Item F2
B9MID OF GOVERNORS
FIRE AND AMBULANCE DISTRICT 1 ..... ~,~,-"-
AGENDA ITEM SUMMARY
Meeting Date: February 20,2008 Division: Emergency Services
Bulk Item: Yes - No X Department: Fire Rescue
Staff Contact Person: Camille Dubroff X6010
AGENDA ITEM WORDING: Approval of Renewal Agreement effective from March 1, 2008
through February 28, 2009, between Board of Governors of Fire and Ambulance District 1 of Monroe
County Florida and Roy Khanna for maintenance of Fire Rescue vehicles (Ambulances) including
inspections, preventative maintenance, and unscheduled maintenance and repairs resulting from failure
or malfunction.
ITEM BACKGROUND: The original agreement provides for annual renewals for up to three (3)
one-year periods, with approval of the District's governing Board. We are requesting approval to
exercise the renewal clause for the first one-year period, commencing on March 1,2008 and ending on
February 28,2009.
PREVIOUS RELEVANT BOG ACTION: On March 19, 2003, the Board approved an agreement
with Roy Khanna for maintenance of Fire Rescue vehicles (Ambulances) including inspections,
preventative maintenance, and unscheduled maintenance and repairs resulting from failure or
malfunction. On September 17, 2003, the Board approved a renewal agreement to extend the contract
with Roy Khanna for the first one-year period, effective October 1, 2003 through September 30,2004.
On September 15, 2004, the Board approved a renewal agreement to extend the contract with Roy
Khanna for the second one-year period, effective October 1, 2004 through September 30, 2005.0n
September 15,2005, the Board approved a renewal agreement to extend the contract with Roy Khanna
for the third and final one-year period, effective October 1, 2005 through September 30,2006. On
September 20, 2006 the Board approved an extension on the contract with Roy Khanna to a month-to-
month basis pending executing of a new contract. On February 21, 2007 the Board awarded a bid and
entered into an agreement with Roy Khanna for the maintenance of Fire Rescue ambulances, including
quarterly inspections, preventative maintenance, and unscheduled maintenance resulting from
malfunction or failure
CONTRACT/AGREEMENT CHANGES: In accordance with paragraphs 2 and 5 of the original
agreement, the hourly rate is adjusted by the most recent CPI for the past 12 months from $73 to $75
and the charge for ambulance inspection with preventative maintenance performed increases from $265
to $273. Contract term has changed to provide service for the period of March 1, 2008 through
February 28,2009.
STAFF RECOMMENDATIONS: Staff recommends approval of this item as written.
TOTAL COST: $75,000.00* BUDGETED: Yes X' No
*which reflects the new hourly labor rate of $75.00. preventative maintenance inspections at $273.00, and all parts. fluids
and lubricants at cost plus 25%.
COST TO COUNTY: $75,000.00 SOURCE OF FUNDS: Ad Valorem Taxes
141-13001-530-462
REVENUE PRODUCING: Yes_\;~o~ AMOUNT PER MONTH_ /",~~~r -
APPROVED BY: County Atty ~ ~B/PurchaSing / Risk Managementf1 ,~
DOCUMENTATION: . Included X Not Required
DISPOSITION: AGENDA ITEM #
Revised 8/06
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MONROE COUNTY BOARD OF GOVERNORS
CONTRACT SUMMARY
Contract with: Roy Khanna Contract #_
Effective Date: 3/1/2008
Expiration Date: 2/28/2009
Contract Purpose/Description:
First renewal of agreement dated 2/21/2007 for scheduled general and preventative
maintenance of Monroe County Fire Rescue ambulances; and for unscheduled
maintenance and repairs resulting from equipment failure or malfunction.
Contract Manager: Camille Dubroff 6010 Emergency Services / Stop 14
(Name) (Ext.) (Department/Stop #)
for BOG meeting on 02/20/2008 Agenda Deadline: 02/05/08
CONTRACT COSTS
Total Dollar Value of Contract: $ FY 08- $75,000.00 Current Year
Portion: $
Budgeted? Yes[Z] NoD Account Codes: 1300t-530-462 - $75,000.00
Grant: $
County Match: $
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ADDITIONAL COSTS
Estimated Ongoing Costs: $~yr For:
(Not included in dollar value above) (eg. maintenance, utilities, janitorial, salaries, etc.)
CONTRACT REVIEW
Changes Date Out
Date In Needed ! -/&f:;r)
Division Director - YesD NoD
Risk Manage~ent ~r'" }06 YesD Nog \ -7ot?
te... ~ 'in^' # ~~ \IIDb~
O.M.B./Purchasl g I <6 YesD NoD
County Attorney I~ YesD No[K] ~ 1.JhJ) I f 02'
Comments:
OMB Form Revised 2/27/01 Mep #2
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RENEWAL AGREEMENT
This AGREEMENT dated the day of , 2008, by and between ~
the Board of Governors of Fire and Ambulance District 1 of Monroe County, Florida, hereinafter called the
"District" and Roy Khanna., whose mailing address is 3117 Carol Avenue, Palm Springs, FL 33461,
hereinafter called the "Contractor".
WITNESSETH
WHEREAS, the parties hereto did enter into an agreement dated February 21, 2007 for scheduled general
and preventative maintenance of all Monroe County Fire Rescue ambulances, and for unscheduled maintenance
and repairs resulting from equipment failure or malfunction; and
WHEREAS, said agreement provided an option to the District to renew the contract for three additional
one year terms; and
WHEREAS, the DISTRICT has elected to exercise said option for the continuation of scheduled general
and preventative maintenance of all Monroe County Fire Rescue ambulances, and for unscheduled maintenance
and repairs resulting from equipment failure or malfunction; now therefore
IN CONSIDERATION of the mutual convenants and obligations contained herein, the parties agree as
follows:
1. The District elects to renew the contract for the first one additional year pursuant to
paragraph 2 of the agreement entered February 21, 2007.
2. In accordance with paragraphs 2 and 5 of the original agreement, the hourly rate is adjusted
by the most recent CPI for the past 12 months from $73 to $75 and the charge for
ambulance inspection with preventative maintenance performed increases from $265 to
$273.
