
$	
$	
$7 Mill	
$	
July 1 2019		
2024	

Heritafe National	
$7.2 Mill	
$	
$	
$2.6 Mill	
$	
Seot 19 2016		
2028	

Lake Club	
$6 Mill	
$	
$	
$3.2 Mill	
$	
Seot IO 2018		
2026	

Kalea Bay	
$11 Mill	
$	
$	
$7.6 Mill	
$	
Sept28 2019		
2026	

Orane.e Blossom	
$4 Mill	
$	
$	
$3.2 Mill	
$	
Nov 2019		
2023	

Valencia	
$3.8 Mill	
$	
$	
$3.6 Mill	
$	
Feb 2018		
2022	

Star Farms	
$5.6 Mill	
$	
$	
$2.4 Mill	
$	
Aug2021		
2024	

Heritage Landin2s	
$9.3 Mill	
$	
$	
$8. l Mill	
$	
March 2017		
2023	

Corkscrew Shores	
$5.6 Mill	
$	
$	
$5.6 Mill	
$	
Jan 20016		
2021	

Grey Hawk	
$9.6 Mill	
$	
$	
$8.3 Mill	
$	
Jan 2015		
2022	
	
$	
$	
$	
$	
$				

Subtotal Uncompleted Work	
$61,400	
$		
			
Total Uncompleted Work on Hand		
1$	I				

I

PROJECTS APPLICANT COMPANY COMPLETED IN THE LAST TWO YEARS

Company Name Sunny Grove Landscaping & Nursery Inc.	Date 05/13/2022	_

List all projects completed in the last two years for which the contract value individually exceeded 3% of the applicant's annual total work completed for the year the project tarted. Include in the list projects that were started earlier than two years but were completed within the 1,asr two 1ears.

Project Name/Location	
Final Contract Amount	
Prime or Sub1	
Classification of Work Performed	Year Started/ Completed	

Owner Name/Location2	Name & Phone Number of Owner's Representative on
this Project3	

The Crest of Naples	
$908,000		
Landscape - Irrigation - Sod	
April 2020	
Brooks & Freund		

Eastwood Apartments	
$625,000		
Landscape- Irrigation- Sod	
January 2020	
Brooks & Freund		

Sky Ranch 1 & 2	1.5 Mill		Landscape - Irrigation - Sod	November 2020	Taylor Morrison		

Dodge Dealership	
$555,000		Landscape - Irrigation -
Sod	2021			

Corkscrew Shores	
6.4 Mill		Landscape - Irrigation -
Sod	2021	Pulte Homes		

Bonita Shores	
2.8 Mill		Landscape - Irrigation -
Sod	2020	Lennar		

Multiple custom homes	
2.4 Mill		Landscape - Irrigation - Sod	2021	
London Bay Homes		

Island Walk Homes	
7.8 Mill		Landscape - Irrigation-
Sod	2020	
Pulte Homes		

Sarasota National	
3. Mill.		Landscape- Irrigation -
Sod	2022	
Lennar		

WindinJ!.Cypress	
9.1 Mill		Landscape - Irrigation -
Sod	2021	
Pulte		

Verona Walk Naples Esplanade	
7.3 Mill

8.1 Mill		Landscape - Irrigation- Sod

Landscape - Irrigation - Sod	
2020

2022	
Pulte Taylor Morrison		

'Prime or Sub' should indicate whether applicant performed the work as a prime contractor or as a subcontractor.
'Owner Name/Location' should indicate the Owner of the project if the applicant performed the work as a prime contractor or the general contractor if the applicant performed the work as a subcontractor.
'Name & Phone Number of Owner's Representative on this Project' should list a reference from the business entity listed in the previous column familiar with applicant's contract performance.
2

LIST OF ADDITIONAL DOCUMENTS FOR INCLUSION IN APPLICATION

Please include the following additional information with this application:

Applicants shall provide letters of recommendation from at least two agencies or firms with direct knowledge of the applicant's key personnel and work performance in sufficient detail to assist in rating the applicant's ability to perform the classification of work for which the applicant is applying for prequalification. The letters must contain specific information regarding the following:

Specific projects, including project numbers and location.
Size of projects by dollar value.
Description of projects and classes of work performed with applicant's own employees and equipment.
Whether projects were timely completed.
Whether the applicant was cooperative and facilitated changes to the project when required.

