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Item J3BOARD OF GOVERNORS FIRE AND AMBULANCE DISTRICT 1 AGENDA ITEM SUMMARY Meeting Date: November 17, 2010 Division:Emergency Services Bulk Item: Yes _ No X Department: Fire Rescue Staff Contact Person: Camille Dubroff X 6010 AGENDA ITEM WORDING: Approval to award bid and enter into an Agreement between the Monroe County Board of County Commissioners, Board of Governors Fire and Ambulance District 1 of Monroe County, Florida, and Bound Tree Medical LLC to furnish medical supplies and pharmaceuticals at set bid pricing. ITEM BACKGROUND: On September 30, 2010 sealed bids were opened to furnish medical supplies and pharmaceuticals at set pricing to Monroe County Fire Rescue for use at the Fire Stations and on the ground and air ambulances. There were nine bidders. From the nine bidders, only 3 respondents (Bound Tree Medical LLC, Henry Schein Inc and Midwest Medical Supply Co, LLC) submitted bids with the majority of the items from the price list. The other 6 bidders did not submit pricing for 54 or more of the price list items which eliminated them from the bid process. Out of the 3 top bidders, Bound Tree Medical LLC had the most competitive pricing on the most frequently purchased medical supplies. We are requesting that the Board accept the Bound Tree Medical LLC bid and enter into a contract commencing on December 1, 2010 and ending November 30, 2013. The contract pricing on medical supplies and pharmaceuticals is provided in Attachment H of the contract. PREVIOUS RELEVANT BOARD ACTION: On August 18, 2010 the Board (BOCC) approved the advertisement of sealed bids to furnish medical supplies and pharmaceuticals at set bid pricing. CONTRACT/AGREEMENT CHANGES: This contract is to furnish Monroe County Fire Rescue with medical supplies and pharmaceuticals at set bid pricing. Pricing list is on Attachment H of the contract. STAFF RECOMMENDATIONS: Staff recommends approval as written. TOTAL COST: 100,000.00*per yea INDIRECT COST: BUDGETED: Yes X No, *Fund 141, Fire and Ambulance Dist 1: 70% or $70,000; and Fund 101, Fine & Forfeiture: 30% or $30,000. DIFFERENTIAL OF LOCAL PREFERENCE: NIA COST TO COUNTY; $100,000.00 per year SOURCE OF FUNDS: Ad Valorem 13001-530512/520 Fine & Forteiture 1 1001-530512/520 REVENUE PRODUCING: Yes No X AMOUNT PER MONTH Year APPROVED BY: County Atty O�' +M16chasing ✓ Risk Management DOCUMENTATION: Included X Not Required DISPOSITION: AGENDA ITEM # Revised 07/09 MONROE COUNTY BOARD OF GOVERNORS FIRE AND AMBULANCE DISTRICT I CONTRACT SUMMARY Contract with: Bound Tree Medical, Contract # LLC Effective Date: Expiration Date: 12/01/2010 11/30/2013 Contract Purpose/Description: Contract Ageement to furnish medical supplies and pharmaceuticals for Monroe, County Fire Rescue at set bid pricing., Contract Manager: Camille Dubroff (Name) for BOG meeting on 11/17/2010 6010 Emergency Services / Stop 14 (Ext.) (Department/Stop #) genda Deadline: 11/5/2010 CONTRACT COSTS Total Dollar Value of Contract: $1_00,000.00* per year Current Year Portion: 100 000.00 *Fund 141, Fire and Ambulance Dist 1: 70% or $70,000; and Fund 101, Fine & Forfeiture: 30% or $30,000 Account Codes: Budgeted? Yes® No ❑ Fire and Ambulance Dist 1: 13001-530-512/520 Fine & Forfeiture: 11001-530-512/520 j County Match: $ ADDITIONAL COSTS Estimated Ongoing Costs: $ /yr For: (Not included in dollar value above) (e . maintenance, t CONTRACT REVIEW Changes Date In Needed Division Director !-.2 /D Yes❑ No Risk Managem nt ! �' Yes❑ No O.//./Purchasing lo1a�1 l0 Yes❑ No County Attorney fO�S [� Yes[:] No I Comments: anitorial d X.N�P ro Date Out UM13 norm Revised 2/27/01 MCP #t2 m z .- 0 (D 'a Q � G a u O LL U U C" z^ �} .v E O1 Wo 0 H O DC CO z o z W .. 