3. The effective date of this amendment is March 1, 2008 and shall extend through February
28,2009, under the same terms and conditions of the contract dated February 21, 2007.
4. All other terms and conditions of the contract dated February 21, 2007 shall remain in full -
force and effect.
A1test: DANNY L. KOLHAGE, CLERK BOARD OF GOVERNORS,
FIRE AND AMBULANCE DISTRICT 1
By: By:
Deputy Clerk
WITNESS;
MONROE COUNTY ATTOR~
"~Vi.D~FORM:
-- CYNTH. A L. HALL
ASSISTANT COUNTY ATTORNEY
Date__L~ Lf ~ oK
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CORD E DhT~ F,'ii:l'OWVYi
I y r_~ 12/07/2007
PRODUCER THIS CERTIFJCATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RJGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTJFICATE DOES NOT AMEND, EXTEND OR
JOHNSON & MILLER INSURANCE AL TER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
1225 N MILITARY TRAIL #2 COMPANIES AFFORDING COVERAGE -
WEST 'PALM BEACH, FL 3 3 ~O 9 i 1-(1 ;. I ~!;NX) i
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561-640-4333 r"~.'._~~'-< - '" . . -A - HERMITAGE INSURANCE CO.
INSURED I COMPANY i
' ROY KHANNA 1 DEe '1 nBi,;C1J I
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3117 CAROL AVE f-~O~fANY __-1 I
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PALM SPRINGS, FL 33461 t\11 '; ,(JCO~~~NY.!_ !
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,(561) 641-2360 i ..----.. ." '0 .. ~ . p' ,~..
COVERAGES
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 DR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRISED HEREIN IS SUBJECT TO ALL mE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE (MMIDDIYY) DATE [MMIDDIYY)
GENERAL LIABILITY GENERAL AGGREGATE sl MILLION
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X COMMERCIAL GENERAL UABIUTY PRODUCTS - COMP/OP AGG sEXCLUDED
>.. ./ CLAIMS MADE 0 OCCUR PERSONAL /I AOV INJURy $1 MILLION
A I- OWNER'S & CONTRACTOR.S PROT #HGL448978-07 12/01/07 12/01/08 EACH OCCURRENCE 51 MILLION
FIRE DAMAGE [Anyone fife) $ 50,000
MEO EXP (Any ono person) S 5,000
AUTOMoalLE LIABILITY
f-- COMBINED SINGLE LIMIT S
I-- AF( AUTO
I- All OWNED AUTOS BODILY INJURY
(Per person) S
I- SCHEDULEO AUTOS
- HIf,EO AUTOS :J- BODIL Y iNJURY
'1(1) ~/ S
NON-OWNED AUTOS f?l.cc_ _ {Per aCCldonl)
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- ~ ,,(~J !i >. -1- PROPERTY DAMAGE $
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GARAGE LIABILITY "..... Ii j- AUTO ONLY - EA ACCIDENT S
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I- ANY AUTO OTHER THAN AUTO ONL y
I- EACH ACCIDENT S
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AGGREGATE $
EXCI;SS LIABILITY () f1r ' lJlhl&_ LJ EACH OCCURRENCE S
R UMBRELLA FORM -! \ AGGREGATE S -
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OTHER THAN UMBRELLA FORM S
WORKERS COMPENSA nON AND ~.!- ~-'-'!( I WC STATU- J 10TH.
EMPLOYERS' LIABILITY /\- , r; e-.. 00.. U.,,, "
w1 EL EACH ACC10ENT S H' I
THE PROPRIETORI R1NCL ( ,', IA.lt ._.2; ,6 1 c (/7 ' I (I EL DISEASE - POLICY LIMIT S
PARTNERS/EXECUTIVE ~ -6>: Q / L'-tJL(~lf~) ELDISEASE-EAEMPLOYE~~_
OFFICERS ARE. EXCL
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:RIPTlON 'oF OPERA TIONS/LOCATlONSNEHICLES/SPECIAL ITEMS
mROE COUNTY BOARD OF COUNTY COMMISSIONERS SHALL BE LISTED AS ADDITIONAL
rSURED.
T/FICATE HOLDER CANCELlA TfON
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
MONROE COUNTY BOARD OF COUNTY EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
COMMISSIONERS ~ DAYS WRITTEN NOTICE TO TNE CERTIFICATE HOLDER NAMED TO THE LEFT.
AT TN RISK MANAGEMENT BUT FAILUIflfJO MAIL SUC~OTIC~ SHALL IMPJ~ NO 08LiGATION OR liABiliTY
1100 SIMONTON STREET " OF ANY lUND UPON THE CCjI\lfANY, ITS ioNTS OR REPRESENTATIVES.
KEY WEST, FL 33040 AUTHORIZEDF(sP-El,ESENT;.;lwE J{",. [yi l S
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jFAX: 305-289-6336 if ___ ~:::..... j (_,~_ " "t--.- -~
to 25-8 (1/95) / 0 ACORD CORPORATION 1938 I
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fi:'l.GREEMENT BETWEEN
THE BOARD OF GOVERNORS
"-;: FiRE AND AMBULANCE DISTRICT '! -
OF MONROE COUNllt, FLORIDA
AND
ROY KHANNA
FOR MAINTENANCE OF MONROE COUNTY fiRE RESCUE
TYPE I AMBULANCES
THIS AGREEMENT, ("AGREEMENT") made and entered into this 21st day of February,
2007 by and between the Board of Governors of Fire and Ambulance District 1 of
Monroe County, Florida, ("DISTRICT") and Roy Khanna, ("CONTRACTOR").