Applicants shall list the name of any subcontractor(s) that may be utilized to complete any work falling within the scope of the Contractor Classification Listing(s) for which the Applicant is submitting its Application for Qualification.

Centeno Sod

(Continued on Next Page)

15

May 9th, 2022
To Whom It May Concern:

The purpose of this letter is to recommend Sunny Grove Landscaping based on PulteGroup's extensive experience with their services.
Sunny Grove has been an outstanding vendor of PulteGroup for over 25 years, installing irrigation and landscaping for common areas and individual homes throughout all of PulteGroup's Southwest Florida communities. Sunny Grove has consistently been a high performer, always meeting our development and homebuilding timelines and providing their services at a fair cost while maintaining a high degree of professionalism. We are pleased to recommend Sunny Grove as they are a devoted and qualified company supplying top quality Irrigation and landscaping services in Southwest Florida.
If I can answer any questions about my experiences with Sunny Grove, please feel free to contact me.

Regards,

Mike Hueniken

Vice President of Land Planning & Development

Mike.Hueniken@PulteGroup.com

24311 Walden Center Drive, Suite 300 Bonita Springs. Florida 34134
239.495.4800  pultegroupinc.com

WELLEN  PARK

941.960.7805
WellenPark.corn

May 3, 2022

To Whom it may concern:

Re: Sunny Grove Landscaping

I am writing this letter of recommendation on behalf of Sunny Grove Landscaping, who has been one of our very valued vendors for over 6 years. They are accredited to the outstanding workmanship performed in Irrigation and Landscape services provided and it is my pleasure in recommending them as a company to do business with.

Besides doing business with Sunny Grove for many years, I have worked closely with Mark Williamson, the owner, as well as Penny Nicol, Project Manager. I hold them in the utmost respect as veteran landscapers in their field.

Specific projects I've worked with Sunny Grove have been, Sarasota National, Oasis and most recently Wellen Park. Wellen Park has had vast work extending to Lake Trail Improvements of $380,000's, Roadways of $522, 000's and Downtown exceeding $900,000's, with an overall work of $1.8 million.

Sunny Groves maintenance division keep our properties maintained at a high standard at all times. They take great pride in their work and completes assigned work within their scope of deadlines.
Sincerely, 13vadt So-ule,, Brad Soule
Director of Land Development
Wellen Park, LLLP
19503 South West Villages Parkway, Suite 14
Venice, FL 34393
941.999.4822, ext. 103
brad.soule@mattamycorp.com

AFFIDAVIT FOR PARTNERSHIP

State of		  County of		

ss:

is    a    member    of    the    firm    of
	 , being duly sworn, deposes and says that the statements and answers to the questions of the foregoing experience questionnaire are correct and true as of the date of this affidavit; and, that he/she understands that intentional inclusion of false, deceptive or fraudulent statements on this application constitutes fraud; and, that the District considers such action on the part of the applicant to constitute good cause for denial, suspension or revocation of a certificate of qualification for bidding on West Villages Improvement District projects.

Signature Print Name

Sworn to before me this 	day of 	.2022.

Notary Public/Expiration Date:

(SEAL)

4884-9891-9193.1	18

AFFIDAVIT FOR INDIVIDUAL

State of	Florida	_	ss:

County of	Lee	 _

Mark Williamson	being  duly  sworn,
deposes and says that the statements and answers to the questions concerning experience contained herein are correct and true as of this date; and that he/she understands that intentional inclusion of false, deceptive or fraudulent statements on this application constitutes fraud; and, that the District considers such action on the part of the applicant to constitute good cause for denial, suspension or revocation of a certificate of qualification for bidding on West Villages Improvement District projects.

Mark Williamson	
Print Name

.  ,  "'eta"' Assn.

...........Bonded through Nat1ona, " .  '

.., or f".,··

,'.J	'Ji'/ My Comm. Eltpim Jul 7, 2023

·	3 0808

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r  •

,·f.,.-m• ,:P1(l;\<_·ts1:;•-.. "' t "'Public. State of Florida

i • • A: i	Commission # GG 1 ·

PAMELA L. Ff.LABELLA .

