12/20/2006 Agreement
Clerk 8Ilbe
Circul COUll
Danny L. Kolhage
Phone: 295-3130 Fax: 295-3663
Menwrandum
To:
Dent Pierce, Director
Public Works Division
Attn:
From:
Beth Leto
Isabel C. DeSantis,. I )
Deputy Clerk JfY'
Date:
Tuesday, January 30, 2007
At the BOCC meeting of December 20,2006, the Board approved the following:
Agreements between Monroe County and D & J Industries Etc., Inc for roof
repair at the Monroe County Detention Facility on Stock Island that was damaged due to
Hurricane Wilma; and partial roof replacement at the Marathon Sheriff's Substation.
Attached hereto are duplicate originals of the subject documents for your handling.
Should you have any questions, please do not hesitate to contact me.
Cc: County Attorney
Finance
File
AGREEMENT
THIS AGREEMENT, ("Agreement") made and entered into this 20th day of December,
2006, by and between MONROE COUNTY, FLORIDA, ("County"), 1100 Whitehead
Street, Key West, Florida, and D & J Industries Etc. Inc. ("Contractor") whose address is
P.O. Box 430674 Big Pine Key, FL 33043
WITNESSETH:
The parties hereto, for the consideration hereinafter set forth, mutually agree as follows:
1. THE CONTRACT
The contract between the County and the Contractor, of which this
Agreement is a part, consists of the contract documents, as specified in
paragraph 2.
2. THE CONTRACT DOCUMENTS
The contract documents consist of this Agreement, the Request for Bid,
the Specifications, the Drawings, all Change Orders and any addenda, the
Contractor's Bid documents, any other amendments hereto executed by
the parties, together with the required County documents furnished as part
of the Bid or required to be furnished by the BID, and all required
insurance documentation.
3. SCOPE OF THE WORK - Partial Roof Replacement - Marathon
Substation, 3103 Overseas Highway, Marathon, Florida 33050.
A. The Work includes removing of existing membrane roofing system
where shown on the Contract Documents, minor roof substrate
improvements required after removal, and installation of a new
membrane roofing system as contained within the Contract Documents.
4. THE CONTRACT AMOUNT
A. The Owner shall pay the Contractor in current funds for the Contractor's
performance of the Contract per Section 01290 of the Specifications, the
Contract sum of One Hundred Twenty-Five Thousand & 00/100 Dollars
($125,000.00).
B. Final payment, constituting the entire unpaid balance of the Contract Amount,
shall be made by the Owner to the Contractor when the Contract has been fully
performed by the Contractor.
5. CONTRACTOR'S ACCEPTANCE OF CONDITIONS
A. This Agreement and the provision of the services at the location listed
have been fully considered by the Contractor, who understands the same
and agrees to their sufficiency and suitability. Under no circumstances,
conditions, or situations shall this Contract be more strongly construed
against the County than against the Contractor.
B. The passing, approval, and/or acceptance by the County of any of the
services furnished by the Contractor shall not operate as a waiver by the
County of strict compliance with the terms of this Contract, and
specifications covering the services. Failure on the part of the Contractor,
immediately after Notice to Correct shall entitle the County, if it sees fit,
to correct the same and recover the reasonable cost of such replacement
and/or repair from the Contractor, who shall in any event be jointly and
severally liable to the County for all damage, loss, and expense caused to
the County by reason of the Contractor's breach of this Contract and/or his
failure to comply strictly and in all things with this Contract and with the
specifications.
6. HOLD HARMLESS
The Contractor covenants and agrees to indemnify and hold harmless Monroe
County Board of County Commissioners 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 Contractor or any of its Subcontractor( s) in any tier, occasioned
by the negligence, errors, or other wrongful act of omission of the Contractor or its
Subcontractors in any tier, their employees, or agents.
In the event that the service is delayed or suspended as a result of the Contractor's
failure to purchase or maintain the required insurance, the Contractor shall
indemnify the County from any and all increased expenses or lost revenue
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 ofliability is in no way limited to,
reduced, or lessened by the insurance requirements contained elsewhere within
this agreement. The provisions of this section shall survive the expiration or
earlier termination of this agreement.