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LLi ❑ W} O m 0 O p j z 2 � aim � Q _ � �� 72 d } 4- a of C � OC o x 0 m LL 0 m Lz Q W ��--- s� } w ~ d 0 V r m > 4- W -j Ul 0 G. o s Z p Z M W a _0 w -2 a L)LU a L oLL=N W 00 a U(DZM V z a za zF- W v) aE Ice o— IJ) COM CL U aa�cn © � r Z cn c O L nt W C'J < r } G a G W ¢ U L J a 0 - m Z d , L SL W W d a Q H L o > V1 0 Vi - W rs z V °- 1-4 C o 4 4- 1) cn w v G o °' V 'i3 o`ni N _u J CL LE N U Ln W � o a OL LU `} F +- T- o °o Q Q U U- 0� O L N -0 0 LU 4 C OO H V) ao CONTRACT BETWEEN THE BOARD OF COUNTY COMMISSIONERS AND THE BOARD GOVERNORS FIRE AND AMBULANCE DISTRICT 1 OF MONROE COUNTY, FLORIDA AND BOUND TREE MEDICAL, LLC FOR THE PURCHASE OF MEDICAL SUPPLIES AND PHARMACEUTICALS THIS CONTRACT, hereinafter "CONTRACT" or "AGREEMENT", is made and entered into this day of , 2010 by and between the Monroe County Board of County Commissioners and Board of Governors Fire and Ambulance District 1 of Monroe County, Florida, hereinafter referred to as "COUNTY", and Bound Tree Medical, LLC, hereinafter referred to as "CONTRACTOR". WITNESSETH: WHEREAS, the COUNTY advertised a notice of request for bids for medical supplies and pharmaceuticals. WHEREAS, the successful Bidder was Bound Tree Medical, LLC, and; WHEREAS, this CONTRACTOR represents that it is capable and prepared to provide such services, and; WHEREAS, the COUNTY intends to enter into an agreement to furnish medical supplies and pharmaceuticals at set pricing and; WHEREAS, this contract is an "Agreement" between both parties, NOW, THEREFORE, in consideration of the promises contained herein, the parties agree as follows: 1. CONTRACT DOCUMENTS — This contract consists of the Agreement, the CONTRACTOR'S response to the Request for Bid (RFB), the documents referred to in the Agreement as a part of this Agreement. In the event of any conflict between any of the contract documents, the one imposing the greater burden on the CONTRACTOR will control, 2. CONTRACT PERIOD AND RENEWAL - The effective date of this Agreement shall be December 1, 2010 through November 30, 2013. 3. CONTRACT TERMINATION - This Agreement may be terminated for any reason by either party on 30-day written notice without cause. If the CONTRACTOR fails to fulfill the terms of this Agreement, or attachments, properly or on time, or otherwise violates the provisions of the agreement or of applicable laws or regulations governing the use of funds, the County may terminate the contract immediately by written notice. The notice shall specify cause. All finished or unfinished supplies or services shall, at the option of the County, become property of the County. The County shall pay the CONTRACTOR fair and equitable compensation for expenses incurred prior to termination of the agreement, less any amount or damages caused by the CONTRACTOR'S breach. If the damages are more than compensation payable, the CONTRACTOR will remain liable after termination and the County shall pursue collection for damages. 4. SUBJECT MATTER OF CONTRACT - This Agreement is to fiu-nish medical supplies and pharmaceuticals at set pricing to Monroe County Fire Rescue. S. PRICING — is set forth in Attachnnent H. This will be inserted in the contract from the Bid Response. G. QUALITY INSURANCE PROVISIONS A. Quality and Quality Control. A system of test inspections shall be used to insure receipt of the duality and quantity of nnaterial(s)/service(s) purchased. Material(s)/Service(s) will be promptly inspected any discrepancies from the purchase order and/or the supplier's invoice shall be reported immediately from the Monroe County Logistics Specialist. B. Material Safety Data Sheet (MSDS). Any items delivered must be accompanied by a MSDS. The MSDS must be maintained by the user agency and must include the following information: 1) The Chemical name and the common name of the toxic substance. 2) The hazards or other risks in the use of the toxic substance, including; a) The potential for fire, explosion, corrosively and reactivity; b) The known acute and chronic health effects of risk from exposure, including the medical conditions which are generally recognized as being aggravated by exposure to the toxic substance; and c) The primary routes of entry and symptoms of overexposure. 3) The proper precautions, handling practices, necessary personnel protective equipment, and other safety precautions in the use of, or exposure to, the toxic substances, including appropriate emergency treatment in the case of overexposure. 2 4) The emergency procedure for spills, fires, disposal and first aid. 5) A description, in lay terms, of the known specific potential health risks posed by the toxic substance intended to alert any person reading this information. 