.............,,,

(SEAL)

AFFIDAVIT FOR CORPORATION

State of	Florida	

County of	Lee 	

_	ss:

_

	Mark Williamson	
(title) President	 of the
Sunny Grove Landscaping & Nursery Inc.	 _
(a corporation described herein) being duly sworn, deposes and says that the statements and answers to the questions in the foregoing concerning experience are correct and true as of the date of this affidavit; and, that he/she understands that intentional inclusion of false, deceptive or fraudulent statements in this application constitutes fraud; and, that the District considers such action on the part of the applicant to constitute good cause for denial, suspension or revocation of a certificate of qualification for bidding on West Villages Improvement District projects.

Mark Williamson

Print Name

CORPORA TE SEAL

Sworn to before me this   //r- day of 		,2022.

Y ,Jt,,,,

-=-,a\ t

i:-f,,•/..

PAMELA L. FALABELLA
Notary Public State of Florida
Commission# GG 310808
My Comm. Expires Jul 7,
roush NationaI Notary

 ;;u;ryPublic/Expiration Date: (SEAL)

4884-9891-9193.I	19

The undersigned hereby authorize(s) and request(s) any person, firm or corporation to furnish any pertinent information requested by the West Villages Improvement District, or their authorized agents, deemed necessary to verify the statements made in this application or attachments hereto, or necessary to determine whether the West Villages Improvement District should prequalify the applicant for bidding on its construction or maintenance projects, including such matters as the applicant's ability, standing, integrity, quality of performance, efficiency and general reputation.

The undersigned acknowledges and consents to the use of the evaluation criteria set forth under the Section herein titled "Determination of Qualified Prospective Bidder.

The undersigned acknowledges that the West Villages Improvement District can terminate its use of the prequalification list for bidding purposes at any time.

Sunny Grove Landscaping & Nursery Inc
Name of Applicant Company

	Mark Williamson President	
[Type Name and Title of Person Signing]

This  /)--  day of 	   ,2022

(Corporate Seal)

Sworn to before me this 	

+-Ji>.£_d:::	 day of		, 2022.
1

otary Public/Expiration Date (Seal)

Applicant acknowledges receipt of the following addenda:

Addendum No. 		 _ Addendum No. 	 _

Date 	 _ Date 	 _

16

SWORN STATEMENT UNDER SECTION 287.133(3)(a), FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES

THIS FORM MUST BE SIGNED IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICER AUTHORIZED TO ADMINISTER OATHS.

1.	This sworn statement is submitted to West Villages Improvement District for Prequalification of Construction and/or Maintenance Contractors.
Sunny Grove Landscaping & Nursery Inc.
This sworn statement is submitted by 	 _
[Print Name of Entity Submitting Sworn Statement]
whose business address is -----'1=5'-"1=1=1-"S=· M=al""la""r;,,,;:d'"'L=an::.:ce=--=-F-=-t ""M-=-y,._,e:..:.r=-s=F-"'lo::..:rc:.id=a=3"'-39""'1,,.,3"------		_

and (if applicable) its Federal Employer Identification Number (FEIN) is 59 1769969	 _

(If the entity has no FEIN, include the Social Security Number of the individual signing this

sworn statement: Mark Williamson	 _
	 .)

My name is -- M=a=r k W il=li=a=m=s o=n	and my relationship to the
entity named above i-sS u_n_n y_G r o_v e_L a n d s c.a.....p..,_i=n_g & N u=r=s ery l=n c . 	 _

Iunderstand that a "public entity crime" as defined in Section 287.133(l)(g), Florida Statutes, means a violation of any state or federal law by a person with respect to and directly related to the transaction of business with any public entity or with an agency or political subdivision of any other state or with the United States, including, but not limited to, any bid or contract for goods or services to be provided to any public entity or an agency or political subdivision of any other state or of the United States and involving antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material misrepresentation.

I understand that "convicted" or "conviction" as defined in Section 287.133(1)(b), Florida Statutes, means a finding of guilt or a conviction of a public entity crime, with or without an adjudication of guilt, in any federal or state trial court of record relating to charges brought by indictment or information after July 1, 1989, as a result of jury verdict, nonjury trial, or entry of a plea of guilty or nolo contendere.

