01/20/2010 AgreementDANNY L. KOLHAGE
CLERK OF THE CIRCUIT COURT
DATE: January 28, 2010
TO: Judy Clarke, Engineering
Public Works Division
FROM: Isabel C. DeSantis, D.C. , !v
Y"
At the January 20, 2010, Board of County Commissioner's meeting the Board granted
approval and authorized execution of the following:
Design/Build Contract between Monroe County and Structural Preservation Systems,
LLC for the Geiger Creek Bridge Repair Project. Enclosed is a duplicate original for your
handling.
Should you have any questions please do not hesitate to contact this office.
cc: County Attorney
Finance
File
Geieer Creek Bridee Reoair Desi2ll Build Proiect
Section 00500
Standard Form of Agreement Between
Owner and Design/Builder
Where the basis of payment is a STIPULATED SUM
AGREEMENT
Made as of the 20" day of January in the year of Two Thousand and Ten.
BETWEEN the Owner:
Monroe County Board of County Commissioners
1100 Simonton Street
Key West, Florida 33040
and the Design/Builder:
Structural Preservation Systems, LLC
2001 Blount Road
Pompano Beach, Florida 33069
For the following Project:
Geiger Creek Bridge Repair
Design Build Project
Scope: The Scope of Work shall include, but not be limited to, all work shown and listed in the Request
for Proposal (RFP), the DesignlBuilders Technical Proposal and Bid Price Proposal. The Design/Builder
is required to provide a complete job as contemplated by the RFP, the Technical Proposal, Bid Price
Proposal, all drawings, specifications and submittals, which are a part of this Agreement
Oversight for Owner is:
MACTEC Engineering and Consulting, Inc.
3100 Overseas Highway
Marathon, Florida 33050
The Owner and Design/Builder agree as set forth below.
.:t
oS' ~.,.,
?eC"")~ _ .......
-,0 r- ~ r--
C:) rr1 ~ k !!J
f ~q ~::.:~;1 -< :e '-"
J(") ~r- .. .."
1212.&(9 srANDARDFmM<FAGREEMENTBEIWFENOWNFR.AND~ (~~ ~1 0
~.;.. =0 a .::0
~1' + r- ~ .::0
-<' ('J :r: :z ".,
~1' :-I ~ 2it CJ
..-~_ C) -.r 0
. rt1 "z:- ~
W _~
Geier Crerl: Bricl2e RqJair ~DII Build Proiect
ARTICLE 1
TIle CODtnet Doauaea"
The Coanct Dr:,.~...~. CODSist oftbis Apeemad, Cortditions of the CoIdr8ct (GmenI, supp~.f _ other
Coaditioas), the Request for Propos8Is (RFP), the Desip/BuiIdcn TechaicaI ~ BieI Price ~
DnIwiDp. ~ - Submitblls, IDsunnce bqDiraneats IIld Documems, MiIestoDe SdleduIe, ~ddead8
issued prior to cxecutioD oftbis Apeemmt, other cIoct.weuts listed in dIis Agreement _ _ issued after
execatioa of tbis Apeemeat. These bill the CoIdmct, _ 8Ie . fidIy . part of the COIdr8ct . if ~ to this
Apeemeat or repeIIIed herein. The CoIdr8ct ..~ the entire IIId intepBted IIJPamad betwee4 the )Bties
brn:to IIId sopersecIes prior aeaotiIIIious, ~.'~I:oas or apeanmts, either written or cxaL
ARTICLE 2
TIle Work of tIlis Contrad
The Desip/BuiIder sbaII execute the entire Work daaibed in the Coanct ~ except to the exteDt
~ iadiaded in the Coanct Docamads to be the respcmsibiIitJ of others, or as follows:
Scope of Work . specified in the Request for PmposaI, the Design Build Yum's TedmiCIII Propos&IIIId
Bid Price PmposaI for tbis project IIId in SpecificIdion SectioD 00300. The CODhId ~11I.'~ the entire _
exclusive ~ bebw~ the 0wDer IIId the DesiplBuilderwith le&.~ to the GeIpr Creek...... Repair
DeIIp .... Pntjed.
ARTICLE 3
Date of CO...eJleeJlleat ..d Sabstaatial Completioa
3.1 The elide of ~~ is the elide fiom which the Coanct TIlDe ofPlraplpb 3.2 is masuml,-
shaD be the elide oftbis Aan=emeat, . fiat wriam above, DD1ess . cIiffaad elide is sbded below or provision is m8de
for the elide to be fixed in . DOtice to pmceed issued by the Owner .. sbded in SecIiaa 00350, Mi1esIDDe ~Ie.
UuIcss the elide of OI)DI"~ is esbIb6sbed by . DOtice to proceed issued by the 0wDer, the Desip/BuiIder
shaD DDIify the 0Imer, tbroup the Director ofP~ Services, in writiD& DOt less dim five clays before
colllllleDCia& the Wort. TIle date 01 ~eM .... he tlte date IpeCiIIed .. tile Natb to Proeeed, ......
tD tile ......,.......
3.2 The DesiplBaiIdr.:r shaD dieve Subsbmtia1 Completion of the entire Work DOt later dum One IIImdred
IIId Twady (120) Days after the Date ofCommCllCaDalt, subject 10 adjustments of the CoIdr8ct TlDle as provided
by the Coatmct ))o.~...~
UQl1lA4mDA4K4GEf
LiqaidIIIed d.m..,. will be baed 011 the Sn.......... Completion Dale for ... WOJt, modified by .n IIppIOYed
~._-. in time . set forth by the Dirrdor ofP~ Service's sigmdme of IppIDYIII OIl the CatificaIe of
Sn.......1 CompIetioa. The liqaidlded ........ tllble below sbaII be utilized to ~UJiue the IIIDOIIIIt ofliquidated
d.~8N
CONTRACf AMOUNT
Under SO,ooo.OO
$50,000.00-$99,999.00
Sloo,ooo.OO-499,999.oo
SSOO,ooo.O ... Up
FIRST
IS DAYS
$5O.GOIDA Y
IOG.GOIDA Y
2OO.GOIDA Y
SOD.GOIDA Y
SECOND
IS DAYS
Sloo.OOJDAY
2OO.00JDA Y
SOO.GOIDA Y
I,OOO.OOIDA Y
31ST DAY at
1HERRAFIER
$2S0.GOIDA Y
7S0.GOIDA Y
2,OOO.GOIDA Y
3,500.GOIDA Y
The Desip/Bailder's recovery of d..ll~ _ sole remedy fbr 811)' delay caused by the 0Imer sbaII be lID
~ of time 011 the COIdr8ct.
11/2&OJ SfANlMIDRIN(F~~OWtBAN)J:JKJNBJI1Bl (1ev(B) 00500-2
GeiRm Creek Bri_ hD8ir DesUm Build Pmiect
ARTICLE 4
CODtract S..
4.1 The CJWDCr sid pay die DesipIBuiIcIer in current fimds for die DesiplBuilclcl's performance of die
COIdI8ct. tbr die Geller Creek BrIdp Repm DeIIp .... ....ject the I1IDl ofElcld a........ Sevs.d~e
'111---' l&e B_dnd EIptJ 11Ine ad Zerafl. Dolan (S871,913.11) subject to additioDs IIIld cIeductioDs
. provided ill die CoDIr8ct Documeats
4.2 The Coatr8ct Sum is b8sed upon die followin& aI~aMdes, if8ll)', whidl.e desc21Dec1 in die COIdr8ct
Documents IIIld ." hereby ~ by die 0wDcr: DOlle
43 Unit prices, if8ll)', 8re. follows: As specified in BieI Price Proposal.
ARTICLE 5
Proal" Paymeats
5.1 BIIIeCI1IJXRl App1icatioDs for Paymeat submitted by the DesiplBuDder to die Director of"P~
Servic:es, IIIld upon IIppIOY8I tbr paymaIt issued by the DirecIor ofP~~ Services, die Oner sldlllllb
propeII....J..... 0Il8CCDllllt ofdle COIdr8ct Sum to the Desip/BuDder.. provided below IIIld eIsewIae in.dIe
CoDIr8ct I)o.~,u~
5.2 The period covered by -. Applicldioa for paymad sid be ODe ~ IDOIIIh eadiDg em die I8st day of
1be IIIOIdII, or . follows:
53 Paymmt wiD be made by die 0wDrI' ill acconImce with die F10ricIa Loc8I Gowmmeat Prompt Paymeat
Act 211, Florida StIItIItcs.
5.4 E8ch AppIiadioD tbr Paymmt sid be baled upon die ScbecIuIe ofVIIIues submitted by die DesiplBuiIder
in acconIance with the Coatr8ct Documads. The SdledP1e of V"" sbIII aIIocIde die adire COIdr8ct Sum 8IDODI
die nrioas podioDs oldie WOIk IIIld be pepired in such bm md ~ by such dID to .~~ its
8CCIII1IC)' . die OwDrI'may requiIe. 1bis schedule, DDleII objecad to by die Owner, sid be used 81 . basis for
nMewiDa die DesiplBuiIder'l AppHCIdioas tbr Paymeat.
5.s App1icadioDs for Paymmt sbaII incIiade die ~ of completion of -. portion ofdle Work as of the
mcl ofdle period covered by die AppIicldioD for Paymeat.
5.6 Subject to die pmvisiaDs ofdle COIdr8ct _ the 8IIIOIIIIt of -. progras P-.J...d sbaII be
~. follows:
5.6.1 T_ dad portion of the COIdr8ct Sum pmperIy allocable to completed Work as cIetamiDed by
multiplyiDs die ~ campIcIioa of -. portion oldie WOIk by die sbIIe of the tDIa1 COIdr8ct Sum
aIIoCIIIed to dIId portion ofdle WOIk ill die Schedule of Values, less p4Ai-. of.Jm.pera.t (10%).
