08/15/2001 Agreement
Clerk oI111e
Circul coon
Danny L. Kolhage
Office (305) 292-3550 Fax (305) 295-3663
Memnrandum
To:
James Malloch, Director
Community Services Department
Attn:
Sandy Molina
From:
Isabel C. DeSantis,
Deputy Clerk J. c. !r:
Thursday, November 01, 2001
Date:
At the BOCC meeting of August 15, 2001, the Board approved the following:
Certification Regarding Lobbying Form; Certification Regarding Debarment
Suspension, and other Responsibility Matters Primary Covered Transactions Form;
Florida Statutes on Public Entity Crime Form; Florida Clean Indoor Air Act Form; and
Certification Regarding a Drug-Free Workplace Form, concerning the Contract with
South Florida Employment & Training Consortium (SFETC) for Jim Malloch to continue
liaison representative duties.
Certification Regarding Lobbying Form; Certification Regarding Debarment
Suspension, and other Responsibility Matters Primary Covered Transactions Form;
Florida Statutes on Public Entity Crime Form; Florida Clean Indoor Air Act Form; and
Certification Regarding a Drug-Free Workplace Form.
Attached hereto is duplicate original of the subject document for your handling.
Should you have any questions concerning the above, please do not hesitate to contact
this office.
cc: Finance
County Attorney
~e
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CERTIFICATION REGARDING LOBBYING
CERTIFICATION FOR CONTRACfS, GRANTS, LOANS, AND COOPERATIVE
AGREEMENTS
The undersigned certifies, to the best of his or her knowledge and belief, mat:
(1) No Federal appropriated funds have been paid or will be paid. by or on behalf of the
undersigned, to any person for influencing or attempting to influence an officer or employee of an
agency. a Member of Congress, an officer or employee of Congress. or an employee of a Member
of Congress in connection with the awarding of any Federal contract. the making of any Federal
grant. the making of any Federal loan. the entering into of any cooperative agreement, and the
extension. continuation. renewal. amendment, or modification of any Federal contract. grant. loan.
or cooperative agreement.
(2) If any funds other than Federal appropriated funds have been paid or will be paid to any
person for influencing or attempting to influence an officer or employee of any agency, a Member
of Congress. an officer or employee of Congress, or an employee of a Member of Congress in
connection with this Federal contract, gram, loan, or cooperative agreement. the undersigned shall
complete and submit Standard Fonn-LLL, "Disclosure Form to Report Lobbying," in accordance
with its instructions.
(3) The undersigned shall require that the language of this cenification be included in the award
documents for all" subawards at all tiers (including subcontracts, subgrants and contracts under
grants, loans, and cooperative agreements) and that a11* subrecipients shall certify and di~close
accordingly.
This cemfication is a materia) representation of fact upon which reliance was placed when .this
transaction was made or entered into. Submission of this cenification is a prerequisite for making or
entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails
to file the required certification shall be subject to a civil penalty of not less than $10,000 and not
more than $100.000 for each such failure.
Monroe County
Grantee/Contractor Organization
George Neugent, Mayor
Date
In these instances. "All." in the Final Rule is expected to be clarified to show that it applies
to covered contract/grant transactions over 5100,000 (per OMB)
NNY l. KOLHAGE, aERK
8yiJoak/-c.. f)v;l ~
DEPUTY CLERK'
U7/12/01 l~:l( tAA
CERTI11!:ADON REGARDING ~~RMENT. SUSPENSION, AND
OIlIER
RESPONSIBILITY MATTERS PRIMARY COYiRED TRANSACTIONS
1. The service provider certifies to the best of its knowledge and belief, that it and its
principals:
a. AIe not presently debarred, suspended, proposed for debarment, declared ineligible,
or voluntarily excluded from covered transactions by any Federal department or
agency.
b. Have not within a tbree-year period preceding this proposal been convicted of or had
a civil judgement rendered against them for commission of fraud or a criminal
offense in connection with obtaining, attempting to obtain, or performing a public
(Federal, State, or local) tranSaction or contract under a public transaction: violation
of Federal or State antitrUst statutes or falsification or destrUCtion of records, making
false statements, or receiving stolen property;
Co Me not presently indicted for or otherwise criminally or civilly charged by a
govemment entity (Federal, State, or local) with commission of any of the offenses
enumerated in paragraph 1. b of this certification; and
d. Have not within a three-year period preceding this application/proposal had one or
more public tranSactions (Federal, State, or local) tenninated for cause or default.