I understand that an "affiliate" as defined in Section 287.133(1)(a), Florida Statutes, means:

A predecessor or successor of a person convicted of a public entity crime; or,

An entity under the control of any natural person who is active in the management of the entity and who has been convicted of a public entity crime. The term "affiliate" includes those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in the management of an affiliate. The ownership by one person of shares constituting a controlling interest in another person, or a pooling of equipment or income among persons when not for fair market value under an arm's length agreement, shall be a prima facie case that one person controls another person. A person who knowingly enters into a joint venture with a person who has been convicted of a public entity crime in Florida during the preceding 36 months shall be considered an affiliate.

I understand that a "person" as defined in Section 287.133(l)(e), Florida Statutes, means any natural person or entity organized under the laws of any state or of the United States with the legal power to enter into a binding contract and which bids or applies to bid on contracts for the provision of goods or services let by a

4884-9891-9193.1	20

public entity, or which otherwise transacts or applies to transact business with a public entity. The term "person" includes those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in management of an entity.

Based on information and belief, the statement which I have marked below is true in relation to the entity submitting this sworn statement. (Please indicate which statement applies.)

True  Neither the entity submitting this sworn statement, nor any officers, directors, executives, partners, shareholders, employees, members, or agents who are active in management of the entity, nor any affiliate of the entity, have been charged with and convicted of a public entity crime subsequent to July 1, 1989.

NIA  The entity submitting this sworn statement, or one or more of the officers, directors, executives, partners, shareholders, employees, members or agents who are active in management of the entity or an affiliate of the entity, has been charged with and convicted of a public entity crime subsequent to July 1, 1989, AND (please indicate which additional statement applies):

NIA   There has been a proceeding concerning the conviction before an Administrative Law Judge of the State of Florida, Division of Administrative Hearings. The final order entered by the Administrative Law Judge did not place the person or affiliate on the convicted vendor list. (Please attach a copy of the final order.)

    r==

NIA  The person or affiliate was placed on the convicted vendor list. There has been a subsequent proceeding before an Administrative Law Judge of the State of Florida, Division of Administrative Hearings. The final order entered by the Administrative Law Judge determined that it was in the public interest to remove the person or affiliate from the convicted vendor list. (Please attach a copy of the final order.)

NIA	The person or affiliate has not been placed on the convicted vendor list. (Please describe any
action taken by o, pend;ng wUh the F!o,Ida Department; em t

Signature
Mark Williamson	_
Print Name
Date: --- 0 51 1=3/=2 02=2 -------

STATE OF _ F l=o ri-d-a	 _
COUNTY OF -=L=ee ----
PERSONALLY APPEARED BEFORE ME, the undersigned authority, 	 _
{tl./J.lt: /A};  {{ ({JuJSI) I\ 	who, after first being sworn by me, affixed his/her signature in the (name of individual signing)

( ..;J/iiii ·•.	PAMELAL. FALABELLA .

f ·=, 5:\ Notary Public. State of Flo.nda

\

-.., 1o,f\-.if..-· My Comm. Expires Jul 7, 2023
.........B. onded through National Notary Assn.

!	Commission ii GG 310808

My commission expires:

CONTRACTOR CLASSIFICATION LISTING

Construction

Excavation/Earthwork

Roadways, including Paving, Repair and Resurfacing

Storrnwater Management Facilities

Water and Sewer Facilities

Irrigation Facilities

Landscape Installation

Hardscape Facilities

Streetlighting

Maintenance

Exotic Vegetation Removal

Canal/Drainage Maintenance

Landscape and Irrigation Maintenance

Lake and Littoral Maintenance

Streetlighting

4884-9891-9193.1	22

DETERMINATION OF QUALIFIED PROSPECTIVE BIDDER

The West Villages Improvement District ("District") is authorized to maintain a list of qualified contractors ("Qualified Prospective Contractors") to submit bids for the procurement of District construction and maintenance projects. Any Qualified Prospective Contractor desiring to submit a bid to provide work for the District must submit a properly completed Contractor's Prequalification Statement to the District Engineer for review and evaluation.

The District shall evaluate the Contractor's Prequalification Statement and based on the District's judgment of the information provided, shall issue in writing to the contractor, the District's rating as to the classification(s) of the Work and the maximum Bid dollar amount for which the Qualified Prospective Contractor can submit a Bid to the District.