PaIdiDg fiDa1........intIfina of cost to die Owner of .-1.-.- ill the WOIt, ....,...& DOt ia dispute may be
included in 8pp1icatioDs for Paymcat. The 8IIlO1IIIt of credit to be aI10wed by die DesiplBuiIder to die
0wDcr for . deIetioD or chmp wbich ....... in . net decICIIC iD die Contmct SIIID sid be die net cost to
die Owner, less 0ndIad, Profit .... Docummted CollI ~&d prior to die a-ae Request, . iDdiaIIr>d
ia die OOIrespoot1inlliDe itrm in die ~oved ScbedaIe of V..... tbr.....1iDe itrm . ~~ by die
Director ofll~ Scnices. WIIIIl both .dditinn. .... cndiIs cowriDa ...... WOIk or ...w~
8m iDvolved in . cb-ae die aIIow...c for ovabeId IIIld profit sid be fi&amd 011 the ... of... iDcrc8e,
if my, with respect to dIId dI8ap.
5.6.2 Add dIId portion ofdle COIdr8ct SlDD pmperIy aIIoc8bIe to IIIIIII:DIs md ~":I_.-=--d deIM:red 8IlCl
suitBbly IIDred III die site tbr sabsequeaI iDcoJporlllioD ia die completed COIIIIracIioIl (or, if IIpIIIOWXI in
8dvmce by die 0wDrI', saiblbly IIDred off the site 1It.1OCIItian Ipeed upon in writiD&).1ess letaiMp of
Isl percmt (10%):
11I1&OJ srAHlMIDRIN<F~J3EIWIrNOWtBAM)~ (tev(ll) OOD)-3
Gei2er Creek Brid2e Rflftllir 1'Bi... Build Proiect
5.63 SubIrBct the 1188f'" ofprevious paymeats made by the Owner; mcl
5.6.4 SubIrBct 8IIIOIIIdI, if my, for which the DireckJr ofP~ Services 01' ArdIitect... withheld
01' mdlified. CcrtifiClde for Paymeat . puvided ill ~.... 9.5 of the GeacnI coacIitioDs. .
5.7 The pro&aCSl payment 8IIlO1IIIt ~inM in IICCOIdaDce with P8r8pBph 5.6 sbaI1 be furdler moctifiecI under
the followiDg circnm~:
5.7.1 Add, upon S"bsf-ntUd Completion of the Wort, . sum suf1iciad to iDaase the tDbII paymeats to
Wmetv pcrceat (90%) of the CoDtnct Sum, less sudl8lllOUldS . the Director ofP~ Services
recomlN!l'ld. mcl the ArdUtect ~ _ incomplele Wort mcl DDSettlecI claims; 8DCI
5.7.2 Add, if fiaa1 comp1etioD of the Wort is 1berc8fta IIIIIIai8IIy delayed t1auaP DO fiadt of the
DesiplBuiIder, lID)' IdditioDaI aIIIUUI1b.-,.b1e in 8CCOIdmce with Subpal~'" 9.10.3 of the GeacnI
CoDditioDs.
5.1 lleduction or limit.tina ofretaimlp, ifllllJ, sbaI1 be. follows: None
5!J The ComIty will wiIhbolcl JIIOIRSI paymmIs fiom the DesiplBuiIcIer for failure to comply with the
rapDrrmads 017-1.1.1 Complimce With Ameaba ltaxMIy 8DCI ~ Act of2009 (ARRA) wbidl is
~ to this ~. A.....-.. A,.o ICkfitionaI docamCldldion md _ a~";'~ under AlUlA
8Dd the FDOT Loc8I ApDcy Prop.... (LAP) reqairemeats.
5.10 The ComIty iDIaIds to pay for tbis CCJIdI8&:t ill whole or ill .-n with FedrnI fimds, the p8Itia acbowIedp
tb1d paymmt UDder this ~8Ct is eopti~Jt 1IpDIl receipt offeden1 ~I
ARTICLE ,
YoaaI Paymeat
YmaI paymmt, ~I..':.C the eatbe 1IDp8icI baImce of the COIdr8ct Sam, sb8II be made by the 0wDr:r to the
DesipIBuiIcIer wbm (1) the CoDtnct'" beat fidIy JKahmed by the DesiplBaiIder c:xcept for the
Desip/Builda"s respollsibility to COII'ect ~ Wcxk ~ puvided in S~ 12.2.2 of~ GeaenI
CoDditioas md to SIIIisfy other Iaf..:a~ if my, wbidl neca. By SIIIYive tiDal paymeat: 8DCI (2) . filial
CatificIde for Paymad ... beat issued by the Owner md 3) the DesiplBuiIcIer his met .0 provisioas oldie
reportiDa IaI";'~ UDder the AmericIIIl Recovay md hinvestmeDt Act of2009 8DCI the FDOT LAP
~~ such tiDal paymalt sbaI1 be made by the 0wDr:r DOt more tb8D 20 days after die issumc:e of the fiDaI
CatificIIte for Paymeat.
ARTICLE 7
~.eoa ProviIio..
7.1 Whme ~~~ is made in this Apermeal to . pmvisioa of the GmcnI ConcJitinn. 01' 8DDIber CoDtnct
Doc:tl."~ the .erla~ refen to tb1d pmvisiaD 81 JlllU!D.W or ~kted by other proYisioas of the CoaInct
Doeu..~
7.2 Paymads sbaII be made according to the Florida Loc8I Gowmmeat Prompt Payment Act CbIIpter 211
F10rida StIdutes.
7.3 T~_~ facilities md services:
None for this project.
7.4 Monroe Couat)". pet~ md obIiptioD to pay 1IIldcr this CCJIdI8&:t is OODtiDaeat upon - .......
IIppIOpriIItion by the Bc.rd of Co1IIIty CommissioDers.
7.5 ..bile EJditIeI c.m.. By sipiDg this A.gn:cmrm, DesiplBuilder &~~ tbIIt the executioD of this
Apeemeat will DOt via... the Public EIIIities Crime Act (Section 217.133, Florida StBIaIes). VIOIIIIion of
12lZ&OJ srANlMmRINCF AGUlMNrBEr\YfFNOWtBAMlIHmNB.JlL1Bl (tev0l) OOD)-4
Geiaer Creek Brid2e hDair Desim Build Proiect
this section sIIIIII resa1t in termiD8tioD of this Agrermrat ... reaJYCI)' of aD JDODies p8icI hereto, ... may
resa1t in deb8nDmt fiom County'. co~~e ~emcat 8Ctivities.
In 8dditioa to die fore&oiD& DesiplBuiIder furtIa' a~'*4tI that there bas bera DO cId~ Iuirwtioa, baled
011_ 8Ddit, tbat it or my _ .. connnittM lID 8Ct defiDed by Sectioa 217.133, Florida S1JduIes,
. . "public catity crime" ... that it bas DOt bera formIIIy ~ with ~m~ .. 8Ct defiDed . .
-public adity crime" reprdIess ofdle _ oflllOlle)' involved OI'whetber subcoatI8Ctor bas bera placed
OIl the CODYicled veador list.
DesipIBuiI'" wiD pi~y DOtify die County if it or lID)' contmck)r is formally dI8rpd with lID 8Ct
defiDed . . -public adity crime" or bas bera placed 011 die CODYictecI veador list.
A penon or afIiIiIIIe who bas bera pJ.ced OIl the coavicted veador list followiq . CODYictioD fbr public
catity crime may DOt submit . bid 011 . coaIr8ct to pmvicIe my pdI or services to . public catity, may DOt
submit. bid on . ~8Ct with. pabHc eatity for die coastmction or repair of. public baiIdiD& or public
walt, may DOt submit bids on lases ofrelll proprItJ to pub6c catity, may DOt be &w_ded or pabJD work
.. DesipIBuiIcIer, sappIia', sobooatr8Ctor, or consuJt-nt 1IIIdeI' . CXJIIImct with .., public eatity, ... may
DOt b....a ~ with 8Il)' public catity in excess ofdle dnsbold mI01IIIt pmvided ill Sectioa 217.017,
for CATEGOR.Y NO for. period of3611101dh1 fiom die dIde of" placed 011 the coavicted veador
list.
7.6 The foDowiD& items 8m pad of this coJltr8ct
a) _ 01 ..... DesiplBuiIder sbaII ....:..ta:.i .n boob, records, ad cbJuillClds
directly patiDmt to pgifooDace UDder this ApecmaIt iD acconI8ace with paeraIIy ~ 8IXXJ1IIdiD& priDciples
CCJIISNtn...II) applied. E8ch ~ to this Apeemeat or their ..A.idd ~ ..... have ....,..,.... ...
timely .x:ess to sadl mcanII of ach oilier ~ to this Apeemcat fbr public mcanII puapullet dariD& the tam of
die Apeemeat ad for .. JellS foIIowiD& die b...IIHIfL.. of this ApecmaIt. If......... empIoJed by the
County or Clerk ~.... tbIIt IIIOIIies p8icI to DesipIBuiIcIcr .......... to this ApeemeaI were spcat for purposes
DOt .....i2ed by this Aarermeat, die DesipIBuiIcIer sbaII repay die IIIOIIies topdIer with iIIIaest CIIIe.I,eM
~ to See. 55.03; FS, ruDIIiDg fiom die elide die IIIOIIies were p8icI to DesipIBuiI....
b) GoY..... Law, V--.IIIterp........ COllI, .... Pees: This Agn:emeat sbaII be gowmed by
ad COIIStnIed in 8CCORI8Dce with die laws of the StIlle ofF1orida 1pp6cable to eoadiacts made ... to be paCormed
adireIy in die StIlle.