2. Where the prospective primary participant is unable to certify to any of the statements in this
cenification, such prospective participant shall submit an explanation to SFETC.
Monroe County
SERVICE PROVIDER AOENCY -:;;;. d-
George Neugenr, Mayor - - ~ e ~~
NAME OF CERTIFYING OFFICIAL
SIGNATURE OF CERTlFYINCi OFFICIAL
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05.08.311IS
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SWOM SIAn::MbB' PVaSUANT 10 SICl10N 2I1.W (3) (a).
noRmA n'ATUI'ES ON J'VJII,lC END1Y t')t~
'OIlS roRM MtJST IE SIGNED AND SWORN TO IN 'I'HE ~ or A NOTARY PVJLlC O. omEa omcw.
At11'HOJUZED TO ADMINISTER OAms.
I. nil JWQra ltatemml ilmbmla.ed III ne Soutb ftnid. F.nmllmDmt Ie Tr.... CBMGrthI.
., George Neugent, Mayor
(priaI tIaIt ........1.. ........1iIIe)
Iw Monroe County
(priat .... el-*7 ,~ .........)
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aDd I( applic8ble lis F_"" Eta,..,.. I~ ..... (J'EIN) II
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_ _'a .... iii ~_I. aIaIII be. .....1_ ease"'. OM..... ....... ~ pII'IOII. A penaa .... batrll&11 ....
lata . Jobd "IIIt1IR willa a perIOD wIlD ... ... IIOIIftct.eII et a .... -titr aiIIae .. I10ridI dariIII tile ...........C " ....... ....
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or Ipplies .. bid 01 COIItJ'IdI '.r die pntftsIoa of &GOds or ..... ... .., . ...bIic __, ." ~ 0IbIrwiIe ........ ", ."..
lit .IUad basiD8s.... . ,.bIic -*J. 'De'" ................. oII"lCa"I, ......,........' .....eIIoIdeft. ..pIG,-,
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.plo)'18. _.bers. Dr' aceDIS ... aft dwe" .............. of die -" er _....... ot dIe..aitJ .... ..... cIwpd widl
... maYidld or. ,altle eatltJ criIH..... die put J6 -.dII. MIl (Please WIcate wWdl ....""-1....... appfiII).
TIac aaCiIJ aabala.lDc CIUs ______.. or...or~otllloftlnn,.. .eon. ~,........ .......In.
tmplo,ees. lDemben. or 81.... ... 11ft IICtIft .. .. .......... 01... .....,. -...... ... ..... fa &lie -...v-- 01
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1M ..... ...eat _ CIte ilia'" 9IMor is&. (aIUcb . ." 01 die ... ....),
I UNDEItSTAND ntAT"I1IE SVlMlSSlONOF'lmSPOItM TOTRECON'I'RACTING omCD FOR THE PUlUC
~N11n'IDENTJFlED IN PAJlAGIIAPH I (ONE) AIIOVE IS FOa THE P\JIUC EN11TY OJIILY AND, 11IAT 11IIS
fORM IS V AUD 11IJlOUGH DECEMBER 31 OF 1HE CALENDAR YEAR IN WIDell IT IS FILED AND THE FOa
PERIOD OF mE CONTRACT ENTEIlED INTO, WIIICHEVIR PElUOD 15 LONGE&. I ALSO UNDEIlSTAND
THAT I AM REQUIRED TO INFORM 11IE PUlUC EN'I1TY PRJOJl TO ENTEaIMG INTO A. CONDACT IN
EXCESS Of 11IE 11IIlESHOLD AMOUNT PROVIDED IN SECnON 217.01'1, n..oR'DA STA.TlTJ'ES. ma
CATEGORY TWO OF ANY CHANGE IN 'nIE INFORMATION CONTAINED IN nus FORM.