WITNESSETH:
WHEREAS, CONTRACTOR represents that it is capable and prepared to provide
ambulance maintenance services; and
WHEREAS, the DISTRICT wishes to enter into an Agreement with Contractor for
maintenance of Monroe County Fire Rescue Type I ambulances including inspections, . .
preventive maintenance and unscheduled maintenance and repairs resulting from failure
or malfunction;
NOW, THERFORE, in consideration of the promises contained herein, the parties agree
as follows:
1. CONTRACT DOCUMENTS - This contract consists of the Agreement, the
CONTRACTOR'S submission response to the RFP "Attaohment A ': the documents
referred to in the Agreement as a part of this Agreement and all attachments. 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 shail
be March 1, 2007 through February 29, 2008. This Agreement may be renewed annually
for one (1) year terms, not to exceed three (3) renewals, subject to approval of the Fire
Chief of Monroe County Fire Rescue, the Office of Management and Budget and the
Monroe County Board of Governors Fire and Ambulance District 1. Renewals shall be
increased by the Consumer Price Index (CPl).
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3. . eONTRACT TERMINATION - This Agreement may be terminated for any reason by
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elihE'lr party on a 30~day written notice without cause. If the CONTRACTOR fails to fulfili
the terms of this agreement, or attachments, properly or on time, or othei\vise violates
the provisions of the agreement or of applicable laws or regulations governing the use of
funds, the County may immediately terminate the contract by written notice. The notice
shall specify cause. All finished or unfinished supplies or services shaU, 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.
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4. SUBJECT MA ITER OF CONTRACT ~ This Agreement is for performing scheduled
general and preventative maintenance of aU Monroe County Fire Rescue Type!
ambulances, and for unscheduled maintenance and repairs resulting from failure or
malfunction. See "Attachment B' for list of Ambulances. The amount of ambulances may
be added and deleted throughout the life of this contract by Monroe County Fire Rescue.
5. RATES - The hourly rate shall be $73.00 per man hour with no travel time or mileage
charge. The charge for conducting an ambulance inspection with each preventative
maintenance performed will be $265.00.
6. WORK SCHEDULE - Regularly scheduled inspections and preventative maintenance
shall be conducted at such intervals as are approved by the DISTRICT and by the
Manufacturer. The modular portion of the vehicle shall also be maintained in accordance
with the manufacturer's recommendations.
7. PARTS, FLUID AND LUBRICANTS ~ All parts, fluids, and lubricants used for
maintaining and repairing vehicles shall be supplied by CONTRACTOR and billed to the
DISTRICT not to exceed 25% over cost. For parts $200.00 and over, a copy of original
parts supplier invoices shall be attached to the bill. Contractor will be required to keep . .
all original parts supplier invoices available at request by County for spot checking and
auditing purposes.
8. ENGINE OIL AND FILTER CHANGE ~ CONTRACTOR shall complete drive train
lubrication and any other fluids and/or filter changes as recommended by the
manufacturer.
9. WEEKLY MAINTENANCE SCHEDULE ~ CONTRACTOR shall provide to the
DISTRICT a preventative maintenance schedule that can be performed weekly by
Monroe County Fire Rescue personnel.
10.MAINTENANCE INVOICE - CONTRACTOR shall provide an invoice at the
completion of each scheduled maintenance repair. This invoice shall contain at a
minimum, but not to be limited to, the following:
(a) Starting date and time
(b) Completion date and time
(c) Billable labor hours
(d) County Identification number of Apparatus serviced
(ef,Service performed
(f)'< Parts used and cost
(g) Name of service personnel
(h) Vehicle mileage
(i) Engine hours (if applicable)
A copy of this invoice shall be supplied to the Monroe County Fire Rescue within 30
days of the service.
11. COMMUNICA TION ~ CONTRACTOR shall be available to be reached twenty-four
(24) hours a day by telephone or paging device.
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~j 2. RESPONSE TO SERVICE REQUEST - CONTRACTOR shall have two (2) hours to
contact Monroe County Fire Rescue upon initial notification. The contractor shall ensure
that all maintenance ffi:ld repairs are performed in a timely manner in accordance with -:-
operational needs.
13. CERTIFICATION - CONTRACTOR shall provide evidence satisfactory to the
DISTRICT they are an Emergency Vehicle Technician (EVT) certified as Level III Master
Ambulance Technician and Automotive Service Excellence (ASE) certified Master
Medium/Heavy Truck Technician.
14. QUALIFICATIONS OF MAINTENANCE PERSONNEL - Unsupervised personnel
performing maintenance, repairs, adjustments, and related work on the DISTRICT
equipment shall be certified or experienced in the work to be performed. Personnel
performing work who are not certified or experienced in such work shall be directly
supervised (in person) by an individual with such certification.
15. INDEMINIFICATION - The Respondent to whom a Agreement is awarded shall
defend, indemnify and hold harmless the County as outlined below.
The Respondent covenants and agrees to indemnify, hold harmless and defend Monroe . .
County, its commissioners, officers, employees, agents and servants from any and all
claims for bodily injury, including death, personal injury, and property damage, including
damage to property owned by Monroe County, and any other losses, damages, and
expenses of any kind, including attorney's fees, court costs and expenses, which arise
out of, in connection with, or by reason of services provided by the Respondent or a~y of
its Subcontractor(s) in any tier, occasioned by the negligence, errors, or other wrongful
act or omission of the Respondent, its Subcontractor(s) in any tier, their officers,
employees, servants or agents.
In the event that the service is delayed or suspended as a result of the Vendor's failure
to purchase or maintain the required insurance, the Vendor shall indemnify the County
from any and all increased expenses resulting from such delay. The first ten dollars
($10.00) of remuneration paid to the Respondent is consideration 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.
This indemnification shall survive the expiration or earlier termination of the Agreement.
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 DISTRICT. "Attachment
C".
16. LOCATION OF WORK - This Agreement covers ambulances located throughout
Monroe County.
17. INSURANCE - During the term of this Agreement, the CONTRACTOR must keep in
force and affect the following insurance:
Worker's Compensation Statutory Limits
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Genera! Liability, including $300,000 Combined Single Limit
Premises Operation or -
Products and Completed Operations $100,aDD/person; Blanket Contractual
Liability $300, ODD/occurrence;
Personal Injury Liability $50,000 Property Damage
Expanded Definition of Property Damage
Vehicle Liability $100,000 Combined Single Limit or
(Owned, Non-Owned, and $50,000 per Person
Hired Vehicles) $100,DOO per Occurrence
$25,000 Property Damage
Garage Liability $300,000 Combined Single Limit Liability
$25,000 Garage Keepers Legal Liability
Monroe County shall be named as an Additional insured on the General Liability
and Vehicle Liability policies.