In the event that IIIIJ cmse of action or _ ~.. is iDstitutecJ for die ~ument
or i.6..l'a~ of this Apermeat, the County ad DesiplBuilder agree tbat venue wiD He in the ap..uP_ court
or before the appropIiate _ body in Momoe County, F1orida.
c) ~ Ifay tam, CXMII8IIt, CODdition orpmvisioD of this ApeemeaI (or die IIppIicatioa
tbrRof to .., cia~...~~ or penon) sbaII be decl8md inYBIid or 1IIIIIIfon:e8b1e to B)' extad by . court of
cu..~mII jurisdicIioD, tile JllJlllIlinn.g tams, covCll8lds, oonditinn. IIIld provisiOlll of this ApeemmI, sIIIIII DOt be
afrec:ted 1bereby; ... ach ......... tam, c:ovmmt, (PItIitioa ... provision of this Apeemcat sbaII be valid ...
..... be eabceab1e to die fidIest exIIIIt permitIed by law DDIess die adOIcemad of tile lMQIIininl tams, ccm:amts,
CODdiIioas ... pmvisioas of this ApeemeaI wou1cI JRWIII tile ICCOIIlpIisbmmt of die oriPaBI iDtmt of this
A&rermeat. The County ... DesiplBuilder agree to reform die Apeemad to rep- 8IIJ strictaI pmvisioa.
d) AtIDnleJ'. P.. .... CallI: The County ad DesipIBaiIcIer agree tbIIt in die eveaIlIII)' CIIIR of
8dioD or _ ~"I is iUj~ or defeDded by 811)' pIItJ rel8live 10 die eabcemeat or i.6....~
of this Apeemeat. die prevaiIiDa ~ ..... be aditIed to 1'eIIIOIIab1e 1IIDIDey'. fees ... court costs, . _ aW8I1l
IIpiDst die IlOIl-pIt:V8iIi ~, ........ iDclade 1IIIDmey'. fees ... coarts c:osII iD IppOIIIIIe ~.
MediatioD pmceetIi..,. iDitiIded ... ~ ~ tDtbis ApeemeaI..... be iD atCOicllDce with tile Florida
Rules ofCiYil ~e'" .... ... ~.llInMJ ~~ Jafuia~ by the ciraIit court ofMoame County.
~) ~ aIid: The tams, COWII8IIIs. coadiIioas. 8Dd provisioDs of this Apeemad sW1 biDd
... inure to tile benefit of tile Co1lllt)' ad DesiplBuiIder mcI their mspecIiYe lepI repraadldives, successors, ...
IISSipl.
12/1&0) SfANlMU)R:BM<F_~0WNRAM)~ (tev(B) mD-S
GeiI!a" Creek BriclRe Rllftltir TWi.... BuiIcI Pmiect
f) AIdIIoritJ: Eadl, p8Ity rep:esads 8Dd ......... to 1be other tbat 1be exfJCIIIioD, delivery IIlCI
peafotJD1lllce of this Apeanad have been duly 81dborized by all aeceI-:Y ComIty 8Dd corporlde 8CtioD, 81 ~
by law.
g) cw- for Federal or State AId: DesiplBuildcr IIlCI ComIty apee thId e8dl sbaD be, IIlCI is,
~ to apply far, seek, IIlCI obIDl fedenI 8Dd sbIte fimds to farther 1be pmpose of this Apecmmt; provided
tbat aD ~ mqaests, grmt- proposIIs, 8Dd fuDding IOlicibdioas shaD be 8ppIUYeII by e8dl p8Ity prior to
submission.
h) AdJ-dlo- of ~_ or DIIapI_~II: The Owaer 8Dd DesiplBui1der Ipee tbat aD
cIisputes 8Dd ~ sbaD be ~ to be reso1ved by-meet"" coafer sessioDI bGt".~ &~~ieI of
e8dl of1be ..... Ifdle issue or iaaeI 8m still DOt rao1ved to die ~ of die pRes, thm ..., p8Ity shaD
have die riabt to leek IIICh relief or remedy 81 may be pmvidecl by this Apcmad or by Florida law. This
Agreemeat is DOt sabject to ikbib....
i) CoopendIeE In 1be cveat 8DY ldminildl1dive or I" ~I is "';I.dAd .... either pII'l)'
rel8liDJ1D 1be "'IA~ ~ performIIDce, or.... of this Apeemeat, County 8Dd DesiplBui1der Ipee to
~ to die eDDt ~ by die other p81ty, in aD pmceett-.,., be8riDp, pnKeIleII' ~ 8Dd other
8CIivitieI related to die IU~ of this ApermeDt or pmvisioD of the services ... this Apeemeat. CoUDty IIlCI
,DesipIBaiIder speci&caIIy apee tbat DO p8Ity to this ApermeDt sbaD be Rilluiasd to eatI:r iDtD 8IJ'f nib*'-
~ reIIIIed to this Apeaamt.
j) N.......I_........~ ComIty 8Dd DesiplBui1der apee tbat dime wDI be lID di.,.:...in....
......, pcnoa, ad it is c:xpressIy DDdrntoocI thId DpOIla dd*"-...in.tion by a CDIIt of ClJlllldadjurisdiclion dud
_ ... ~~ this Apeemad ..dofn.....Oy fI!nn~ witboat my farther Ktioa oadle p8It of ay
p81ty, rBective die dIIIe of1be CDIIt order. ComIty or Desip/BuiIda" apee to comply with aD Feckn18Dd Florida
~.. ad .0 Ioca1 uadi.~ .1Ipp1bble, reI8IiD& to 1IOIlCIiIcrimn-tinn. 11Iac iDcIude but me DOt limited to:
1) T'dIe VI ofdle Civil Ripts Act of 1964 (PL 11-352) wbidl pmIIibits discrimn-tinn em die ... of mce, color or
ptlfitwual oriaia; 2) Tille IX oldie EcIucIItinn A~ of 1972, .. ~ (20 use ..1611-1613, ad 1615-
1616), whida pmIIibits discrimn-tinn on die besis of ~ 3) SecIioD S04 ol1be __ Act of 1973, ..
.........wI (20 use L 794), whida pmbibiIs _ 011 die ... of~ 4) The Aae - Ad
of 1975, .....-Jed (42 use.. 6101-6107)whidapmbibils - 011 tile... of-ar; 5) The DmlAbase
Office 8Dd T~ Act of 1972 (PL 92-255), 81 IIMfttI-dI' reJatiDg to ."..mtaYimintltinn on die ... of drug
abase:; 6) The ~cbaIsive Alcobol Abase 8Dd AIcoboIism ~adion, T1Cllmad 8Dd - Act of 1970
(PL 91-616), 81 ~. reI8tiDg to aoqafk...:...inMioa 011 tile... ofllc:ohol.... or 1IIcobo6sm; 7) The Pub6c
IIeII1tb Service Act of 1912, IS. 523 8Dd 527 (42 use IS. 690dd-3 IIlCI 290ee-3), as ~ rel8liDg to
CODfi~..it:y of lIIcoboIad dma .. pBtmt records; I) TItle vm of the Cd RigIds Act of 1961 (42 use L et
seq.), .. ~ reIIdiDB to uuudi...:...intdion in the sa1e. JeIDI or ~ ofbousiDr; 9) The Americ:8IIs with
DiabiIities Act of 1990 (42 use L 1201 Note), .. maybe ....~ fi:am time to time, reI8IiD& to ~-1A:...intdinn
011 tile ... of cIisIIbiIity; 10) Momoe ComIty Code CbBpIer 13, Article VI, whidl prohibits disw:...il.tim 011 the
... ofmce, color, sex, reJisioa, ....... CJri&ia, aacestry, semBI~ pader idadity or ~eaio&, famiIiIII
stIdIIs or lip; II) Any other _ provisioas in IIIIJ Feden1 or sbIte stIdDIes whida may IIppIy to the
pIdics to, or tile subject _ ot this Agrecmeat.
k) eow.ut .f No IIdenIt: ComIty ad DesiplBuiIdcr COWII8IIt thId neither ~1 ... any
iDtaest. ad sbaD DOt II:qDire IIIIJ iDIrnst, whidl woaIcI caafIict in IIIIJ ID8IIIICI' or ... with its paformmce UDder
1bis A&rer:mmt, ... tbat oaIy interest of e8dl is to pafOllD ad receive beaefits . recited in this Apeemcat.
I) Code of EtIda: CoUDty agrees dud oflic:cn ... employees of tile ComIty recopize 8Dd wiD be
required to comply with tile stIIDd8nIs of coacIuct _ public officers 8Dd employees . deJ~ in SecIioD 112.313,
Florida StIItuIes, &~diD& but DOt limited to, solicibdioa or ~tWCe of sifts; doiDa busiDea with ODe'. IIpIlCJ;
..-_.II..:-i&ecI ~apet'~ ..u.. of public positioD, CODfIic:tiq emp10ymeat or ~.ctDaI ~..~ ad
~1ii or use of certIIiD iDbJIIIItimL
m) No -fAeK The ComIty ad DesipIB....W8II1IIIt did, in respect to itself; it IIIIs
neither emp10yed DOl' ntaiDed IIIJ compIIlJ or pcnoa, other thm . boaa fide employee WOJtiD& solely far it, to
solicit or IeCIR 1bis .Apermeat 8Dd dad it ... DOt paid or .- to .'" fIIIJ pcnoa, compIIIJ, corporation,
iDdividuaI, or finD, other tbm a bcJDa fide employee wa4ia& IOIeIy for it, my fee, CDIIIDIissioa, ~~~ lift. or
other COIIIicIInIioD CX}lIdi~4 upOIl or JRIIIItinI &om tile award or IIIIIkiDa of this ApaDeat. For die .... or
Yiollllion of the pmvisioD, tile DesipIBuiIcIer agrees that tile CouaI.y .... have the ri8bt to tmmimIIe tbis Apermeat
11/J&OJ srAN:lQDRIN<F .AGU:JMNr~0WtBAM)1EiIHBUIIJBl (&vOl) mm-6
GeiRa' Creek BriclRe Rea8ir TlMi.... Build Pmiect
without liability 8Dd, lit its discretioD, to offset fiom monies owed, or otherwise recover, the fbD IIIIlO1IIIt of such fee,
_ pcr~.t~) gift, or CXJIISidendioD.
n) PIIbIc AI:aa: The County _ DesipIBuiIder sbIII aI10w - permit ~Ie 8CCeSI to, -
iDspectioa o( aD ~ ....... IetIa"I or oIher IIIIIteriaIs in its poaession or 1IIIder its COIdIoI subject to the
proviIioDs of CIIaptrr 119, Florida StIdIIIeI, _ m8de or receivecI by the County - DesipIBuiIder in CODjuacIioa
with dds Apecmad; ad the County sbaD have the right to 1DIiIIdaaIIy amceI tIUs Agreemmt 1IpOIl violldion of this
pmvisioD by DesipIBuiIder.