(SiI..wre)
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'~:s MY COMMISSION # CC 850213
i~ff EXPIRES'
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U'/~~IUL ~~;~O CnA
~Iorida CI.an Indoor Air Act
'The purpose of the Florida CIon Indoor Air Act is to protect the publIC health. comfon. and environment
by creating areas in public pI8ces and at public meetingS 11181 are ~nably tree ~ tobaCCO. ~e by
providing a uniform statewide maximUm code. The law c:annOl be inteflJl'eteG to requsre the designalion of
smoking areas. However, it is the intent of the Legi$lcJture to discourage the des..gnatiOn of any area
within a government building .. a smoking ....
The Florida Clean Indoor Air Act provides the following:
A Smoking Area MAY NOT Be Designated In:
(s. 386.205(2)(a). F .5.)
. Elevators
. School BusH
. Public Means of Mass Transportation
. Common Nus of RetirerMnt Homes & conc:tomIniums
. Restrooms
. HospitalS
. Doctor's or DentiafS Waiting Rooms
. Jury Defiberation and w.iting Rooms
. CountY Health [)epartmtmt5
. Day Care C8nters
. Schools or other Educational Facitities (Public or Private)
. Common Areas of public places These are defined as any hanway, corridor. lobby, aisle, water
fountain area, restroom, stairwell. entryway, or conference room in any publiC place.
Smoking is not permitted in common....s of.ny pubtic place, (a. 3145.203(6), F.S.). Smoking areas may
be deSignated in the following public places, however; no more th;In one-haIf of th8 total square footage
of a single enclosed indoor area can be designated as a smoking area.
. Libraries
. Museums
. Theaters
. Indoor Auditoriums
. Indoor Arenas
. Indoor Recreational Facilities
. Grocery Sto..
. Retail Stores
. Nursing Homes
. Court Rooms
. Places of empIoymIInt
. Government Buildings - (~ building or por1iDn of any building owned by or teased to the state or
any potiticaI subdMaion ihereof 8nd UIed for governmental pu~)
Key points of the law:
. A person may not lmOke at . public meeting except in dBgnated smoking ...s.
. A restaurant that .... .......... 50 persons must ensure that et..... 50 percent of l1li dinif'9.... is
reserved nonsmoking (s. 386.~'), F.S.). EffeCtip 0cIDber 1. 2001 all res1BUnInts must ensure !hat 65
percent of Ita dining ... is ,.eNed nonsmoking. Res1aunmt owners may c:hOOIe to be smoke-frH.
. Tenninals of public tranaponation camers lOcated in standard metropOlitan etatilatic8l8fUS with
popul8tionS tNet" 230.000 Bra required tD announce fNf6 public address systems every 30 minutes. in
appropriate languages, tnat FIOnd8 is 8 deen indoor IIir state and that smoktng is Btlowed only in
designated 111'88$. (s. 386.211, F.S.).
U I I J... I U,j. .&. ~ . .&. U 1- rt.A
.. . S~ing is pruhiIHtad for any person under 18 years of lISle in. on. or within 1,000 feel of the real
!,",pe~ comprising a public or private elementary. middle, or secondary school. (s. ~6 212. F .5.)
,,-'-'.-: .~ ,.. -;.._:~'.:.''1''.,.., ".~.
. A piIl1ent's room in . hospital, nursing home. or other NtaIh care facility may be designated - 8
smoking area only Ir such designation Is ordered by the 8tte11dii'!g physiciM and agreed to by 811 patients
assigned to that room. No more than ~half or the rooms in any health care facility may be designated
as smoking areas (s. 386.205(2)(a)(b). FoB.).