A Qualified Prospective Contractor shall mean a prospective contractor which in the sole judgment of the District has the capability, in all respects, to perform fully the contract requirements, and the business integrity and reliability which will assure good faith performance. In determining the Qualified Prospective Contractor's qualifications, the following criteria will be considered:

The ability, capacity, and skill of the contractor to perform the contract or provide the work required;

Whether the contractor can perform the contract or provide the work promptly, or within the time specified, without delay or interference;

The character, integrity, reputation, judgment, experience, and efficiency of the contractor;

The quality of performance of previous contract or work. For example, the following information will be considered:

The cost overrun incurred by owners on previous contracts with contractor;

The contractor's compliance record with contract general conditions on other projects;

The contractor's record for completion of the work within the Contract Time or within Contract Milestones and contractor's compliance with scheduling and coordination requirements on other projects;

The quality, availability, and adaptability of the goods or work to the particular use required;

The contractor's demonstrated cooperation with owners, architects, engineers, and others on previous contracts; and;

Whether the work performed and materials furnished on other contracts were m accordance with the contract documents; and

Whether contractor has performed previous work for an independent special district.

The previous and existing compliance by the Prospective Bidder with laws and ordinances relating to contracts or work;

4884-9891-9193.1	23

The sufficiency of the financial resources and ability of the contractor to perform the contract or provide the work;

The ability of the contractor to fulfill its guarantee and warranty period;

Such other information as may be secured by the Board having a bearing on the decision to award a contract to include, but not be limited to:

The ability, experience, and commitment of the contractor to properly and reasonably plan, schedule, coordinate, and execute the work; and,

Whether the contractor has ever been debarred from bidding or found ineligible for bidding on any other projects.

The District will make such inquiries and investigations as deemed necessary to verify and evaluate the applicant's statements regarding:

The necessary organization and management including experience possessed by the applicant's employees;

Adequate equipment, as shown on the equipment list, to perform normal operations for each class of work in the industry such as that called for in the contract documents in force at the time of application;

For construction services, any contractor pre-qualified and considered eligible by the Department of Transportation to bid to perform the type of work the project entails shall be presumed to be qualified.

If herein required, or if requested by the District at any time after the conclusion of the initial pre­ qualification process, the Qualified Prospective Contractor shall submit a certified financial statement(s) in a form acceptable to the District, prepared no later than the past 180 days, indicating current financial resources, current bonding capacity, liabilities, capital equipment, in its sole discretion, may adjust the Qualified Prospective Contractor's Prequalification contract limits

Furthermore, a Qualified Prospective Contractor acknowledges the right of the District to determine a Qualified Prospective Contractor to be not qualified to submit a Bid in response to the District's Advertisement for Bids at the sole determination of the District for, but not necessarily limited to, any of the following specific reasons:

Failure to submit a properly completed Contractor's Prequalification Statement in accordance with the above requirements;

Failure of the Qualified Prospective Contractor's rating by the District as to classification of the Work and the maximum Bid dollar amount to meet the requirements of the Bid;

4884-9891-9193.1	24

Reason to believe that collusion exists among Bidders;

Determination of lack of competency as may be revealed by qualification statements, financial statements, experience records, or other sources;

The Qualified Prospective Contractor's uncompleted work load which, in the judgment of the Board, may cause detrimental impact on timely completion of the project being bid; or

The Qualified Prospective Contractor's Surety is unacceptable to District.

Submission of excessive or unreasonable suggested modifications to the District's Standard Form of Construction or Maintenance Contract.

Any contractor submitting a Contractor's Prequalification Statement, which in its judgment is adversely affected by the District's rating as to the contractor's qualifications and wishes to protest such decision must file with the District a notice of protest in writing within seventy-two (72) hours (excluding Saturdays, Sundays and state holidays) after receipt of the notice of the District's ranking, and shall file a formal written protest within seven (7) days (including Saturdays, Sundays and state holidays) after the date of filing of the notice of protest. The formal written protest shall state with particularity facts and law upon which the protest is based. Failure to timely file a notice of protest or failure to timely file a formal written protest shall constitute a waiver of all further proceedings under Florida law and the District's Rules of Procedure. You may obtain a copy of the District's Rules of Procedure by contacting the District Manager's Office at 2501A Bums Road, Palm Beach Gardens, FL 33410.

4884-9891-9193.1	25