0) N__Wmw of....My: -. the pmvisioas of See. 761.21, Florida StIdIIIeI, the
puticiJ*ioa of the CoIIIIty _ the DesiplBuiIder in dds ApeemaIt - the 8CCpIisition of my commacialliability
iDsur8Dce cownp, self-iu.ua..Mj cownp, or 1ocI11O\'"~......e4t liability iDsunmce pool CXJYCDp sbaD DOt be
deemed. waiver of:.~~nu.lllky to the cadmt of liability c:overBp, IIOI'sbaD 8IIJ coatnct eataecI iDto by the County be
required to COIdIIia my pmvisioD for waiver.
p) Prlw~ ad ......: All of the p;viIeps _ immuDities fiom liability, ~~ fiom
laws, ordJ"~~ _ rules _ peasioDs _ relict ctis8biIity, worbn' compea~ IIlCI oIher brac6ts wbich
IIppIy to the 8Ctivity of ofIicrn, 8pIIII, or employees of l1li)' public ...... or employees of the County, whea
pmbmiDI tbeir Jespedive fimctioDI1IIIder dds ApeemrId within the taritDriallimits of the Couaty sbaD IIppIy to
the __ drpe _ eDrIIt to the pertbmumce of such timctioDs _ duties of such ofticen, apatI, wlaatlln, or
employees oatsicIe the lc.a&.iaIlimits of the County.
q) LepI OUIpf ...... ......Al4IIIIes: NoD-De1eptioa of ComtiI..t:.o.J 01' S~.J Duties.
11ds ~ is IMJt iu~~ to, aor sWI it be caasInJed 81, reIieviDg my pricip8IiDa eatity fiom my obIipIioa
or IeIpOI'ItDiIitJ imposed 1IpOIl the eatity by law ea:ept 10 the extaIt of ~ ad timely ..h~ tbcnof by
aay ~I eaIity, in wbich CIIe the ~~ IIIIIJ be ofliRd in pdi~ of the obIipIioa 01'
i~PbiIity. Fartbcr, this Apermeat is mfinfendM to, DOI'sW1 it be COIIIIraed 81, ..A.~ the del. ptL- of
the ccMl,,,I~ or ~ duties of the County, ea:ept 10 the extrDt p-nnittM by the Florida ~;,...'~ stille
sbIIaIe, - CBe law.
r) N__P...... by N__......: No person or eatity sWI be aditIed to JeIy 1IpOIl the tams, or
8D)' ofdlaD, oftIUs Ap-ec:mmt to adbn:e or daDpt to eafon:e 8DJ tbinI-pBIty cllaim or ~ to or beaefit of
8IIJ scnice or prop... e1...bnp1lded ~~. - the ComIty - the DesipIBuiIder JIIIIee dad neither the
County DDr the DesipI.BaiIda' 01' my lipid, oflicer, or employee of eitber shaD have the ..6.oahy 10 iDform,
COUDSeI, or otbawise indiCIIe dad my puticul8r iDdiYidD8l or poup of individuals, eIIIity 01' adities, have
adidemads 01' beadits 1IIIder this Apeemmt .,.,-* md IIp8It. iDirior to, or supaior to the \NIIIIUuuity ill gearnI
or for the J)dipolCS cc.,.hII....'11ded ill this Agreemmt.
s) AIteIta_: DesipIBuiIder..... to execute such cha.meDts . the County IIIIIJ reIISOIIIIbly
require, to iDcIade . Pub6c EDt:ity Crime Sttd~I~4, .. Ethics S~ _ . Drag-Free Wcxtpl8ce SI"'A~
t) No ....... LiaIIay: No covClllllt or ........ ~ baeiD sbaII be cIermecllo be .
ccmmal or apeemaat of .., ~, officer, .. or employee of MmIroe CoaaIy in his 01' her indiYida8I
CIIpKity, ad lID ....." oflicer, .... or emp10yee ofMoame Coaaty shIIII be Ii8bIe pcnDIIIIIIy on this Apeemad
or be subject to my penoaaIliIIbiIity or ~iIity by reIIOIl of the execatioD oftIUs Apecmeat.
u) EDadIItII .. ComderputE 'Ibis Agreemeat may be executed in 8IIJ D1IIIIber of ~J*1I,
eBCh of which sWI be r.-aW . .. orip.I, all of which tIIba ~ sWI ~ ODe - 1be ....
~..... md .., of the .... hereto may execute this AgreemeaI by siDsinllIIIJ such ~ part.
v) SedIoII B...-..,. Section~ have been iDsated in tIUs Apeemmt .. . matter of
CXJIIWIIieIIce of Id.~ oaIy, ... it is ...- dad IIIdt secIioa ~ are DOt ..-rt oftIUs A&Jeemad md wiD
DOt be used iD 1be i.A...~ of my pmvisioD oftIUs Apeemeat.
w) SpedIII C~ if 811)' are detailed in 1be Request for PmposaI for this Project.
x) BHlIIanIIea: The DesipIBuiIder COWIIBIdI_....lo incJsnnifJ ... hold bIIm1ess
Momoe County Bc8d of County CnnnniBioDrn &om.., _ aD claims for bodily iDjuIy fmcludiDa dadh).
penaIIIII iqjIBy, .. pmpcrty .... [1IIC1adiDa praperty cnmed by Maaroe CoaaIy) ad oIher losses, ~ -
expeIIIeI r~ .atDmey'. feel) wbich __ out 0( iD cxmaecIiaD willi, or by reIIOIl of.... ..~ by the
11IJ.&QJ STANltQDlUtMCF AGUIMNr~<>WMRAN)IBDB.JIlBl (tevCB) mD)-7
Gei..- Creek BridI!e haair 1lMi.,.. BaiIcI Pmiect
DesiplBlIiIdm or my of its subcoatl~s(s) in 11II)' tier, ~ by the negJi~ ann, or other wroagfid
act or omission of the DesipIBuiIda" or its SubcoatndDn(s) in my tier, their employees, or .....
In the evmt the c:ompIetioD of the project flllCludiDs the WOJk of oIben) is delayed << ~ . . result olthe
DesiplBaiIder's fiIiIIIIe 10 pua.... or maintJdn the ~uiled iDsInDce, the DesipIBuiIder shaD ~ the
Couaty fiom 8IIJ 8Dd lID iaacIscd expeases resaItin& from such delay.
The tint tea cIoIIm (SI0.00) of I~MioD pIIicI to the DesipIBuiIder is fiJr the ~~.uificatioa pmvidecI fbr
above.
The extent ofliability is in no way limited to, reduced, or lesseued by the insunmce requirements
COIdAinAi elsewhere within this agreement.
y) ~~ In the weal: tb8t the DesiplBuiIder sbIIII be fouDd to be wveJipnt in 8J 8Ipect of
m...ntltina, ~.. 1IIA:..b~ repair, or service, the ComIty sbIIII have the right to trmIiIIIde this asreemeat
.... five days writIal DOtificIIIion to die DesiplBuiIda-.
7.7 o.r...Idp 0' tile PNjed Dck _IUts: The docmJIent!I..~ by the DesiplBuiIcIer fiJr this Project
beIoD& to the ComIty 8Dd may be reproduced mcI copied witbout ~ 01' permitLmn ofdle
DesiplBuilder.
7.1 S.ef.... .... AIIIpI: The DesiplBailder sbIIII DOt .... or sabeoatnct ill obQpmn. ......dds
.......... except ill writiD&"" willa the prior writIalllJlllftJV8l of the BoInl ofCoaaly Ownm~ fiJr
Moaroe Comdy, whidl8pIIIUWI shaD be subject 10 such ~ 8IlCI pmvisioas as the BoInl may deem
DeCelRfJ. 1bis .......~ sbaIl be iDCDlaMMed by ..~ bdo 811)' ....,....,.- or sabcoatract mcI my
~ or ~ sbIIII compIJ wiIIa.n of the pmvisioas oftbis Apeaar.at. Subject to the
pmvisioDs of the 1.&~,MNI~1y pncediDa p-2ill&~ ... J*fJ Iaeto biads DeIt its sacealOn, .....-
IepI ~ to the other 8Dd 10 the sacceslOlS,.... mcIlep1 ~ ofsuch other
.,my.
7.9 No tIdrd PartJ _"lies: NodIiDs coJdaiaed baeiD ..... CIeIIte IIIIJ lel~ Wdbac1u81 or
oIhawise, willa or.., ripts in favor o( 8IIJ dIinI .,my.