7. INDEPENDENT CONTRACTOR
At all times and for all purposes under this agreement the Contractor is an
independent contractor and not an employee of the Board of County
Commissioners for Monroe County. No statement contained in this agreement
shall be construed so as to find the Contractor or any of his/her employees,
contractors, servants, or agents to be employees of the Board of County
Commissioners for Monroe County.
8. ASSURANCE AGAINST DISCRIMINATION
The Contractor shall not discriminate against any person on the basis of race,
creed, color, national origin, sex, age, or any other characteristic or aspect which is
not job related, in its recruiting, hiring, promoting, terminating, or any other area
affecting employment under this agreement or with the provision of services or
goods under this agreement.
9. ASSIGNMENT/SUBCONTRACT
The Contractor shall not assign or subcontract its obligations under this agreement,
except in writing and with the prior written approval of the Board of County
Commissioners for Monroe County and Contractor, which approval shall be
subject to such conditions and provisions as the Board may deem necessary. This
paragraph shall be incorporated by reference into any assignment or subcontract
and any assignee or subcontractor shall comply with all of the provisions of this
agreement. Unless expressly provided for therein, such approval shall in no
manner or event be deemed to impose any obligation upon the board in addition to
the total agreed-upon price of the services/goods of the Contractor and
compensation to County.
10. COMPLIANCE WITH LAW
In providing all services/goods pursuant to this agreement, the Contractor shall
abide by all statutes, ordinances, rules and regulation pertaining to, or regulating
the provisions of, such services, including those now in effect and hereinafter
adopted. Any violation of said statutes, ordinances, rules and regulations shall
constitute a material breach of this agreement and shall entitle the Board to
terminate this contract immediately upon delivery of written notice of termination
to the Contractor. The Contractor shall possess proper licenses to perform work in
accordance with these specifications throughout the term of this contract.
11. INSURANCE
Prior to execution of this agreement, and maintained throughout the life of the
contract, the Contractor shall furnish to the County Certificates of Insurance
indicating the minimum coverage limitation as listed below:
A. General Liability - include as a minimum:
. Premises Operations
. Products and Completed Operations
. Blanket Contractual Liability
. Personal Injury Liability
. Expanded Definition of Property Damage
The minimum limits acceptable shall be $500,000 Combined Single Limit
If split limits are provided, the minimum limits acceptable shall be:
$500,000 per person; $500,000 per Occurrence; and $500,000 Property
Damage.
An Occurrence Form policy is preferred. If coverage is changed to or
provided on a Claims Made Policy, its provisions should include coverage for
claims filed on or after the effective date of this contract. In addition, the
period for which claims may be reported should extend for a minimum of 48
months following the termination or expiration of the contract.
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS MUST
BE NAMED AS ADDITIONAL INSURED.
B. Vehicle Liability - include as a minimum:
. Owned, Non-Owned, and Hired Vehicles
The minimum limits acceptable shall be $300,000 Combined Single Limit
If split limits are provided, the minimum limits acceptable shall be:
$100,000 per Person; $300,000 per Occurrence; and $50,000 Property
Damage.
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
MUST BE NAMED AS ADDITIONAL INSURED.
C. Workers Compensation -limits sufficient to respond to Florida Statute 440.
In addition, the Contractor shall obtain Employers' Liability Insurance with
limits of not less than:
$500,000 Bodily Injury by Accident
$500,000 Bodily Injury by Disease, policy limits
$500,000 Bodily Injury by Disease, each employee
Coverage shall be provided by a company or companies authorized to transact
business in the State of Florida and the company or companies must maintain
a minimum rating of A-VI, as assigned by the AM. Best Company.
If the Contractor has been approved by Florida's Department of Labor, as an
authorized self-insurer, the County shall recognize and honor the Contractor's
status. The Contractor may be required to submit a Letter of Authorization
issued by the Department of Labor and Certificate of Insurance, providing
details on the Contractor's Excess Insurance Program.
If the Contractor participates in a self-insurance fund, a Certificate of
Insurance will be required. In addition, the Contractor may be required to
submit updated financial statements from the fund upon request from the
County.
12. CONTRACTOR'S RESPONSmILITY
The Contractor warrants that it is authorized by law to engage in the performance
of the activities encompassed herein, subject to the terms and conditions set forth
in these contract documents. Contractor shall at all times exercise independent
judgment and shall assume responsibility for the services to be provided.