As required by "Attachments a'. "Attachments 0' are attached and incorporated into this. .
Agreement.
18. PAYMENTS - Payments shall be made by the DISTRICT pursuant to the Florida
Local Government Prompt Payment Act after the completion of the rendered services on
each vehicle and proper invoicing by the CONTRACTOR. All unscheduled maintenance
and repairs resulting from equipment failure or malfunction requiring service shall be.
billed by the CONTRACTOR at the applicable rates as specified in Section four of this
CONTRACT. The CONTRACTOR upon notification by the DISTRICT of an equipment
failure or malfunction requiring unscheduled maintenance shall, in a timely manner
investigate the problem and provide to the DISTRICT an estimate of the cost for repair
and vehicle downtime. The CONTRACTOR upon receiving authorization to proceed
from the DISTRICT shall effectuate such repair; upon completion of same the contractor
shall notify the DISTRICT of the outcome and actual cost. The DISTRICT shall issue a
separate purchase order for each occurrence of unscheduled maintenance and repair.
19. CONTINGENCY. Monroe County's performance and obligation to pay under this
Agreement is contingent upon an annual appropriation by the Board of County
Commissioners.
20:,SECTION HEADINGS - Section headings have been inserted in this Agreement as a
m.atter of convenience of reference only, and it is agreed that such section headings are
nofa part of this Agreement and will not be used in the interpretation of any provision of
this Agreement.
21. OWNERSHIP OF THE PROJECT DOCUMENTS - The documents prepared by
the CONTRACTOR for this Project belong to the DISTRICT and may be reproduced and
copied without acknowledgement or permission of the CONTRACTOR.
22. SUCCESSORS AND ASSIGNS - The CONTRACTOR shall not assign its right
hereunder, except its right to payment, nor shall it delegate any of its duties hereunder
without the written consent of the DISTRICT. SUbject to the provisions of the
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immediately preceding sentence, each party hereto binds itself, its successors, assigns
and legal representatives to the other and to the successors, assigns legal
representatives of 8u6ft other party.
23. NO THIRD PARTY BENEFICIARIES - Nothing contained herein shall create any
relationship, contractual or otherwise, with or any rights in favor of, any third party.
24. PUBLIC ENTITIES CRIMES - 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 contracts 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 CONTRACTOR
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 of the Florida
Statutes, for CATEGORY TWO for a period of 36 months from the date of being placed
on the convicted vendor list.
By signing this Agreement, CONTRACTOR represents that the execution of this .
Agreement will not violate the Public Entity Crimes Act (Section 287.133, Florida
Statutes). Violation of this section shall result in termination of this Agreement and
recovery of all monies paid hereto, and may result in debarment from DISTRICT's
competitive procurement activities.
In addition to the foregoing, CONTRACTOR further represents that there has been no
determination, based on an audit, that it or any SUBCONTRACTOR has committed an
act defined by Section 287.133, Florida Statutes, as a "public entity crime" and that it has
not been formally charged with committing an act defined as a "public entity crime"
regardless of the amount of money involved or whether CONUSUL T ANT has been
placed on the convicted vendor list. .
CONTRACTOR will promptly notify the DISTRICT if it or any subcontractor or
SUBCONTRACTOR is formally charged with an act defined as a "public entity crime" or
has been placed on the convicted vendor list.
25. MAINTENANCE OF RECORDS - 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
. Agr~ement or its authorized representatives shall have reasonable and timely access to
sLlch 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 DISTRICT or County Clerk determines that monies paid to
CONTRACTOR pursuant to this Agreement were spent for purposes not authorized by
this Agreement, the CONTRACTOR shall repay the monies together with interest
calculated pursuant to Sec. 55.03, of the Florida Statutes, running from the date the
monies were paid by the DISTRICT.
26. GOVERNING LAW, VENUE, INTERPRETATION, COSTS, AND 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.
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in the event that any cause of action or administrative proceeding is instituted fot' the
enforcement or interpretation of this Agreement, DiSTRICT and CONTRACTOR agree -
that venue shall lie in-= Monroe County, Florida, in the appropriate court or before the
appropriate administrative body. The Parties waive their rights to a trial by jury. This
Agreement is not subject to arbitration.
27. 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 DISTRICT 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.
28. A TIORNEY'S FEES AND COSTS - The DISTRICT 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, courts costs, investigative, and out-of-pocket expenses in appellate
proceedings. 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.
29. BINDING EFFECT 8 The terms, covenants, conditions, and provisions of this
Agreement shall bind and inure to th~ benefit of the DISTRICT and CONTRACTOR and
their respective legal representatives, successors, and assigns.
30. 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 action, as required by law.
31. CLAIMS FOR FEDERAL OR STATE AID - CONTRACTOR and DISTRICT 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,
grabt proposals, and funding solicitations shall be approved by each party prior to
sublnission.
32.ADJUDICA TION OF DISPUTES OR DISAGREEMENTS - DISTRICT 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 15 days after the first meet and confer session,
the issue or issues shall be discussed at a 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.
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33. COOPERATION ~ In the event any administrative or legal proceeding is instituted
against either party relating to the formation, execution, pelforrnance, or breach of this -
Agreement, DISTRICT- 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. DISTRICT and CONTRACTOR specifically agree that no party to this
Agreement shall be required to enter into any arbitration proceedings related to this
Agreement.
34. NONDISCRIMINATION - CONTRACTOR and DISTRICT 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. CONTRACTOR or DISTRICT agrees 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 use 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 sqle, rental or financing of housing; 9) The Americans
with Disabilities Act of 1990 (42 USC s. 1201 Note), as maybe amended from time to
time, relating to nondiscrimination on the basis of disability; 10) Monroe County Code
Chapter 13, Article VI, which prohibits discrimination on the basis of race, color, sex,
religion, 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.