7.10 DIIathaatapd .....-_ EIdeqIriIe (DBE) ..., ad ObIIptioB: The DesiplBlIiIdm IIIfC'CS to comply
widt the pmvisioas ofFDOrs Dis8dvIIIIIIpd BasiDess Eataprise Prop.... . oadiDed in the CertificIdioa
c-.--,..i~ in the RFP. The DesiplBlIiIdmwill complete mcI eecuIe IDOT ..... 275-131-118, BIlE
~ AdIDa ..... which is iDc1aded as A.....-.. B to this Apeemmt.
7.11 FIIW A 1'..... 1273: Fonn1273 is .......ed hcnto . Attacblst C 8Dd made . p8It aftbis COJdract. The
DesipIBuiIcIer wi118dbere to all pmvisioas in FIIW A Fonn 1273.
Section v. S'w.~.~. 8Dd Payrolls 011 P8p 5 ofFHW A Form. 1273 is JIIIV1D.ied . follows: The statcmeat,
"except fiJr projedI1ocIIIed 011 .u.dw.ys c1...miN1 . local roads or IIII'Il c:oDecIDn, wbicb 8m exempt", is
deIeIed.
2. PaymIIs mcI Payroll Records PId d (I) is revised to read: tb8t the paymII fiJr the paylOR pcriocI WdWdS
the iuL~ ~~ to be ....I.t.bainecl...... .....~ 2b oftbis Sectioa V, ... die _.... ordle
..,..,..' .... .....,..................... ............ he....... _ flAl.6..........,
mcI1bat such :.&.~ is comd mcI complete;
PayroD __ ..... include _ iDdivicIuaIIy icIeatifyiaa number for ... employee.
7.12 .., ~ The DesipIBuiIder.... dull it will comply with the teq";'~ of4' U.8.C SecIioa
5323 (j) (I). SecIioa 165 (a) oftbe s.r.ce T~...-pua~ A~ Ad of 1912, . ......dell bat it may
qDIIify for .. ea:epIiml to the .~~ pua.....lo Sectioa 165 (b) (2) or (b) (4) of the Surface
Ta-...pua1Mioa ~-...... Act of 1912 8Dd n:pIIdioa in 49 CPR 661.7.
7.13 p....... Coatrad8r.... ~ RIIbtdIoII: The DesiplBuilder..... DOt bowingi)' eater into 8IlJ
subcoatrKt 1IIIdc:r this \iOIl1ltd:
11J2&(p STAMlMmRmMCF _BEI'WIBlOWl6lAM)IHmNBUIJBl (Jev0l) 0lm-8
Gei2t:r Creek BricII!e R..-ir ~1nI BaiId Pmiect
(I) W'1th. ~ of a foreip COUIdIy iDcluded 011 die 6st of COIIIdries dud - apiDst
u.s. firms pubIisbecI by. die United _ Tmde Represadldive (USTR) or
(2) For die supply of..., product for use 011 die FedrnI Public Worb project UDder dds CODIr8ct dud is
pmduced or 1II.....~~h;d in. b:eip COIIIIby iDcIuded 011 die 6st of ~~ tbII_ apiDst
U.s. firms published by US1R (IDcIudes -Buy AmericIm" pnwisioas).
7.14 ..... Jc-q s.be6-b~ to Prhate Sedor EIdity eo.tnct Pn.......: in ~dIIICe with die
pruvisioaI of23 CPR. 635.112(0). No public ..-cY sWI be ~diiaed to bid in ~ or to cater iDto
_ with priVIde CoaIr8CtDn. A bIach ofany ofdle stipaIIIIicms 23 CPR. 63S.112(e) sWI be
...&ieat poaads for tamiDatioD ofdle Contr8ct.
7.15 o.Ip/IIIIIder....... Lt~... for Leal 0wBenIdp: in IICCOIdIace with die pruvisioaI of23
CPR. 140 _ 49 CPR. Sectioa 11.3 die DesiplBuilderwiD DOt puadl8se ~uipmmt for COIIIIly uw.......
7.16 ..............tea: in ICCORIIDcewith 23 CPR. 635.120 and 41 CFR.31 die CoImly will..,
........ .....eat.... ndes fortbe Ioc8IIrea where die WOlk is beiDB ~ forftllled ~~
. needed clariDa die project.
7.17 LealIIIriIII ~ die ComIty wiD DOt iDclude a Local HiriDg Pldta~ce fordds CODtr8ct.
7.11 hMdy Owaed L.4--t: in ~ with tbe provisioas of23 CPR. 635.106 pabIicIy cnmed
~u~~ wiD DOt be IIOowed to compete with prMdeIy cnmed equipmeat UDder tis IIJP'BIleDt.
7.19 State ~.tltnace: No lafui.~ will be impoIed:
(a) To require die DIe of or povide. price difIi-....&I in favor of a1icIes orllllllaials pmcIaced within die
S.... or.... wiile to pmbibit. restrict or m...~ IpiDst die use of 8dicIes or IIIIIIaiaII shipped ftom
or ..~.... or pmcIaced iD my StIlle, b.ib~ or ~ ofdle 11Dited ~ or
(b) To pmIIibit, restrict or otbawise _ apiDst die use of 8dides or IIUItrriaII offoreip orisin to
IIIIJ ...... atad'" is ~-.... UDder policies of die ~tmcDt ofTlaampua~ . cvictaK:ed by
~uia~ and ..~~ pnIICribed by die mw A ~dmiftiwh... to cmy out sach policies.
7.20 AIMriaIII:ReawerJ .... ......Mble.i Ad of~ SpecW provision SP007011lES is.u.dled hereto
. ~ A _ .... a pBrt of tis CODtr8ct. 1he DesiplBuilder wiIllIdheIe to aD pnwisioas ofdle
Special Pmvision.
7.21 ..... CndIII: 1he DesiplBuilder will DOt receive credits for salv8gelb1e IIIIIIaiaIs.
7.22 ....... ~z." ~~ (EEO) ~.....---= tbe CoDtr8ctDrwiD adba:e to die DOT EEO
I~.~ iD ~ with F.ucuIiYe Order 11246 and. oudined iD tbe Equal EmpIoymeat
0ppaItIIDitJ ~ ia Sectioa rift oldie RFP. Prior to die art of coastructiaa die ~- wiD
CCJqIIeIe FOOT P... 27~1-13 ~... a.1DOT 01 Em 0IIker - P..... 27~1-415,
...... era..... .Wy .... 0IIIee ....... Em M..... or ........ on....., wbicb 8m
iDcluded. AtIac:Iua.t D to this Apeemeat.
7.23 DnII-:'CIIII Ad: In acCOIdIIDce with die Davis-Bacon Act. die CoIIII8ctDr - their ~11dOi1 sbaII
.., ~ employed cIiIdy.. die site oftbe wmk 110 less... die Joc8IIy ~ w..- -
fiiDp ....... paid OIl pmjecIs of. similar ~. 1he CIIII1IIt pI1MIiIiDa WIIp'" CIIIl be foaDd III:
..,. ~ "",.mv/~ hbnl uadcr Maame Coaaty. W...... Ded--... PL-_.....
tit ddI....Jed.
AR11CLJ: .
T.......... or ..,......
1.1 1he CODtr8ct may be ....inllMd by tbe Owner. pmvicIed in Article 14 oftbe GeaenI CoaditioaL
11J1&Q) _R:BM<F AGUB.BITBEIWfEN09t'MRAN)IESDHJIJBl (BW(B) OOD)-9
Gei2er Creek Brid2e Repair Desio Build Proiect
1.2 The Work may be suspended by the Owner as provided in Article 14 of the Genen! Conditions.
Artide ,
Elluaentioll of C..tnd Doaoaeats
9.1 The ContnIct Documents, except for Modifications issued after execution of this Agreement, are
enumerated as follows:
9.1.1 The Agreement is this executed Stmdard Form of Agreement between Owner and Design/Builder.
9.1.2 The General Conditions are the General Conditions of the Contract for Design and Construction.
9.1.3 The Suppl~f and other Conditions of the ContnIct are those contained in the Request for PmposaI
including but DOt limited to:
a) Bidder's Tedmica1 PmposaI
b) Bid Price Proposal
c) Schedule of Values
cI) Monroe County Certification Forms (Section Five of Request for Proposal).
9.1.4 The Addenda, if lilY, lie as follows:
AI bid ctoao.eJds, lIeqIIest for ......... ad portio.. of AddeDda relatblc to bidcIiDc reqairem.... are part
of tile CoIItnct DoaoDstL
9.1.5 OtIIer ctoao.eJds, if ny, fo...... part of the COIItnd DoaoIleatsare .. follows:
This Agrecmmt is eDtered into as of the day and year first written above and is executed in at least four original
coMs'~wIIicb one. is to be delivered to the Design/Builder, one each to the Director ofEDgineering Services and
AK:Wtect for use in the IdmiDistration of the Contract, and the remainder to the Owner
(~l..:. .. ..'
A~\~~L.KOUlAGE, Clerk
..,t1;J..uiQ, ~~
Deputy Clerk
\-~tr \'0
BOARD 01' COUNTY COMMISSIONERS
OFMONR~' ~
By Mayor MONROE COUNTY ATTORNEY
('. ,PPRO ED AS TO FORM:
CHRIS N M. LIMBERT-BARROWS
ASSISTANT COUNTY ATTORNEY
Date. liNd-liD
DESIGNlBUILDER "L ).if" ~1IIt II. n ......... u.o
By:
Date
(SEAL)
Attest:
Trtle:
ide:
By. CE:~ ~
/~~~
By:
END 01' SECI10N 115II
11J1&OJ STANDMIDRIN<F AGRJH.e<<:BEIW.fFNOWNBlAN)~ (JeVCB) mB-IO
A'ITACIIMENT A
lAWS TO BE OIISEIlVED.