6) The year and month, if available, that the information was compiled and the name, address, and emergency telephone number of the manufacturer responsible for preparing the information. C. CONTRACTOR must be able to supply contracted requested supplies within a three (3) business day time frame of normal request of supplies when the County has made that request within normal working hours of 8 am to 5 pm Monday through Friday. During emergency (natural or man- made emergencies) situations CONTRACTOR must be able to supply requested supplies on a next day basis, twenty-four (24) hours a day seven (7) days a week. 7. CONTRACTOR'S LIABILITY A. Warranty. It shall be the CONTRACTOR'S responsibility to submit at the time of shipment the original manufacturer's warranty for the materials supplied. CONTRACTORS shall follow procedure(s) to accomplish supplying a replacement product, if warranted. Replacements shall be finalized within five working days of reporting the defect. B. Guarantee. The material(s) supplied shall be guaranteed to be free from defect of composition, conception and workmanship for a minimum period of 120 days from the date of acceptance by the County. Any parts or portions found not in accordance with this specification will be rejected by the County and returned to the CONTRACTOR at the CONTRACTORS expense for immediate replacement. 8. SPECIFICATIONS: A. Substitutions. Items supplied shall be as ordered and specified. When substitutions are recommended or necessary, the determination as to whether any proposed substitution is or is not equal to the product specified as a standard shall be made by the COUNTY, and such determination shall be final and binding. B. Quality. The materials to be furnished shall be currently in production and shall be of the manufacturer's standard or better quality. C. Quantities. The quantities listed on the Medical Supplies and Equipment Worksheet is estimated quantities for one year. The COUNTY shall not be required to purchase any minimum or maximum quantities during the term of any award resulting from this specification. The COUNTY may purchase as Tittle as zero percent (0%) or exceed as much as one hundred percent (100%) of the forecasted or estimated quantities. D. Packaging. Only materials that are packaged in the original factory fresh packaging shall be accepted. No materials that have been re packaged or that are in the adulterated or damaged packages shall be accepted at the receiving location, nor shall after market materials be accepted at the receiving location. Any attempts by the CONTRACTOR to furnish the COUNTY with other than first duality materials shall constitute default as outlined in this specification. E. Expiration Dates. All merchandise shall have a minimum expiration date of 18 months from date of shipment, and date must be displayed on the package. 9. CONDITIONS: A. Authorization. All orders shall be placed via Monroe County by individual Purchase Orders, or as "Open" Purchase orders. B. Furnishing items. Contract items are to be furnished on an "as needed, when needed basis" during the life of the contract. C. Delivery. Materials ordered shall be delivered within three (3) business days after receipt of order. Failure to do same shall be considered breach of contract or default, and the COUNTY shall utilize its options as stated within the bid specification. D. Backorders. Any backordered materials shall be made available to the COUNTY within 15 working days of the time of backorder (original date of receipt). If the backorder cannot be filled within the time frame of this section, then the COUNTY is to be notified, in writing, thus permitting the COUNTY to obtain the required materials anal/or exercise its options. E. Penalties. The COUNTY reserves the right to increase or decrease quantities shown without penalty. F. Addition/Deletion. The COUNTY reserves the right to add or delete any item fiom this bid or resulting contract when deemed to be in the interest of the COUNTY. G. Samples. When required, samples shall be labeled with the CONTRACTORS' name and item number and shall be furnished free of charge. Samples not destroyed will be returned upon request at the CONTRACTOR'S expense. H. Substitution. The CONTRACTOR shall not substitute items for like items without the approval of the COUNTY. Any violation of such procedure may result in a possible cancellation of the contract. All approved substitutes shall be annotated as such on the CONTRACTOR'S shipping document(s). 