13. NOTICE REQUIREMENT
Any notice required or permitted under this agreement shall be in writing and
hand delivered or mailed, postage prepaid, to the other party by certified mail,
returned receipt requested, to the following:
FOR COUNTY
Director, Middle Keys Operations
Monroe County Facilities Maintenance
5501 College Road
Key West, FL 33040
AND
Monroe County Administrator
1100 Simonton Street
Key West, FL 33040
FOR CONTRACTOR
OR
REPRESENTATIVE AT JOB SITE
David Schlapper
D & J Industries Etc. Inc.
P.O. Box 430674
Big Pine Key, FL 33043
Notice shall be deemed received when hand delivered, delivered by mail, or when
deemed undeliverable by the U.S. Postal Service.
14. CANCELLATION
A) In the event that the Contractor shall be found to be negligent in any
aspect of installation, stocking, maintenance, repair, or service, the County
shall have the right to terminate this agreement after five days written
notification to the Contractor.
B) This contract may be terminated for convenience by County upon ten (10)
days written notice to contractor delivered by hand or certified mail, return
receipt requested, of intent to terminate and the date on which such
termination becomes effective. Contractor shall cease work as directed. In
such case, Contractor shall be paid for all work executed and termination
expenses, and expenses incurred prior to termination. No payment shall
be made for profit for work, which has not been performed.
15. GOVERNING LAWS, VENUE, INTERPRETATION, COSTS, FEES
This Agreement shall be governed by and construed in accordance with the laws
of the State of Florida applicable to contracts made and to be performed entirely
in the State.
In the event that any cause of action or administrative proceeding is instituted for
the enforcement or interpretation of the agreement, the County and Contractor
agree that venue shall lie in the appropriate court or before the appropriate
administrative body in Monroe County, Florida. This Agreement shall not be
subject to arbitration.
Mediation proceedings initiated and conducted pursuant to this Agreement shall
be in accordance with the Florida Rules of Civil Procedure and usual and
customary procedures required by the circuit court of Monroe County.
16. RECORDKEEPING
Contractor shall maintain all books, records, and documents directly pertinent to
performance under this Agreement in accordance with generally accepted
accounting principles consistently applied. Each party to this Agreement or their
authorized representatives shall have reasonable and timely access to such records
of each other party to this Agreement for public records purposes during the term
of the Agreement and for four years following the termination of this Agreement.
If an auditor employed by the County or Clerk determines that monies paid to
Contractor or not paid to County pursuant to this Agreement were spent for
purposes not authorized by this Agreement or wrongfully retained by Contractor,
the Contractor shall repay the monies together with interest calculated pursuant to
Sec. 55.03, FS, running from the date the monies were to have been paid.
17. SEVERABILITY
If any term, covenant, condition or provision of this Agreement (or the application
thereof to any circumstance or person) shall be declared invalid or unenforceable
to any extent by a court of competent jurisdiction, the remaining terms, covenants,
conditions and provisions of this Agreement, shall not be affected thereby; and
each remaining term, covenant, condition and provision of this Agreement shall be
valid and shall be enforceable to the fullest extent permitted by law unless the
enforcement of the remaining terms, covenants, conditions and provisions of this
Agreement would prevent the accomplishment of the original intent of this
Agreement. The County and Contractor agree to reform the Agreement to replace
any stricken provision with a valid provision that comes as close as possible to the
intent of the stricken provision.
18. ATTORNEY'S FEES AND COSTS
The County and Contractor agree that in the event any cause of action or
administrative proceeding is initiated or defended by any party relative to the
enforcement or interpretation of this Agreement, the prevailing party shall be
entitled to reasonable attorney's fees, court costs, investigative, and out-of-pocket
expenses, as an award against the non-prevailing party, and shall include
attorney's fees, court costs, investigative, and out-of-pocket expenses in appellate
proceedings.
19. BINDING EFFECT
The terms, covenants, conditions, and provisions of this Agreement shall bind and
inure to the benefit of the County and Contractor and their respective legal
representatives, successors, and assigns.
20. AUTHORITY
Each party represents and warrants to the other that the execution, delivery and
performance of this Agreement have been duly authorized by all necessary
County and corporate or individual action, as required by law.
21. CLAIMS FOR FEDERAL OR STATE AID
Contractor and County agree that each shall be, and is, empowered to apply for,
seek, and obtain federal and state funds to further the purpose of this Agreement;
provided that all applications, requests, grant Bids, and funding solicitations shall
be approved by each party prior to submission.