(IlBV WI.., (3-If)
A.RTJQ.B 7-1 (PIIaII-." 61) it a&M"~ed '" tile fo~
7-1.1.1 C1tIIII- ce willa MlrIaIa -.., IIIIII"'~----, lit Ad"~
Thill project illIIbject to die criIeriIad ~ of die AmericaD RecoverJ aad ~~~I
Act (ARM) of 2009. Satisfy tile fedenI repodiDJ .Isq~omeoIa far die projecI(l).1IICb . die
~ ~.. lipid. far both die COdIIacb ad_ Pnwide die ~ecI
iA.~__ OD bm(1) provided by die DepMtmeal in die timefI... ~tod ia die
L..buClbll.1DdD tbeIe ~ req~1s in III sabcoata..a.
7-1.LL1.A.....~ It~ .,1IIe eo.rtnlrr C_I~_
SediD11902 of die ADA of 2009 JIIOVidesdle u.s. CompImIIer
Gearnlad IIiIlcplOI( "A.ivestlle -tOOdt):
(1) to ~4'A.~.I.~ aay mcooII m die a...~ or aay of i1a
~1Iactom, or., Slate or 1Axal.-cJ p,:...~.., IIICb ~-4 tb8 &.~) per..m to,
- iDvoIve - mIatiDa to, .. Wdb-t or SIItIoWl-t, ad
(2) to i-*w aay afIicer or ~ oldie a..~
or ., of ill ~u.., or of aay S18e or Local p~A..~ IpDCJ ....~.:.EdMi.~ die
eo...~__IIICb~
~~.Ibe CompImIIer 0aIeDl aad 1IiI..~"'''':~ sbaII
have die "..ilI_ ripII. ~idDd 1IIIder Sectimt 902 of tile ADA willa IeIpeCt to this
0I.6-t, wbidlia finrd-4 witb.fimdI DID aniIabIe UDder die ADA. Sec1b1902lmk ....
that dQlw-w& ia tIIiI snbt IbaII be .iDIrapretecI1D 6mit or RIIrid ill .., way my ~
au1hoai11 of die C6..),,~ GeaIDL
7-LU.2A.A1.I17 "'lIIelillJlctw C.fnk
SecIioa 1515(a) of die ADA pmvideI ~ ;1, for my
repRIOJDtiveI of die IIIIpOCIDr GeaenI to ~'flaMillA IIIIJ aecordI or idIa y- IIIIJ ~ or
ofIian ~ 011 dais Coabact. The CoatmdDI is .dy;..d 1IIat repn.....:Y&I of die J~
Geaaal line die ..it, to Olfamillflj IIIIJ maxd ad hIIemew .., ompkJJee. ofIker of die
Co.a..a. its sabc6.lbACto.& or oilier &m. ~ 011 tbia Coabw. .SeCIiaa 151S(b) fualLa
..en'" dIII....-'I iD dIia Sedioa IbaII be .....~ to 6mit or Jestdc:t ia .., way ..,
~I....a, of_ ~GeaenL
ATtACHMENT B
275Gm-118
EQUM. OPPORRNIY OFFICE
...
"'1cfl
DBE AFFIRllA11VE ACTION PLAN
POl.JCY 8TA~
.. .1.,ft.~ IT l......''''''
n .. the paley m th8t di8dv8nIIIged -,
_ defined by 48 CFR PIUt 21, 811bp111t D and ~ under Rule ChapI8r 14-78, F AC., shill h8ve the
opporIunIlr to partItipIIIII_ ~ dlacIDra and suppIin on aI ~.act6 ...-ded by the Florida eep.-.n88l1t m
TrBI Rll'U'1IIoIL
.~.~-:~~'"'!"~. ...,..........- ......~..
The requirwnenls afRule ChapI8r 14-78,F-A-Q". sbaI,sppIy to aI w.6aca enI8r8d iIID between the Florida
~ clT..+utWlun and .......~........ LLC , ·
S~ ndDra 8IIdIor suppIin to tIIruI:IunII "'....-lIon .,....... LLG
willIIso be bound by the reqafti;....'Qf.R.. 'CIiIIi*ir.1.~78 F AC.
Structural preservIIIIon ~ LLC
. and 1'. ~.~ Ih8I
take all1KeI"Y and ....DI1IIbIe "In acconI8IlCe willi Ch8pIer 14-78, F AC., to -- tIIIII di8dv8nIIIged
__ h8vethe opporIunIlr to c:ampeIB.1nI perform wat \NIlb..-W will the Florida eep.tI..m afTrBI~lwtion.
8tructunII.......... .,...,.. LLC . and .. ~.~ shill not
diIcIiminIIIB an the ... of r8C8, color, reIigioI.. nIIIiaI.. origin. diIIaIay, sex. or age in the - d ~.CICA
will the ~._ afTrBllDtNlWiorL
BIn.............fI.M. II ......... LLe . . h8I deIignIIIIId and appointed
. l.i8iIon 0fIIcer to cIeueIap, ......... and mDlliIDr the DBE AIIL..18IMt Action PI8n iTIpIenwRWu... The Li8iIan
0IIicer wiI be ~ tar dill.mi lilting this policy abiIII8nWIt ttuaughout ItrucbnI ~n Svstema. LLC
and to cf~ ~.buled __ The ~ is pasI8d on naIice boBrds afthe CompBny.
X~
, F IJ I1t
~>4-, Sb (f
x
275Gm-11.
EQUM. (IIPOR1'UNI1'Y OFFICE
calli
PIlla 2 atJ
I. _noN OF l>>1SON OFFICER
StruCtInI......... ~ u.c wiI.....1wtIy I8CRII
diI8dv8nIIIged ~ _ ~.___ and suppliers far.. ""'.~ will... Florida eep.tment dT.....-WbL
The Comp8ny __ ...... a LiIIIIIan 0IIICer to dIMIIop and rn8InI8In this AlII...... Adian PI8n in acc:onBD will ...
requiwnenIII d Rule ChIIpIIr 14-78, F AC.
The LiBiIon 0IIIcer wII h8ve prirIwy f8IIPOIISIJIIy far dev8Ioping. m&i 1bIining. and rnonIoring ... CompIIny's
"III,-'on d diI8dv8nIIIged ~abactDrs In addIion to the following 8P8Gific duties:
(1) The LiIIIIan 0IIIcer sh8I ~ IOIIcI bids fn:rn diI8dv8nIIIged --- ~.actDrs for aI
Florida DeperIment d TrBI...- bItion \Allah acta;
(2) The LiIIIIan 0IIIcer wII aubrnl8I18COIda. reports. and - requDd by the Florida DeperIment d
TrBI"bIIIoI.. and 8h8I1NIi1llin IUCh MCOrda far . peI1ad ~ not leBa th8n tine ,.... or. diredIId by
any .pecIIc "'" Ibadual requiwnenIII d... Florida DeperIment rI TI'8I...-bIIion.
The foIowing individuIII __ been deIIign1IIed UaiIan 0IIIcer will f8IIPOIISIJIIy for iIIpIemenIing ... CompIIny's
.II~ acIion P'''wIail. in accard8IKa will... requlrernen1s rI... Florida eep.tment T~t8IIon.
(LiIIiIon 0IIiceI'a N8me)
(Your CompIIny's N8me)
(Your~.~)
(Phone tunber far LiBiIon 0IIicer)
(EnIIIr FBN or Tax lei Nwnber)
II. _TIVE ACTION IIII:TNnnR
Shawn Abraham
Structural Group, Inc
. 7455 Nai Ridge Rd, Suite T Hanover, MD 21076
410-850-7000
FEIN: 52 211.3986
In order to fQnrulllle . r88IiItic AIL II" Adian Plan.
__ identified ... foIkMing known b8rriers to ~ by cfll8dvRaged subwI.tr&tDrs. befant deIcrI*Ig b
pmposed dlll.ative 8CIian meIhods:
8truc:b81d PrNervetIon Systems, LLC
1. Lack d qU8IIIiId cfll8dvRaged ~.badors in our specific geographic8I- d work;
2. Lack r:A C8ItiIied diI8dvanIaged ~ dlacIDra who seek to perform Florida DeperIment of TnII...,o. bIIion
work;
3. Lack d idInIt in ~ing on Florida eep.tment ofTranspartaIion \AII.-.b.;
4. Lack rI f8IPOI" wI8I ~ to bid;
5. Liniled kncMIedge d Florida eep.tment d TrBI...- tation pI8ns and Ip8CibIIions to pI1Ip8I'8 a
r8IpOIlIMt biI.
In view ~tM b8rriers to ~ _ staled above,1 sh8I be... policy d
Structural p~ 48IIon ayst8ms, LLC to pnwide appaItLdy by uIIIzing ... foIowing
aIInnIItive acIion meIhodIlD .... ~ on ... ~.ada will ... Florida eep.tment rI TrBI-.MWio...
8tructunII........ atIon 8yat8ma, LLC wII:
1. PnwIde wriII8n naIice to 81 cediIIed DBE ~ &.aors in ... geaglllphic8l... where ... WOIt is to be
~,b-*d by'" eomp.,y;
2. Advertise in mi10rIly facuIed medii concerning ~.bacl apporbm- will the eomp.,y;
3.
2Jl.a).118
EQlMLCRamNTY OFFICE
CIIIII
PIgIlafS
4. Provide 8deqI_ _ &bout the pl8ns.1p8dfic8IiaI., and requiI........ of the 1NI.eid. not
rejecting ~ ...cbs wiIhalt acxnI AI.lans baled on a thorough im.uIigPion d their CIIp8biIieII;
5. Waive requDmenIs d perfoIn8lC8 bands ... . is pradic8I to do 10;
6. AtIend pre-bId rneeIinga held by the Florida Dep8I1ment afTraJAIIA"bItion to apprise diII8dvanIaged
.uw..actora d appartuniIieB will the Comf81y;
7. Follow up on inIiIII_ d inIInIIt to DBE ~.hMD'S to deIennine willi cerIIIinty wheIher the
DBE comp8I'Iy is inIInIted in the ~..a apportunly.