1. Contract Prices. Contract prices shall be firm and shall not be amended after the contract is executed. Any attempt by the CONTRACTOR to amend said prices shall constitute default as outlined in the contract. Prices quoted include all shipping costs, shipped F.O.B Marathon, Florida or to the facility location specified by the requestor or the purchase order. All taxes of any kind and character payable on account of the word done and materials .furnished under the award shall be paid by the CONTRACTOR and shall be deemed to have been included in the price. The County is exempt from all state and federal sales, use, transportation and excise taxes. Contract prices shall include all royalties and costs arising from patents, trademarks, and copyrights in any way involved in the work. Whenever the CONTRACTOR is required or desires to use any design, device, material or process covered by letters of patent or copyright, the CONTRACTOR shall indemnify and save harmless the COUNTY, its officers, agents, and employees from any and all claims of infringement by reason of the use of any such patented design, toll, material, equipment or process, to be performed under the contract, and shall indemnify the said COUNTY, its officers, agents and employees for any costs, expenses and damage which may be incurred by reason of any infringement at any time during the prosecution or after the completion of the work. J. Contract Changes. No changes, over the contract period, shall be permitted unless prior written approval is given by the Monroe County' Board of Commissioners and the Board. of Governors of Fire and Ambulance District 1. No CONTRACTOR shall assign the contract or any rights or obligations there under to a subcontractor without the written consent of the COUNTY and approval of the Monroe County Board of Commissioners. K. Price Escalation. The COUNTY will allow a price escalation provision with this contract. The original contract prices shall be firm for a one-year minimum period. A price escalation/de-escalation will be allowed one year after the beginning of the contract period and at one year intervals thereafter, provided the CONTRACTOR notifies the COUNTY, in writing, of the pending price escalation/de-escalation a minimum of 60 days period the effective date of the price change. The price escalation/percentage change shall not exceed the previous one -year's percentage change of the Consumer Price Index for All Urban Consumers (CPI-U) published by the U.S. Department of Labor's Bureau of Labor Statistics. If, at the point of exercising the price escalation provision, market media indicators show that the prices have decreased, and that the CONTRACTOR has not passed the decrease on to the COUNTY, the COUNTY reserves the right to place the CONTRACTOR in default, cancel the contract, and remove the CONTRACTOR from the Counties bidder list for a period of time deemed suitable to the COUNTY. L. Invoicing. The CONTRACTOR shall furnish the COUNTY complete itemized invoices for the goods received. Invoices are to reflect the prices stipulated on the purchase order and as outlined in this bid/bid document on the bid response/pricing sheets. The COUNTY will not accept an aggregate invoice. As part of the award process, the COUNTY may request a sample invoice. Invoices shall contain, but not limited to the following information: a Invoice number a Company name o Purchase order number o Location and dates of delivery o Cost of items as stated on the contract and extended price to reflect total cost for number of items received. M. Payment. Full payment will be made by the COUNTY after receipt and acceptance of materials/services and proper invoices in accordance with the Florida Local Governrnent.Prompt Payment Act. Normal processing time is approximately 30 days in total. The COUNTY does not pay service charges on late payments; however the COUNTY is subject to the Florida's Local Government Prompt Payment Act. N. Ordering. CONTRACTOR will provide web -based online ordering website designed specifically for service. 0. Disaster Recovery. CONTRACTOR must have a proven Disaster Support Program in place and shall provide the COUNTY with emergency numbers for these situations. These numbers will be updated inunediately if the contact number changes. 