22. ADJUDICATION OF DISPUTES OR DISAGREEMENTS
County and Contractor agree that all disputes and disagreements shall be
attempted to be resolved by meet and confer sessions between representatives of
each of the parties. If no resolution can be agreed upon within 30 days after the
first meet and confer session, the issue or issues shall be discussed at public
meeting of the Board of County Commissioners. If the issue or issues are still not
resolved to the satisfaction of the parties, then any party shall have the right to
seek such relief or remedy as may be provided by this Agreement or by Florida
law. This provision does not negate or waive the provisions of Paragraph 14
concerning cancellation.
23. COOPERATION
In the event any administrative or legal proceeding is instituted against either
party relating to the formation, execution, performance, or breach of this
Agreement, County and Contractor agree to participate, to the extent required by
the other party, in all proceedings, hearings, processes, meetings, and other
activities related to the substance of this Agreement or provision of the services
under this Agreement. County and Contractor specifically agree that no party to
this Agreement shall be required to enter into any arbitration proceedings related
to this Agreement.
24. NONDISCRIMINATION
County and Contractor agree that there will be no discrimination against any
person, and it is expressly understood that upon a determination by a court of
competent jurisdiction that discrimination has occurred, this Agreement
automatically terminates without any further action on the part of any party,
effective the date of the court order. County or Contractor agree to comply with
all Federal and Florida statutes, and all local ordinances, as applicable, relating to
nondiscrimination. These include but are not limited to: 1) Title VI of the Civil
Rights Act of 1964 (PL 88-352) which prohibits discrimination on the basis of
race, color or national origin; 2) Title IX of the Education Amendment of 1972, as
amended (20 USC ss. 1681-1683, and 1685-1686), which prohibits discrimination
on the basis of sex; 3) Section 504 of the Rehabilitation Act of 1973, as amended
(20 USC s. 794), which prohibits discrimination on the basis of handicaps; 4) The
Age Discrimination Act of 1975, as amended (42 USC ss. 6101-6107) which
prohibits discrimination on the basis of age; 5) The Drug Abuse Office and
Treatment Act of 1972 (PL 92-255), as amended, relating to nondiscrimination on
the basis of drug abuse; 6) The Comprehensive Alcohol Abuse and Alcoholism
Prevention, Treatment and Rehabilitation Act of 1970 (PL 91-616) as amended,
relating to nondiscrimination on the basis of alcohol abuse or alcoholism;; 7) The
Public Health Service Act of 1912, ss. 523 and 527 (42 USC ss. 690dd-3 and
290ee-3), as amended, relating to confidentiality of alcohol and drug abuse patent
records; 8) Title VIII of the Civil Rights Act of 1968 (42 USC s. et seq.) as
amended, relating to nondiscrimination in the sale, rental or financing of housing;
9) The Americans with Disabilities Act of 1990 (42 USC s. 1201 NoteO, as maybe
amended from time to time, relating to nondiscrimination on the basis of
disability; 10) Any other nondiscrimination provisions in any federal or state
statutes which may apply to the parties to, or the subject matter of, this
Agreement. Monroe County Code Ch. 13, Art. VI, prohibiting discrimination on
the basis of race, color, sex, religion, disability, national origin, ancestry, sexual
orientation, gender identity or expression, familial status or age. 11) Any other
nondiscrimination provisions in any Federal or state statutes which may apply to
the parties to, or the subject matter of, this Agreement.
25. COVENANT OF NO INTEREST
County and Contractor covenant that neither presently has any interest, and shall
not acquire any interest, which would conflict in any manner or degree with its
performance under this Agreement, and that only interest of each is to perform
and receive benefits as recited in this Agreement.
26. CODE OF ETHICS
County agrees that officers and employees of the County recognize and will be
required to comply with the standards of conduct for public officers and
employees as delineated in Section 112.313, Florida Statues, regarding, but not
limited to, solicitation or acceptance of gifts; doing business with one's agency;
unauthorized compensation; misuse of public position, conflicting employment or
contractual relationship; and disclosure or use of certain information.