StrucbnI........ Systems, LLC u..." that B*1iIt of arr.....uve
action meIhads ill not _ 811d.. include 8ddIIaI18I 8PPfOIIChes &Iter having - f&.iII8rIy willi the
diII8dvanIaged ~ ...Jing carnnully and/or delermil8d the stated 8PPfOIIChes to be inetfedIve.
ID. ,- -=-uTATION
On ~.adt will Ip8dfic DBE pis. Structural P....."atlon Systems, LLC
.. mIIke every eIbt to meet "",.--a g08Is _ stIII8d by utIIzing Is ana ...aIIve acIIDn rneIhods. On ptOjeda will no
specik pis. the Comp8ny", _ .. expreaion of goad fIIIIh, seek to uIiIm DBE ~"acIDrs ... work Is to be
~lb6ded.
IV. REPORTING
Structural Pf'8HMltion Systems, LLC shill keep 8IId m.i&lin such records -
.. nee..." to determine the CompImy's compII8IlCe will Is DBE AIr...klllive Action Plan.
The Comp8ny .. design Is I8COI'd keeping system to incflClll8:
1. The number of DBE ~.adDra and suppr.. L88d by the Comp8ny. idMIiI'ying the ..,. dwark,
1118l8I'" 8IId services provided;
2. The eIforts and progress being made in ablaining DBE suIA.u. .actora through local and communlly sources;
3. Doc:uma..wion d allNI~bacta, to include correspondence, telephone calls, _ -. etc..
to abIain DBE particip8tiDn on 81 Florida Dep8I1ment rA TraI-t"'I Wion prajecIs;
4. The COftIPIIIIY shall comply willi florida o.p.tment of T,.~ 1wIkIn.. 18qu..........l1IgIIIdIng
""""10 ..~.KIDfs Including DIIE8 for 8Kh monIh (...... period) In which the
COIIIpIIIII.- __ WOIbd.
v. DE DIRECTORY
Structural Preservation Systems, LLC
wiI uIIize the DBE DiedDly published
by the FIoriIa Dep8I1ment r:I Tf8I AlIA" taIIorL
The Comp8ny .. cfl8trbde Form Number 275-030-01, Schedule A CeItiIicaIion Form Number 1. to poIBnIiII
DBE ""'Ib~ n 8IIIiIt in their ~.
ATrACBMENT C
L
L
...
rv.
v.
VI.
VI.
VII.
IX.
X.
XI.
XI.
~
...... flI
MIIr;
fIIIIj
....
ldIIIJInI
AlTM:H1ENT8
A. ~~Ma"'~~".~.'"
(IndIdId It AwA- ~.. ClIIIII1IIiIcII cdr)
L .......
t. n-Kw- ..... ....,....__..........d...
.. ....... .., '1 - ~... -......... ... ... ..
... ..4. II ...... .........,..._~
............ ~....._.........., ......
.......,
2.~. ........................ T ..
........... ~~ II.... ... - _ _M"''''
-- -- .... .. ... ..... .....,.....
............1IlIIf .... ,~~dl~-~ ........ .....
..... lie -.IlL ........ PIa , · .... ... lie
II~~~ _....-.1111..'~....~......
J'~ ---r tar "r!..~ T a........
U ,..vrtM'... .... ......... ..........
3. A~""~" r ...........In...~
ec.ncI .... _1iIIII:IIIt......... far..."""" ill..
CIDIIDcL
4. A..... _ "1aIIaIIIIg ..... ,... ........ ~
~ ..., ... be .......... ...... _ PnMdId In 21
CFR 5.12:
..... .. ........ 2;
..... ,,~ .....LJ ___l~T - 1.2.1. 4. MIl 7;
..... Y. ............ t ... 28 ...... 2g.
5. ...... GIIIar..............II~f6.....
~ ...'!:.-==M~,~~~
...... .... . .... .. ........ III Jh I......
~I II_II" D-.-IJt IJ ~""""'IDOU."'''''In21
CFR 1,:\ :;-t.~n ......~af..............
~ 1 ..p..,""." ~.~ II. .,.....
~lfll'~ ...DOI.....~.~..........
.........diI....
I. '1'1.1. n "la..IIaI': DulIng" ........,... rI.... canbcI.
.. .......... .... nat
.. Ci:5.... ......,.........,1 a I.IIIT~..
P,... ~...__-..-r ..-!~~~far
.....~ ilT __.............~
Ilar
b.. .....CII:IWId .........~~...... ....fJI..
.............1..... ~....~ Dr ..... ..... - .....
.............. .........
.. ~"IATIDII
(AnA -A.L ID .. FedItII.... ClDIIIWcIan CIDI*-Ia ... III ..
Fonn FHWA-1273 (Aw. 3-14)
....... ........ ~tlD.ooo ar-.)
1. .............~1 J Il~ .............~
.... (Em) ........ ..lD till I .............. ~~ ~
....tD........~_...................
............ ~..~....aIII.....4t CFR->>
... _..lit ~.., ............. r~ ~~
~-=-=~.&:::..ell I r'far--:
1 !(II T 1 ~.~ ..... ......... ".~a..n.-
"ClItiA- rf.&c.DaI""~ - 1.............41d=R..
4.......~ar..,. 1_17 .17 Idfll_fG
U.a.c. tit .____111......... CFR..... CFR ..
.....~ Jj ~ l............. .........~~af....
..... lie, 1 r.__"~~"'''IaIIIIIng'''''''''
....... T _~_flIEEO:
& ,... b 1 .. . -- ... .. .... ........ ~iDI
(8If8.....~IGD..~...~.......-ElD~
1nI.. ... ...fII............- ........ ........
II. ,... ........ .. --..a - ... ~..,. paler ..
........ 1 1 ._L
=at... fII.... c.....,.. -- ...~..-
"'~~~-"""""-A. l
~...... ~---=~~~ iIIIaiIIII....
~'i~ J 1T ~'=:1_ n J.~~~
~~!~~~.:...J.TIi ...af=.....~'t-
_~ .l .& ~......~..............
2. ... ~.... --A.. ~ .. ............. .... ......
ID.. Ita . r.. .... _lID......... .....
... , Tl.....IIIiIIIII-.....ar~=l..1 . - · ...
........ _ _ .... 1 ......... II ... ... .... ..
~... -- ......,.......~....lDdD_
I. V - - ~ M.......af.........~...
... .. _Ad ..... lit II1II8; It'J ..... ...... "'e
A.~........_l 1 .............._
........ III .... -. .. .. __ ... ....... at. ...
.. -.-11 1 ~ ..... PlJ..$>-....~. EEO......... -............
...ID~EED................. - - - fJI~
TO-...............I ........ .............
.. lie...... _. _____
.. .-.....:...... '" ~ ... ~ ....
___ .. ........... ........... flIwiIIk..... naI
..............,...... ............4*~
EEO..-.....L,..-I . -.-I~..............._-.-T1T~
,..............~..,.. EEI)......
II. M.. ==_ !l k-w...l.............. be
.............. ...,..EED~............
=flI .. _&.......-. EEO .1- - _.... ...., .,.
............ ...-..... ~.~.
c. M ...............___.. ................
... .. be IMIruDletl __.. -.0 ~ III .. .,....~.I. ~.
....... ............. ..............,.... ...........
d. ~.......-.-...........~EEO~
............--... 1 ~..~.-....a-;.ti'
_~.-8Ml... ....... .._........
.. ,... ....tl.-..L ~ ~~ .......... II ....
.... .... ..... .. lie II...... ,. ....~~ ..,
.-. ~ ........... .~ ........ . ... ...........
--.
4..... -- 1 __............~......~....
.. ...... III .. .. ~I .fiII .. .......... .......... -An
EquIIOppaIIunIIrE1~-....... M....~............
.....1
Inpe~" ......-...........~~Ia..
............ jIaJId __..............., tie........
~~.:&, ' l...il~=:r.aiiJ
...~ . .................
~I - t. To........,... _I. iii - 1 --..
"'M.-.tJ:.t~...... S............
... .... -- == ......, ...
=---..,.. tD"~ IDr tlIld~iIdIf..
"~.c.n.llr ~.........~~..
..........~~:..;:;;i~
..18).....10 II~ IXL
I ~~ .~!l~~lai-=::
-..... .~_..a.~........ ~....
0nIIr 11'" _ )
c. ""m-::r-~l~~ID""
::u-.: ID ..r:t. ........, ... ...,A-~ :::
~ T.'"
I. ""'~w.~. ~...~
...-.... ... J '-1 A"'rA~
...., -'_1 --- 2.i rrtr... - , .......
"~.w-.~ hdl~ -~ .. .....~III
-. .... ~ ....... ..... ... ........ ,..
taIaIIIIg ............
.. ...........- III .. I ~ir . fII pq.d
....111....... _ -. ...................
~ h&_~flI""''''~
IL n.aa==- .~........~ar.a.
............. III ...~....,...... flI.........
....,....
....:..::.... ..7~~~':I~
.... __ .. ......, .. u L --DW............
...... -- ............. ..................,
...... __ .... "WId. .... -... - ....
...... ......
tL ,.. .. ~............ ....~~ ~
~ ................4*1- J ~+.......
... -_ - ~ .... .-,. .. ~ III .... -=II .....
.............. ...-J.~........Jr r J ""-T L
... ... ............. A-.l.L - .II!IIJ IIIIIcI
..... .... .. ............ .... an. rII .... ....
........ .. .... .......111... .. 1J.. --1.