10. INDEMNIFICATION - CONTRACTOR shall indemnify and hold the COUNTY and Monroe County and Monroe County Fire and Ambulance District I harmless for any negligence on its part or faulty or improper workmanship, for all work performed under this contract, including all costs of collection, reasonable attorney fees, claim costs, and as per "Attachment B". All property or equipment being directly maintained or repaired by CONTRACTOR shall be considered in its care, custody, and control while such work is in progress and until physical control of such property or equipment is restored to the COUNTY. 11. INSURANCE — No insurance is required for this contract. 12. ADDITIONAL REQUIRED STATEMENTSNERIFICATIONS/AFFIDAVITS. Attached hereto in Attachments B, C, D, E, F and G are Non -Collusion Affidavit, Public Entity Crime Statement, Drug -Free Workplace Form, Conflict of Interest Clause, Indemnification to Hold Harmless, and the Local Preference Form (if applicable). 13_ Monroe County`s performance and obligation to pay under this contract is contingent upon an annual appropriation by the Board of County Commissioners of Monroe County, Florida. 14. Venue for any litigation arising under this contract must be in a court of competent jurisdiction in Monroe County, Florida. This Agreement is not subject to arbitration. IN WITNESS WHEREOF, each party hereto has caused this contract to be executed by its duly authorized representative. Attest: DANNY L. KOLHAGE, CLERK By: Deputy Clerk Attest: DANNY L. KOLFIAGE, CLERK Deputy Clerk WITNESS: By: Print Name and Title MONROE COUNTY BOARD OF COUNTY COMMISSIONERS in Mayor/Chairman BOARD OF GOVERNORS, MONROE COUNTY FIRE AND AMBULANCE DISTRICT 1 Mayor/Chairman NAME And ADDRESS OF CONTRACTOR Print Name: Bound Tree Medical, LLC1Heather Vincent Address: 5000 Tuttle Crossing Blvd Dublin, OH 43017 8 Date: 10/19/10 Title: Bid & Contract Representative MO OE COUNTY ATTORNEY A ROIAED Al T#p Fff M: ICYNTHIA L.-HALL ASSISTANT COUNTY ATTQRNEY Date U FORMS Attachment A Attachment $ Attachment C Attachment D Attachment 1 Attachment F Attachment G Attachment I-1 Submission Response Form and Supply List with. Pricing Non -Collusion Affidavit Public Entity Crime Statement Drug Free Workplace Form Lobbying & Conflict of Interest Clause- (Ethics Clause) Indemnification and Hold Harmless Local Preference Form Pricing List SUBMISSION I3IJ) RESPONSE FORM Set Pileing for Medical Supplies anti Plrarnlrtcetrticals Bidders Name and Mailing Address: Bound Tree Medical LLC Telephone and Fax Numbers: All amounts must be written clearly. 5000 Tuttle_ Crossing Blvd Dublin, OH 4.3017 1-80D-533-0523,fax 1-800-257-5713 *See Attached Pricel,istin AftachmentH** I have included: o Bid/Tabbed Sections o Submission Response Form_ o Non Collusion Affidavit o Public Entity Crime Statement _ o Lobbying and Conflict of Interest Clause Form _ 0 drug Free Workplace Form o Indemnification and Hold Harmless o Local Preference Form ~_ o Medical Supply and Pharmaceutical Price List (Checkmai* items above, as a renihid1er IIIa1hey am hichided)- I state that i alsi subunit t1lis bjej, � STATE OF' Ohio (Signature of Bidder) COUNTY OF Franklin 09/28110 Date PERSONALLY APPEARED 13EFOREML, the undersigned arttltority, }cct _ fit; fR who, after first being sworn by tne, (aame of individt€al signing) affixed histher signature in the space provided above on this 28 day of September 2010 My commission expires: NOTARY PUBLIC ,,y��rrrrrrr��` w A NON- COLLUSION AFFIDAVIT I, Heather Vincent , of the city of Dublin according to law on nay oath, and under penalty of perjury, depose and say that; 1) I am Bid & Contract Representative , the Bidder making the Bid for the project described as follows: Medical Supplies and Pharmaceuticals 2) The prices in this bid have been arrived at independently without collusion, consultation, communication or agreement for the purpose of restricting competition, as to any matter relating to such prices with any other Bidder or with any competitor; 3) Unless otherwise required by law, the prices which have been quoted in this bid have not been knowingly disclosed by the Bidder and will not knowingly be disclosed by the Bidder prior to bid opening, directly or indirectly, to any other