27. NO SOLICITATIONIPAYMENT
The County and Contractor warrant that, in respect to itself, it has neither
employed nor retained any company or person, other than a bona fide employee
working solely for it, to solicit or secure this Agreement and that it has not paid or
agreed to pay any person, company, corporation, individual, or firm, other than a
bona fide employee working solely for it, any fee, commission, percentage, gift,
or other consideration contingent upon or resulting from the award or making of
this Agreement. For the breach or violation of the provision, the Contractor
agrees that the County shall have the right to terminate this Agreement without
liability and, at its discretion, to offset from monies owed, or otherwise recover,
the full amount of such fee, commission, percentage, gift, or consideration.
28. PUBLIC ACCESS
The County and Contractor shall allow and permit reasonable access to, and
inspection of, all documents, papers, letters or other materials in its possession or
under its control subject to the provisions of Chapter 119, Florida Statues, and
made or received by the County and Contractor in conjunction with this
Agreement; and the County shall have the right to unilaterally cancel this
Agreement upon violation of this provision by Contractor.
29. NON-WAIVER OF IMMUNITY
Notwithstanding the provisions of Sec. 768.28, Florida Statues, the participation
of the County and the Contractor in this Agreement and the acquisition of any
commercial liability insurance coverage, self-insurance coverage, or local
government liability insurance pool coverage shall not be deemed a waiver of
immunity to the extent of liability coverage, nor shall any contract entered into
by the County be required to contain any provision for waiver.
30. PRIVILEGES AND IMMUNITIES
All of the privileges and immunities from liability, exemptions from laws,
ordinances, and rules and pensions and relief, disability, workers' compensation,
and other benefits which apply to the activity of officers agents or employees of
any of any public agents or employees of the County, when performing their
respective functions under this Agreement within the territorial limits of the
County shall apply to the same degree and extent to the performance of such
functions and duties of such officers agents, volunteers, or employees outside the
territorial limits of the County.
31. LEGAL OBLIGATIONS AND RESPONSIBILITIES
Non-Delegation of Constitutional or Statutory Duties. This Agreement is not
intended to, nor shall it be construed as, relieving any participating entity from
any obligation or responsibility imposed upon the entity by law except to the
extent of actual and timely performance thereof by and participating entity, in
which case the performance may be
offered in satisfaction of the obligation or responsibility. Further, this Agreement
is not intended to, nor shall it be construed as, authorizing the delegation of the
constitutional or statutory duties of the County, except to the extent permitted by
the Florida constitution, state statute, and case law.
32. NON-RELIANCE BY NON-PARTIES
No person or entity shall be entitled to rely upon the terms, or any of them, of the
Agreement to enforce or attempt to enforce any third-party claim or entitlement to
or benefit of any service or program contemplated hereunder, and the County and
the Contractor agree that neither the County nor the Contractor or any agent,
officer, or employee of either shall have the authority to inform, counsel, or
otherwise indicate that any particular individual or group of individuals, entity or
entities, have entitlements or benefits under this Agreement separate and apart,
inferior to, or superior to the community in general or for the purposes
contemplated in this Agreement.
33. ATTESTATIONS
Contractor agrees to execute such documents as the County may reasonably
require, to include a Public Entity Crime Statement, an Ethics Statement, and a
Drug-Free Workplace Statement.
34. NO PERSONAL LIABILITY
No covenant or agreement contained herein shall be deemed to be a covenant or
agreement of any member, officer, agent or employee of Monroe County in his or
her individual capacity, and no member, officer, agent or employee of Monroe
County shall be liable personally on this Agreement or be subject to any personal
liability or accountability by reason of the execution of this Agreement.
35. EXECUTION IN COUNTERPARTS
This Agreement may be executed in any number of counterparts, each of which
shall be regarded as an original, all of which taken together shall constitute one
and the same instrument any of the parties hereto may execute this Agreement by
signing any such counterpart.
36. SECTION HEADINGS
Section headings have been inserted in this Agreement as a matter of convenience
of reference only, and it is agreed that such section headings are not a part ofthis
Agreement and will not be used in the interpretation of any provision of this
Agreement.
37. CONTINGENCY STATEMENT
Monroe County's performance and obligation to pay under this contract is
contingent upon an annual appropriation by the Monroe County Board of County
Commissioners.