35. COVENANT OF NO INTEREST - CONTRACTOR and DISTRICT covenant that
nertrer presently has any interest, and shall not acquire any interest, which would
cqnflict 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.
36. CODE OF ETHICS - DISTRICT agrees that officers and employees of the DISTRICT
recognize and will be required to comply with the standards of conduct for public officers
and employees as delineated in Section 112.313, Florida Statutes, 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.
37. NO SOLICITATION/PAYMENT. The CONTRACTOR and DISTRICT warrant that, in
respect to itself, it has neither employed nor retained any company or person, other than
"
7
~ .,.
~
>> .>' ....... _ '!"'. ---
a bona fide employee worJ,ing solely for it, to solicit or secure this Agreement and that it
has !lot paid or agreed to pay any person, company, corporation, individual, or flnn, -
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 DISTRICT 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.
38. PUBLIC ACCESS - The CONTRACTOR and DISTRICT shalf 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
Statutes, and made or received by the CONTRACTOR and DISTRICT in connection
with this Agreement; and the DISTRICT shall have the right to unilaterally cancel this
Agreement upon violation of this provision by CONTRACTOR
39. NON~WAIVER OF IMMUNITY - Notwithstanding the provisions of Sec. 768.28,
Florida Statutes, the participation of the CONTRACTOR and the DISTRICT 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 DISTRICT be required to contain any provision for waiver.
40. 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 public agents or employees of the DISTRICT, when performing their
respective functions under this Agreement within the territorial limits of the DISTRICT
shall apply to the same degree and extent to the pertormance of such functions and
duties of such officers, ag~nts, volunteers, or employees outside the territorial limits of
the DISTRICT.
41. LEGAL OBLIGATIONS AND RESPONSIBILITIES - on-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 pertormance thereof by any
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
COi1strued as, authorizing the delegation of the constitutional or statutory duties of the
DISTRICT, except to the extent permitted by the Florida constitution, state statute, and
caSe law.
42. NON-RELIANCE BY NON-PARTIES - No person or entity shall be entitled to rely
upon the terms, or any of them, of this 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 CONTRACTOR and the DISTRICT agree that neither the
CONTRACTOR nor the DISTRICT 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.
..
8
<."'
-
",..... ~~._'-nn-
43. ATTESTATIONS AND TRUTH fj\! NEGOTIATIO!\! - CONTRACTOR
execute such d(jcume~ts as DISTRICT may reasonably require, including aJ Public Entity -
Crime Statement, an Ethics Statement, and a Drug-Free VVorkplace Statement
Signature of this Agreement by CONTRACTOR shall act as the execution of a truth in
negotiation certificate stating that wage rates and other factual unit costs supporting the
compensation pursuant to the Agreement are accurate, complete, and current at the
time of contracting. The original contract price and any additions thereto shall be
adjusted to exclude any significant sums by which the agency determines the contract
price was increased due to inaccurate, incomplete, or concurrent wage rates and other
factual unit costs. All such adjustments must be made within one year following the end
of the Agreement.
44. 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 ihis Agreement.
45. 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 and any of the parties
hereto may execute this Agreement by signing any such counterpart.
//6~~~~i~ W~EREOF, each P:3rty hereto has caused this Agreement to be execu~ed
f~~</ ,ee~}(~~~~~:~~~on:zed representative.
j/.:-~.:.-:(' c;>".,;O{_\\ ~~Y-~W{i-r:\'~s.l<-}C ",\;\
~~~f~~pf.~~)[)L. KOHLAGE, CLERK
......li!/iJ!1lJ~~,-j!(~ --
~uty Clerk
CONTRACTOR
WITNESS: 711=-----
Print
Print Name and Title
Date: d ,) I/o{
MONROE COUNTY ATTORNEY
APPRO\t D AS TO FORM:
J ~
'1'tA -~
SUSA\ M. GRIMSLEY
" Da~~H~r~NJ ;~~u~~r~rrORNeY
~~
9
,~
~
-"" .,~ <?' ~ 1'<-, .~
-: ~ij~WJ]S~~fl1VJH\B 1M~~~@li\ll~~ fF€J~&0~ .
mH~r:j {~c~r:jr!?'S\E: Roy Khanna
~ ~~ -~~ " "-
1033 Va1encia Road
~~
Key Largou FL 33031
Telephone Numbers: (3(5) ~53-1646 O:f:fice/Fa~ c,
AU amouWl~ mM~ be mBti~ftil arrlld hll rrllumbww fCIl'i1'nGt 8rtJ ~$e of a.! fl:omli~t b~twee!l1l
t!h~ ~@l!j<<!lt Rall w@wa!Eii ~@" thli tailiffi@UU1f1: 6f1l1 h'ilMm~r$, ttn~ .t!lMil)Unt UfIlI w@wd5J lih&jJ~6
controU,
U St_ that 9 &jJm I!ftI!B&h@1I'~€tJ ~@ iIlubmfit Wnis pr@p@.o.
Scheduled Maintenance for Preventative Maintenance:
l~ouriy Rate: $ 1:LOO _.~ ...-;..;:: ~
Charge for oonducting amtuJlance inspection with each preventative maintenai1C&
performed:
Charge for Ambulance Impaction: $ 265 Q 00
UnschedWed! Maintenance Rel:lulting from equipment msYilUnction or failure requiring "
~!oo:
Hourly Rats $ 7:=L 00 ~
Parts t@ bs marked up by: 25 _ % rover cost to the Contrewtor
f,/. ~ b
STATE OF . v-~ !
~. ~. c ' Signature of Bidder) 801.19 O~in2r
COUNTY OF .t'<-l;t.. t:::>e-~'-i-..Jt- :t2-2?-06
Date
PE~SOf'JAll Y APPEARED BEFORE ME, the undamlgned authority,
i
< ' . Ho 'if Kbanq"a 'l;1.Jho. afte4f first being swom by me, (nartlS ow "
1000Mdu/lJl.lgn!ngj ~ oIiJ!'!<llI-"" !n 100 SIlElOO PMvldad e"- 00 this
.. -I- .
j ~ ~L. ,20_" I" ,
7i?<L.:2 L 1 ....~ ~ -..-
My mission expires'~ I .