Bidder or to any competitor; and 4) No attempt has been made or will be made by the Bidder to induce any other person., partnership or corporation to submit, or not to submit, a bid for the purpose of restricting competition; and 5) The statements contained in this affidavit are true and correct, and made with full knowledge that Monroe County relies upon the truth of the statements contained in this affidavit in awarding contracts for said project. STATE OF Ohio COUNTY OF Franklin C (Signature of Bidder) 10/19/10 Date PERSONALLY APPEARED BEFORE ME, the undersigned authority, Heather Vincent who, after first being sworn by me, (name of individual signing) affixed his/her signature in the space provided above on this 19th day of October 2010 `,`�titi�ti�rrrrii r • - IV0 ,� � e�V�T 4Q� � My comr ission expires: ... " NOTARY PUBLIC i" OMB - MCP FORDS 41 �'lx �y4r,p S+TEXa A11'r Attachment B ' ArE OF O � W PUBLIC ENTITY CRIME STATEMENT "A person or affiliate who has been placed on the convicted vendor list following a conviction for public entity crime may not submit a bid on a contract to provide any goods or services to a public entity, may not submit a bid on a contract with a public entity for the construction or repair of a public building or public work, may not submit bids on leases of real property to public entity, may not be awarded or perform work as a bidder, supplier, subbidder, or BIDDER under a contract with any public entity, and may not transact business with any public entity in excess of the threshold amount provided in Section 287.017, Florida Statutes, for CATEGORY TWO for a period of 36 months from the date of being placed on the convicted vendor list." By executing this form, I acknowledge that I/my company is in compliance with the above. STATE OFOhio R,4,aao�- (Signature of Bidder) COUNTY OF Franklin 10/19/10 Date PERSONALLY APPEARED BEFORE ME, the undersigned authority, Heather Vincent who, after first being sworn by me, (name of individual signing) affixed his/her signature in the space provided above on this 19th day of October _ , 2010 + �5 llAr—� . My commission expires: pj,� 1 ay apt Cj NOTARY PUBLIC ' Attachment C 12 DRUG -FREE WORKPLACE FORM The undersigned Bidder in accordance with Florida Statute 287.087 hereby certifies that: Bound Tree Medical, l.l_C (Name of Business) 1. Publishes a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the workplace and specifying the actions that will be taken against employees for violations of such prohibition. 2. Informs employees about the dangers of drug abuse in the workplace, the business's policy of maintaining a drug -free workplace, any available drug counseling, rehabilitation, and employee assistance programs, and the penalties that may be imposed upon employees for drug abuse violations. 3. Gives each employee engaged in providing the commodities or contractual services that are under bid a copy of the statement specified in subsection (1). 4. In the statement specified in subsection (1), notifies the employees that, as a condition of wonting on the commodities or contractual services that are under bid, the employee will abide by the terms of the statement and will notify the employer of any conviction of, or plea of guilty or polo contendre to, any violation of Chapter 893 (Florida Statutes) or of any controlled substance law of the United States or any state, for a violation occurring in the workplace no later than five (5) days after such conviction. 5. Imposes a sanction on, or require the satisfactory participation in a drug abuse assistance or rehabilitation program if such is available in the employee's community, or any employee who is so convicted. 