. A smoking area may not contain common areas Which are expeded to be used by the pubflc. (s.
386.205(5). F.S.).
Administration and Enforcement:
. The Department of HeIIlth (DOH) shall enforce the designatiOn of lmoking ...5 and the posting of
signs. For information ragMfing the law or to report norrcompI...... contact the DepaItment or Health.
(DOH) Bureau of F8Cility Programs M 1-800-337-3742. When filing. cornpIaint. DOH must haVe the
following irtfol'n8tion: businesa or fdty name, nllme oI,...on in charge, .... mdras, cily I and
specific informatiOn concemlng exact violations of the law (s. 386.207~ F.S.).
. Any person who YioCates $. 318.204. F.S., ~r.... a nDloCi..1In8I viaI8tion . prDVided In s. ~3),
punishable by a tine of not mEn ... $100 for the fht viOI*In and not men th8n $SOO for -=h
subsequent vlol8tion. JurisdJdion shall be with the appropriate oounty court.
. To report non-complfance of the F1anda Clean Indoor Ak Ad in restaurants c:ontad the Department of
Business and Professional Regulation. DMsion of HoteI8 8M Restaurants at 850-488-9263
Monroe County
George Neugent, Mayor
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Service Provider
Na e and Title of ~ing
Authorized . nature
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Date /
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CERTIFICATION REGARDING A DRUG-FREE WORKPLACE
George Neugent, Mayor. an authorized representative of the Service Provider, do here b)' m.,ke rhe
f"ollowing cenifieation with respect to the execution or raponsibilities assigned to the SOUnI FLOR.IDA
EMPLOYMENT AND TRAINING CONSORTIUM, by die Stale Welfare Transition Propm, Iftd the Drug-Free
Workplace Ad of 19&8. lbe Proposer will:
a. Publish a St.Jtenteatnorifyinl employees that Ibe ...18wfUl mlftuf~ distribution, dispensing, possession or
use of a c:on1:roUcd subslaJK:e is Jll'Dbibiled ill die ~~s wortq>>lace and specif)tin& _OIlS that will be talc.en
against employees for violation of such prohibition; .. ,.. .c,,_
b. Establish a drug-free awareness program to inform emplo)'ecs n:garding I.) The dangers of drug .aouse in Ihe
workplace; 2.) The Proposer's policy of maintaining. drua-ftee workplace: 3.) ADy available drug counseling.
rehabilitation, and employee assi$tllDCe programs; and 4.) The penalties that may be imposed upon employees for
drug abuse violations occurriag ill die workplac:c;
c. Make it a requirement that each employee to be engaged in the perfonnlftce of the contract be given a copy of the
statemenl required by paragraph (_) ofmis certification.
d. Notify the employees in the st3tcment required by paracraph (.) of this certification that, as a condition of
employment under the grant. the employee will; I) Abide by the tenns of the statement: and 2) Notify th~
Proposer of any criminal drug statute conviction, for a violation occurring in the workplace nO later than fIVe (5)
days after such conviction;
e. Notify the SOUTH FLORIDA EMPLOYMENT AND TRAINING CONSORTIUM within ten (10) days after
receh'ing notice under this subparagraph (d)(2), from an employee or otherwise receiving acrual notice of such
conviction;
f. T,ke one of the following actions within thirty (30) days of'receiving notice under the subparagraph (d)(2) with
res~cllo any employee who is so convicted:
I. Take apPlopl iate penonnel action against sudun employlle. up to and iacJucling terDlination; or
2. Require such employee to participate in a drug abuse assistance or rehabilitation program approved
for such JHU1'OSCS by I Federal, State. local health, law enforcement, or OIlIer appropriate agency; and
&. Making _ good-faith effort to continue to ynaintain a drug-free workpl . lementation of parapphs
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'~~,Efil:bANNY L .~AGE, aERK
;y'~a.Pi1C. L9.u~
DEPUTY CLERK '
Authorized Si
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DATE