Remainder of page intentionally left blank
Signature page to follow
IN WITNESS WHEREOF, the parties hereto have executed this Agreement on the day
and date first written above in four (4) counterparts, each of which shall, without proof or
accounting for the other counterparts, be deemed an original contract.
(SEAL)
Attest: DANNY L. KOLHAGE, CLERK
By:
ih~c. lO.u~
Deputy Clerk /
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Title:
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BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By: ~J(}~
MayorlChairman
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SUSAN M. GR SLEY
ASSISTANT COUNTY ATTORNEY
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PUBLIC ENTllY 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 contractor, supplier, subcontractor, or consultant under a contract with any public
entity, and may not transact business with any public entity in excess of the threshold amount provided
in Section 287.017, for CATEGORY TWO for a period of 36 months from the date of being placed on
the convicted vendor list."
LOBBYING AND CONFLICT OF INTEREST CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO. 010-1990
MONROE COUNTY. FLORIDA
ETHICS CLAUSE
- ,rda.V\
ny Officer/Partner/Individual)
warrants that hefot has not employed, retained or otherwise had act on hisflls behalf any fenner
Coooty officer or employee in violation of Section 2 of Ordinance No. 010-1990 or any County officer or
employee in violation of Section 3 of Ordinance No. 010-1990. For breach or violation of this provision
the County may, in its discretion, terminate this Agreement without Iiabiltty and may also, in its discretion,
deduct from the Agreement or purchase price, or otherwise recover, the full amount of any fee,
commission, percentage, gift, or consideration paid to the former County officer or employee".
./
(Signature)
Date: 1/ - /Lj -O.k
STATE OF: r:-LD rl. I {J A
COUNTY OF: ^"^ 0 (I.) (t.() t;.
Subsaibed and sworn to (or affirmed) before me on
(date) by --R b. ,^d,) I /)iA ;:J'...ord/J fA
I
cnown to m~as produced
identification. (type of identification)
(name of affiant). HelSh~Y
as
Q>
NOTARY PUBLIC
My commission expires:
PARTIAL ROOF REPLACEMENT - MARATHON SUBSTATION
"
NON-COLLUSION AFFIDAVIT
~cCo~i~~;~~l~:~y !~~~nd~: ~n~i~ ~~ p~u~ dP~c;;,d ~;(hit:t-L
1. lam_R~l"'t\O \1>11\ '(fOl'l'\I'~of\ [P..e.~v.2..e.I\.j..
ofthefinnofS\4-..:r 'l'i\t\vs:\-n1:!" t..k.'j t.tJt.
making the Bid for the serviceslworklproject described in the Request for
r: ~ I
nd that I executed the said id with full authority to do so:
Bids
.,jz~
2. The prices in this bid/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 and percentage of return which have
been quoted in this bid/Bid have not been knowingly disclosed by the responder and
will not knowingly be disclosed by the responder prior to bid/Bid opening, directly or
indirectly, to any other bidder/responder or to any competitor.
4. No attempt has been made or will be made by the bidder/responder to induce any
other person, partnership or corporation to submit, or not to submit, a bid/Bid for the
purpose of restricting competition.
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 the projectlserviceslwork.
~
(Signature of Bidder)
/I~/'-f -t)~
(Date)
STATE OF: r:LO~\DA.
COUNTY OF: NY\t1't-J (G.fJ IS
PERSONALLY APPEARED BEFORE ME, the undersigned authority, ~...dj)lph :::rO.t~g()-^'1
who. after first being sworn by me, (name of individual signing) affixed his/her signature in the
space provided above on this ..J!:L day of '" 20Qk..
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My Commission Expires:
PARTIAL ROOF REPLACEMENT - MARATHON SUBSTATION
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DRUG..fREE WORKPLACE FORM
The undersigned Contractor/bidder/responder in accordance with Florida Statute 287.087
hereby certifies that:
p ~::f' -j:' ~Ad d-rN' _ ~ ~ .\ :Ct r
(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), notify the employees that, as a condition of
working on the commodities or contractual services that are under bid, the employee will abide
by the terms of the statement and will notify the employer of any conviction of, or plea of guilty
or nolo contendere to, any violation of Chapter 893 (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 requires 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.
6. Make 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 fully with the
above requirements.
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Bidder's Signature
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NOTARY PUBLIC
My Commission Expires:
PARTIAl ROOF REPLACEMENT - MARATHON SUBSTATION