5. Makes a good Faith effort to continue to. maintain a drug -free workplace through implementation of this section. As the person authorized to sign the statement, I certify that this firm complies fiilly with the above requizeznments. / bidders �;xgnature 10/19/10 Date OMB -MCP FORM #5 Attachment D 13 LOBBYING AND CONFLICT OF INTEREST CLAUSE SWORN STATEMENT UNDER ORDINANCE NO.10-1990 MONROE COUNTY, FLORIDA ETHICS CLAUSE Bound Tree Medical, LLC/&A2& �; (Un+ warrants that heht has not employed, retained or otherwise had act on his/its behalf any former County officer or employee in violation of Section 2 of Ordinance No. 10-1990 or any County officer or employee in violation of Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County may, in its discretion, terminate this contract without liability and may also, in its discretion, deduct from the contract or purchase price, or otherwise recover, the full amount of any fee, commission, percentage, gift, or consideration paid to the fo r County officer or emplo ee. U (Signature) Date:10/19/10 STATE OF Ohio COUNTY OF Franklin PERSONALLY APPEARED BEFORE ME, the undersigned authority, Heather Vincent who, after first being sworn by me, affixed his/her signature (name of individual signing) in the space provided above on this 19th day of October , 2010 r NOTARY PUBLIC My commission expires: 1 �)Ll 7 aOfS OMB - MCP FORM 44 Attachment E 14 %00T - NOP MONROE COUNTY, FLORIDA RISK MANAGEMENT POLICY AND PROCEDURES CONTRACT ADMINISTRATION MANUAL Indemnification and Hold Harmless for Other Bidders and Subbidders The Bidder covenants and agrees to indemnify and hold harmless Monroe County Board of County Commissioners AND Board of Governors for District I, its servants, agents and employees from any and all claims for bodily injury (including death), personal injury, and property damage (including property owned by Monroe County) and any other losses, damages, and expenses (including attorney's fees) which arise out of, in connection with, or by reason of services provided by the Bidder or any of its Subbidder(s) in any tier, occasioned by the negligence, errors, or other wrongful act or omission of The Bidder or its Subbidders in any tier, their employees, or agents. In the event the completion of the project (to include the work of others) is delayed or suspended as a result of the Bidder's failure to purchase or maintain the required insurance, the Bidder shall indenmi.fy the County from any and all increased expenses resulting from such delay. The first ten dollars ($10.00) of remuneration paid to the Contractor is for the indemnification provided for above. The extent of liability is in no way limited to, reduced, or lessened by the insurance requirements contained elsewhere within this agreement. Contractor's Signature 10/19/10 Date TCS Attachment F 15 LOCAL PREFERENCE FORM "Not Applicable A. Vendors claiming a local preference according to Ordinance 023-2009 must complete this form. Name of Bidder/Responder. Date: 1. Does the vendor have a valid receipt for the business tax paid to the Monroe County Tax Collector dated at least one year prior to the notice or request for bid or bid? (.Please furnish copy. ) 2. Does the vendor have a physical business address located within Monroe County from which the vendor operates or performs business on a day to day basis that is a substantial component of the goods or services being offered to Monroe County? List Address: Telephone Number: B. Does the vendor/prime contractor intend to subcontract 50% or more of the goods, services or construction to local businesses meeting the criteria above as to licensing and location? If yes, please provide: 1. Copy of Receipt of the business tax paid to the Monroe County Tax Collector by the subcontractor dated at least one year prior to the notice or request for bid or bid. 2. Subcontractor Address within Monroe County from which the subcontractor operates: Tel. Number Print Name: Signature and Title of Authorized Signatory for Bidder/Responder STATE OF COUNTY OF On this day of , 20. before me, the undersigned notary public, personally appeared known to me to be the person whose name is subscribed above or who produced as identification, and acknowledged that he/she is the person who executed the above Local Preference Form for the purposes therein contained. Notary Public Print Name My commission expires: Seal Attachment G 16 C J O LCI LO 10 (0 � ti OD © - m LO C? V3 O CTo p LO LO LO 10 LO Ln V) LC) LO 1� LLC3 uU-s +mac) LO C�! [V N N N N N N to cq p N N N R � � � � q* � �F Z- m 2 n ::--_ i� m m m M— m LU LLI LU LO d co o & LO pNp 3k = CO J "fie o I o CD 0 7k 2 L- .2 Ft 2E F-F— c� cQ cat LO o �t ID cn ai Lei 'd" �rQ � CD � 1=0 CD N ra co CD le4 w U.CO Lin L� cq LO 61r � CO CO Cfl cn co � coo m cars cC i cc i cc*i ti - z = M 64 6y 64 ti3 63 66y [f3 69 � vo cam*) cc cts cu ? 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