NOT ~,;YItYl:I.. j '7 iJ ,
DWiNDAIL w~
p ~NjjD!l4I~
MY ~J!S: Iuly 17.:IDll9
'S~- = Attachment A (1 of 1)
.'
~ ~l
~
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COOJR:lEI'IT F/ilOI'<TJROE Oe>>u.JNT1f FInR:E JRlli:SOlm
Al'V[!l1U1LAGICiES
-= -:-
~~diikP
VEHiCLE Pli'oml::i@fi' <Ca~~
BIG COPP1TT Ambulance 2FZAXFCS76AV92511 5098 Prime R~9
2001 FORD
BIG COPPITT AMBULANCE 1 FDXF46F81EC33365 1416-208 Backup R-109
200"j FORD
CUDJOE AMBULANCE 1FDXF46F61 EC33364 1416.207 Prime R-l1
2002 FORD
BIG PINE AMBULANCE 1FDXF46F22ED14878 1416-215 Prime R-13
2001 FORD
CONCH KEY AMBULANCE 1 FDXF46F41EC33363 1416-206 Prime R-17
1999 FORD
TAVERN1ER AMBULANCE 1 FDXF46F9XEB99283 1416-120 Prime R~22
1997 FORD
TAVERNIER AMBULANCE 1FDLF47F8VEA18040 1416~O80 Backup .;"'J?12~
USAR VEHICLE 1994 F 450 FORD 1 FDLF47M8REA52323 1417-151 USAR
'1997 FORD F450
TRAINING AMBULACNE 1FDLF478VEA73393 1416-059 BLS R-39
Attachment B (1 of 1)
- ~
- ....... -!!'.........
-: SUB5\,~ISS!ON RESPOIi'~SE FORJIfi -;-
Respondent's ~Jarl'1s and Address: Roy Khanna
>44".."'..""'===-""""......
1033 Valencia Road
~
Key Largo, FL 33037
Telephone Numbers: (305) 453-1646 Office/Fax
All CllMount.$ must be written and in number format, In case of a conflict DeW/san
the amount in wordS and the amount in BnJJmbers. the amount in words shall
control.
I State that 0 am Sluthoriztld to submit this pr@posal.
Scheduled Maintenance for Preventative Maintenance:
Hourly Rate: $ 73.00 , . .
Charge for conducting ambulance Inspection with each preventative maintenance
performed:
Charge for Ambulance Inspection: $ 265aOO
Unscheduled Maintenance Resulting from equipment malfunction or fedlure requiring
service:
Hourly Rate $ 73 a 00
Parts to be marked up by: 25 % over cost to the Contractor
STATE OF f-' I ~L,-
~, '/!x Sole Own.:!r
COUNTY OF -r~,-l a.. ~~~,L 12-Z7-06
Date
PERSONALLY APPEARED BEFORE ME, the undersigned authority,
Attachment A (1 of 1)
24
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,~..""
,~ . ,..~ ~-!,,-..~
~1J20~~ROE COijJ!I'~1Jlt9
~ RISK MANAGEft.1Ef'.,tT -
POliCY AND PROCEDURES
CONTRACT ADMn'USTRAnOt~
MANUAL
lrildemroifieation and Hold Hannles$
for
Other Contractors and Subcontractors
The Contractor 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 injurl, 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
or omission of The Contractor or its Subcontractors in any tier, their employees, or . .
agents.
In the avent the completion of the project (to include the work of others) is delayed or
suspended as a result of the Contractor's failure to purchase or maintain tne required
insurance, the Contractor shall indemnify the County from any and all increased
expenses resulting from such delay.
The first ten dollars ($10.00) of remuneration paid to foe Contractor is for the
indemnitk::ation 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.
~~-
Bidder's Signature So1e Owner
12-27-06
-r..
Date
res
Attachment C (1 of 1)
. . 26
,~. t
>-
POA _ fl._ .......
MJA1~AGEk\m!:t~T
. - POUCY AND PROCEDURES -
CONTRACT AD~"NISTRATDON
MAt<lUAl
Gen@lf'allnsl!Ill'ance Requirements
for
Other Contractors and SubcontrCilctors
As a pr€H13quisite of the work governed, or the goods supplied under this contract
(including the pre-staging of personnel and material). the Contractor shall obtain, at
his/her own expense, insurance as specified in any attached schedules, which are made
part of this contract. The Contractor will ensure that the insurance obtained will exl:end
protection to all Subcontractors engaged by the Contractor. As an alternative, the
Contractor may require all Subcontractors to obtain insurance consistent with the
attached schedules.
The Contractor will not be permitted to commence work governed by this contract
(including pre-staging of personnel and material) until satisfactory evidence of the
required insurance has been furnished to the County as specified below. Delays in the . .
commencement of work, resulting from the failure of the Contractor to provide
satisfactory evidence of the required insurance, shall not extend dea.dlines specified In
this contract and any penalties and failure to perform assessments shall be imposed as
if the work commenced on the specified date and time, except for the Contractor1s failure
to provide satisfactory evidence.
The Contractor shalt maintain the required insurance throughout the emire term of this
contract and any extensions specified in the attached schedules. Failure to compiy with
this proviSion may result in the Immediate suspension of all work until the required
insurance has been reinstated or replaced. Delays in the completion of work resulting
from the failure of the Contractor to maintain the required insurance shall oot extend
deadlines specified in this contract and any penalties and failure to perform assessments
shall be imposed as if the work had not been suspended, except for the Contractor's
failure to maintain the required insurance.
The Contractor will be held responsible for all dedUCl:ibles and self insured
retentions that may be contained in the Contractor's Insurance policies.
The Contractor shall provide, to the County, as satisfactory evidence of the required
insurance, either:
in. Certmcateof Insurance - on file
or
0 A Certmoo copy of the actual insurance policy.
The County, at its sole option, has the right to request a certified copy of any or aU
insurance policies required by this contract.
All insurance polieles must speCITy thai: they are not subject to cancellation, non-renewal,
material change, or reduction in coverage unless IE! minimum ofthirty (30) days prior
notification is given to the County by the insurer.
Attaohment D (1 or 8)
27
~
.J
""~ - t'G ........
and/or shan 8.S
relieving Contre.Gmf frorn any liability Oi' obligation assumed under this contract 01'
imposed by law.
The Monroe County Board of County Commissioners, rts employees and officials will be
included as flAdditional insured" on all policies, except for Workers' Compensation.
Any deviations from these General Insurance Requirements rnust be requested in
writing on the County prepared form entitled l1Request for Waiver of InsufCllfice
RequiremeD1isl1 and approved by Monroe County Risk Management.
. .
Attachment D (2 of 8)
28
"."
~
.~ ,...~ - ~~ -..,..
H~~SUIFfA~'~CE ~aE~tBT'S 81 A T~~1E~~T
=~=::-~-.sr,-~-,p "'=~-==~^"
. - -
i have reviewed the above requirements with the bidder named below. The following
deductibles apply to the corresponding policy.
POLICY OEDUCTIBlES
1-1 C- L y\..!~ 7)/i SoO
Uabllfiy policies .r" \/cOccurronoo _ Claims Ma~l'l_) \
,...~ , l?L/!<- /LM - ~-'- {, b
-<..J D h VL .s; OA. J Itl ' /I UL- X:t S
Insurance Agency Sigt:\tur1 . .
,---",/
BIDDERS STATEMENT
I understand the insurance that \i'llill be mandatory if awarded the contract and will
C<lmply I~^~ Ihe requlremems.
~~ 12-27-06
-~ Bid~o1e Owner Signature
INSCKLST
Attachment D (3 of 8)
. . 29
~
d,c "". -~.-.....
-; -
GENERAL UABiUTV
IN$URAt~CE REQUIREMENTS
fOR
CONTRACT
BETWEEN
MONROE COUNTY. FLORIDA
AND
Prior to the commencement of worl( governed by this contract, the Contractor shall
obtain General Liability Insurance. Coverage shall be maintained throughout the life of
the contract and include, as a minimum:
0 Premises Operations
0 Products and Completed Operations . .
0 Blanket Contractual Liability
0 Personal Injury liability
0 Expanded Definition of Property Damage
The minimum limits acceptable shall be:
$300,000 Combined Single Umit (CSL)
If split Jlmits are provided, the minimum limits acceptable shall be:
$100,000 par Person
$300,000 per Occurrence
$ 50,000 Property Gamage
An Occurrence Form policy is preferred. If coverage is 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 reponed should
extend for a minimum of twelve (12) months following the accaptance of work by the
County.
The Monroa County Board of County Commissioners shall be named as Additional
insured on ail policies issued to satisfy the above requirements.
Gl1
Attachment D (-4 of 8)
30
~
,:"
" -f"-' ~ ""-' _.....
~ VEHICLE LIABILITY -;
~NSURA~3CE REQUHREMEt,JTS
FOR
CONTRACT
BETWEEN
fJBONROE COUNTY. FU.:.lRIDA
AND
Recognizing that the work governed by this contract requires the use of vehicles, the
Contractor, prior to the commencement of work, shall obtain Vehicle Liability Insurance.
Coverage shall be maintained throughout the life of the contract and include, as a
minimum, liability coverage for:
0 Owned, Non~Owned, and Hired Vehicles . .
The minimum limits acceptable shall be:
$100,000 Combined Single limit (CSL)
If split limits are provided, the minimum limits acceptable shall be:
$ 50,000 per Person
$100,000 per Occurrence
$ 25,000 Property Damage
The Monroe County BOEl.rd'of County Commissioners shall be named as Additional
I nsured on all policies issued to satisfy the above requirements,
VL1
Attachment D (5 of 8)
31
loA
~
.... - "'~ -......
-: GARAGE UABU..rrV -
ijNSURANCE lREQU~REMENTS
FOR
CONTRACT
BETWEEN
MOr"ROE COUNTY, FLORIDA
AND
.
Recognizing that the work governed by this contract involves the servicing andlor repair
of CountyMO\lmed vehicles. the Contractor will be required to purchase and maintain a
Garage Policy to include Garage Liability Insurance extending to vehicles, owned or
leased by the County, left with the Contractor for servicing, repair, storage, or
safekeeping. Coverage should include, as a minimum:
Premises and Operations Liability . .
0
0 Vehicle Liability
0 Contractual Liability
0 Prooucts and Completed Operations liability
0 Garage Keepers' legal liability, to. include:
Comprehensive and Collision
The Garage Keepersl Legal Liability shall extend to an County-owned/leased vehicles in
the care, custody, and control of the Contractor.
The Contractor's insurance shall be primary to any coverage maintained by the County.
The minimum limits acceptable shall be:
$300,000 Combined Single limit (CSt) for liability
$ 25,000 Garage Keepers! Legal Uability
The Monroe County Board of County Commissioners shall be named as Additional
Il1sufed on all policies issued to satisfy the above requirements.
GK1
Attachment D (6 of 8)
32
~ :1
~
~~,;;- "". - '!'<. --
-: WORKERS. COMPEt~sAnON -
DIMSU~N<&ClE REQU~REMEr~lS
!FOR-
CONTRACT -
BETWEEt4
MONROE COUNTY, !FLORIDA
AND
~.
Prior to the commencement of work governed by this contract, the Contractor shall
obtain Workersl Compensation Insurance with limits sufficient to respond to Florida
Statute 440.
In addition, the Contractor shall obtain Employers' liabiltlY insurance with limits of not
!ess than: . .
$100,000 Booily injury by Accident
$500,000 Bodily injury by Disease, policy limits
$100,000 Bodily Injury by Disease, each employee
Coverage shall be maintained throughout the emire term of the contract
Coverage shall be provided by a company or companies authorized to transact tn.!sinesf$
in the state of Florida.
If the Contractor has been approved by the Florida's Department of Labor, as an
authorized self-insurer. the County shall recognize and honor the Contractors status.
The Contractor may be required to submit a Letter of Authorization issued by the
Department of labor and a Certificate of Insurance, providing details on the Contractors
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.
WC1
Attachment D (7 of 8)
"',..
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cc "",, - '!"-. ......
-= ~~[lJVJest For W~iveg' -
of
InSUD"anCe Requirements
It is requested that the insurance requirements, as specified in the County's Schedule of
Insut'ance Requirements, be waived or modified on the following contract
Respondent: Roy Khanna
Maintenance of fire rescue ambulance includiu9
Contract for: inspections preventative maintenanceq and
unfi:~h"",dul en m",i nt:PlI'llanC'E" aDd repairs re..s.1,lLIJ:ing
Add fAct t from. failure or malfunctiouD
ress (I . aspon en:
1033 Valencia Roadq Key Lar~oq FL 33037
Phone: (561) 312-9792 Cell (305) 453-1646 QffJcelEax
Scope of Work: St.ated Above . .
Reason for Waiver: I perform maintenance and repairs on
ambulances on site (garage liability waiver)
u
Policies Waiver
will apply to:
Signature of Respondent:~ ~
Sole Owner . .'" J Not Approved
Approved -p- '.'
. I S'\ ib
Risk Management: ~1\l . ". JJJJVLft.. ". / ~
Date: t..- d~.v 7
County Administrator appeal:
Approved Not Approved
Date:
Board of Count'\} Commissioners appeal:
Approved Not Approved
Mealing lJate:~ -. 12-21-06
RelIPOndent.: ole o~er SiGNATURE
Attachment D (8 of 8)
34
-
"... _.0:. Yo-
t.JJON~COl!LUSgON AfFIDAVmT
-c
I, Roy 'Khanna , of the
city of Key Largo according to law on my oath,
and under penalty of perjury, depose and say that;
1) I am Roy Khanna , the bidder making
the Proposal for the project described as follows:
~'(aintenance of the Monroe County Fire Rescue T:l}Je I Ambulances
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;
5) The statements contained in this affidavit are true and correct, and made "Vith
full knowledge that Monroe County relies upon the truth of the statements contained in
this affidavit in awarding contracts for said project.
STATE OF ,F/ t.-uJ ~
.~ . 3~ Owner
COUNTY OF ~,-,I iw. 12-27-06
. Date
PERSONALLY APPEARED BEFORE ME, the undersigned authority,
Roy Khanna who, after first being sworn by me, (name of
individ~alSigning) affiXed\h:S/~er sig~81ture in the space :r~Vided above on this
. .. . ~ " da~?f 4r-c{;..,~~ &'L , 20 (J <r,. .
~, i /2i. (;/
< _~~ 1:...-, _ A.J-e :::.?
My commission expires: 'J ~ I \.NI>~AH;i"'PJ.V<;(,'\t~~)
NOTARY PUBLIC ' 17 f iI"j C' BRENDA It WEBB,
_ MY COMMISSION II D041&!l9:\
~ =' EX!llRES: My 17,2009
OMS - MCP FORM #1 ~Aln' fl.~~",=-Ctl.
Attachment E (1 of 4)
, '
35
-
.,.u _ r::- .......
~UBltiC ENTfiTY CRiME STi..\TEMENT -
"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 CONTRACTOR 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."
By executing this fOiTll, I acknowledge that lImy company is in compliance with the
above.
STATE OF ~ c-t-J '---' ~ . .
COUNTY OF ?~^" J (Signaturem Bidder) Sole Owner
p 'CLVL 12-21-06
Date
PERSONAllY APPEARED BEFORE ME, the undersigned authority,
Roy Khanna who, after first being sworn by me, (name of
individual signing) affixed h Iher signature in the space provided above on this
,yL L , 20 {.J &
d 1 day of e.....;....
b~ 72 tJd0
My commission expires: ~ !
NOTARY PUBLIC 7!7 () /
~ llilENlJA Jl. WEBll
MY OOMMlSSlt)l~ I! Dl)lI~S
:f iOO'mES: Jcly 17,2OO!>
~ R.Nci2fi~.1ill~eo.
~$~ '"
Attachment E (2 of 4)
36
..,
~
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,..... _..-c_......
-= DRUG~FREE WORJ\:PlLACE f'ORi\J -
The undersigned vendor in accordance with Florida Statute 287.087 hereby certifies
that
Roy Khanna
(Name of Business)
1. Publish 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. Inform 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. Give 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 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.
s. Impose a sanction on, or require the satisfactory participation in a drug abuse
assistance or rehabilitation program tf 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
tne above r~i~ements.
_ \\69--= .,.'"''''''~ ~'"
\J Bidder sSignature Sole Owner
12-27-06
Date
OMS - Mep FORM #5
Attachment E (3 of 4)
37
~
,",,;J: -- ~~. ......
..
81 f~ lLElli1et,f'r ljJ rUJER "I
~ MONROE COl!lNTV~ FLORIDA -:-
ETHICS CLAUSE
Roy Khanna warrants that he/it 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. 1O~1990. For breach or violation ofthis 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 otheiWise recover, the full
amount of any fee, commission, percentage, gift, or consideration paid to the former
County officer or employee.
~~.-
So1e ~mer (Signature)
Date: 12-21-06
. .
n p'
STATE OF t--Lt A ~
'R(~ J
COUNTY OF .D-eG~
PERSONALLY APPEARED BEFORE ME, the undersigned authority,
Roy Khanna who, after first being swom by me, affixed
hiS/her ~
signature (name of individual signing) in the space prOVided above on this ;) 7 -11-
day
of
i:-e-.....-la-e.-t. , 20 () {P.
/~ ~(?.. I- '<-!.e~ 0 BRENDA R. VlEBa'
NOTARY PUBLIC
My commission expires: I;' 1/0 ') . MVW__IDN'Doi~
~:;f ~: July 17.2009
~Amr i'l. Nalsyrnz-m I\uCA Co.
OMS ~ MCP FORM #4
Attachment E (4 of 4)
38