.. ~ .. ..,........... flI..,..... ___,.
.......
I. TrIIIIIIIII'" ~ 1 Lllu ~
.. .....=........ In ~ . ~...
1I1m-A... ~......,............. ......~...
........ ...
b.. .....~_ 1 · ~....................
~aa,t-~ ~!.~~...~-~~~
..... Lal 21~!lI=."'"
In ... .... lie III .....,... ~ 1*,..
~ ........ ....~.t:=.~
c.. ,................. ...~... ... ~.. ...
..~...J ... flI ......... ...... .....__ ... ...... ........
.......Iar .....
d..;a:s ,....~................
.......&A fJI................=_.....
....... ...-111...., far ... MIl.......
ilia
1. ~ :E-~ .....In..........:......
_.....~ .. ....... . -...... .....
10........ ~.........ID___~tar
P11112
.......~....................... 1I).act......
.., ... .... ...... ......... h ~.... AalalllIIr"
~ 1 r r- ......__.~.... 11 ... -.~II&.4""
-.............................. ....
L n._lJ ....,._IlIII.....ID~!.
....... ............ ~~.....1aIiIId
_ ~ .... JIl. 1 ~. ... .... ... iii iii
........ ~...... II ~.... ~......
..... _till..,...,..., tar..... JIIIIIII...,~~II..
... ..... AlrJr --.... _ ........ID ~ _ EEO
.............. .............. ...._....... be
~.1 ..~......ID................ ~ II.........
caIar. ....... ... ............. ... .......,.
c....... .~ ..~ .. III .......~.... - . - Ira .. .......
~.....--,... ~===...ID......
....IML JlIIf.........~ .. .,..~...
... .... ..... .... ..... lit .... .......... tit ..
....~. .. ...~ .... -.... .. .......... ...
bill................ ..... tit....... -=II ..........
II. II" __ .. ..... II ......... .... .. .....1 ] .~
..... ~...ar~...__................
...l1li........ u11 fIT al _ 114, ~ll .-......1 1J .~
... __ ~ ~ l..~~J iIIiII. . .. ...~I " ..h"
'** d.I.....~1D -..... ---....lIIIIIIiIIiIIIIIn.
... . == ...... .. ..... .. ...... ~ ...
a..-;~.._-=~~~~i.r=.,.~=
._........~I 1~...~. -rt'-"
.....1It.... ~~ J.I$..III) III.. --....... .-..
~;].~-~~t_~ ~~~;i;:w
pIUM..~.... . .. ....~ _.. ., ..IHA.
"fir. T .,T<l ~ I 1 1 ~PNIL ,..-" .....
· ----..-.. .. .....__ L . ....... . I 1 11...
...-;r.. - -........ .......... ......
......::.........,~ 1 I. ....P..:......
.... fJI........... .... ~..........
L ,.. _.~...... II ~ ................
...... ,........ EEO J - _ - ......... ........
II. V .. L .. rJ"'-'-..~ -I L I fIIIQ..........
a=R 21..... ....... ---.""................. ~
.1 ~...................... IiID ~ ID ....
....... ". ... ~.A" _.... .... ..... III .... ...... ....
"''''--DlEM 1 ~ ...~ .. I.~.'" 1 T",
~~~..ar~~~~'::.-.t:i=
.....w...L
c. ............ ._.............ID__......~
tar ~.."'''EEO ~~-...l.
.. -............ De L · tld....~.........
_I~ III ___ ............... EII)..' M....
8uaII........ be........... ..... fII...,........
..... · - A.................. ............... ~ Ilh
........ ........~..,......... .-r'~""~ fII..
81M..... FHWA.
L n............ ....~ .... ~ ..
~
(1) 11Ie.... fI ~ ... ........., ~
........ ... ..... ....~ In ........, - ~~ .. lilt
pIajIGt
C2) 1'- ~ ........ ... ..... III ~i".6..
.......... --........... -- -~...............
Iar"'~~"'....
Pl:n-................_.--...............
~ ......... ... ........ .......,... ..... _.~.--;
...
(4) ,.. ~"''''''''''''''''':=Z''
.....~DIE... Lv.l.-w__ .1.... v-.... IQU
........,........ ,..-.......... -........
b. 1be _*~ .. .... _ .... ......10 .. SHA
FGIIII fHWA.1273 (RIIw. M4)
.... /AlII far.. ...... ..... ~ ~......,.
.....,. --. ... Iah.JI_ ~ .......,
--- 111....51 '1 -T m -.". - ~ br. ..... WIIIIL
1I6~" ..~_.... ......t3It. ....
Jab....... ......,=~ "QQ..**'''
be ........... ... ...... cIIIIIIL
.. IIOlf.llfI!~DD'.......
~ ...: "'1 II"" ~UCIW 0DIDcII ... ID ..
.....~ "S1OJIDD--.)
& .,.......... 01.... IIId. .. ..... ,. .... -*-I .
........ ....I~~__ - .01................ .-....
_ ......111 ~. "1IIdIIIr. FtIIIIiII4Id iIanIIIuD-
Ian ~ 1 ~-(.. .. . ....... ..... .. ...... .
-rr'+'" .....1IIiII..1lll1IIIiIiiIIIII. ~ tar..
.......... ........,ar..l - ~ .....
.......... ...... ~ ID.............
...:......... II ....... ...-.. ..... ..
II Id De ~..........iI..~- - ~...
...... ,. .. pIWll1J'l _ .. .......... ,........
~IIII.. . ...dInIId.................
GII..... eI .........
... ~............... I - 1......
~ -*-. ..dl_u.... r~
_ ~ -. au ) CA. c\, ...........
-. .... ...... ~ ........
-.t .. 1'~.."'=
1.. ~.. ..... .. ~ I - f'"
lid. 1. J .. ~ - .. IiIIIi fJI ~ ~
.. . =- --- -......
1IIi -*. "IT .. lie .... .........
tar............... (.... ..................
... ... . ... ........ .... .....
..... ~.t 1 ~~...........
f6 .. ~ I r If.......
III It.. ..... ... .... .. ...... ....
II. M....
~~...
... ...... .
.. T -- ..
.... .........
~.:.=
=.
.... ..
c. ,..
.........
~_II
In"
IV. M~GPl-_-1IW._...-.J _Trn__
~~r~ ~!~A'" ----.........---
I2.I1II-....... T Tr 1 -- _lar~....._
~ I .a _.....................~..WIlIIIda..
.-p[J
1.__
Farm FHWA-1273 (RIJv. 3-14)
b. ......... ~ ~_ __In....... aile
Ar n IT AAr~ ~ be ~-.-I rr -'A 1111 iii .... ...... far ....
A_.;&._ ....... .......... ....... .......... ... ..
..................-~,1 ~'.. ......................
~iI.....__.. ...-..K
c. AI.... "'IAIII~ _ A 'IT .dill d.. DIIuIa 1ir { · Ad...
................... 21 CFR 1. 3.... 5.. .......16corponIIId
br ,.....~ ...... CXII*-d.
2. ~ 1 )~~I.In:
& ".IHA ~...~ ~................,.... r6
....... .. ... A.1. ..~ ........ aannd. ..... II naI
:-.: ~~~L~...... ~Ar - II In ....~~...
b. ......................~..~~ -II -c...
.... ~ .... ... .... ...... .,..... .. taIbIIng ......
.... ....II1II:
(1) .....ID..~b...br....... -II - ~
.. ... 111 If" .... ...... ..,. ft II m l.-an In .. ....
dIIIQ...........
C2) ..~~ - v ....&~.......In......,..
........~
P) ..,aq ~=-..,. [~...,..........
............r [TI~. 1D...........~....id
In ...... -1"'1 ...... ...
U') .............. -...- .......... A -.......
......In._~..;:;.t;~.....
c:. . lie ....... .~...... _ ----. ..
......... ~ ~ .J ~.. ~1.....1i.........
- -.... ~~~.....1Q L~.~
~ ~1:r.......... ...~ ~ r ~-n:
.... ...... .... lie - br .. lit .. DOL.
~"M... an.~................ . tal ""'..
M.li~4L.. ............ D.c. 2IIZtI. ,.. ... Haar
Mw6M.~.._""""'.. T 1.............-,.
:c:i.1.::-::t .....~n--~&-.::
................ ..,...... ................ II... I L ..
.... ~=--:-::.~:~~
· - "~"""4- III ...... 1 ~~dD
naI....~ - - AlIL_"'~"'~"
.....=.:?='"...r~ ~..~~~tar'.1
III" ~-=:JM.IJJll':': ':~ith:lt.~~
,...".......11 L/ i T .-.,. J .. .. ....... Ji 1 ..16-
..............".._--....... _.1 I J........
.. ...... .j T r,. c-. ..... .. .., pidad ...
....~........ 11.
.. ,......~.......................)
....,..~.......III 2I:arlllel.........,.,.... bit
..........--. __...._~ ~ A _~.
... ........., _...... II ..L..... .... A) -......"
3. p~ Lilli.......... .....
L V"......_~ ..........~.....-....In.........
tar. ....~....... _InRI J1II..... ..... ..........
..nat~LllllI._~...... La - I r.IlW....~ L &...
- ~..- I I .................. _ ...... III .. ....
~~. -... .... PIIr ....... .... ... ...... .... . -
.....,...... .. . .......
b. ."111 1 '" ......1 - Ill.., _ .....41~........ NIl
.... ......... lit . ....... ,. aa. ..... ....... ...... II!IIJ
CDIIIIdiIr. . ... <<I" ..... II., ...... . ..-I1B. ..
~I~I~ -:-...... _.& laer.. .......
"!'!Ir! .......... ............1
flIlAID'''' =......... ~ rII ~"'.IIII
~....... ~af..DIIuII-rc~ItI/!A............ ,..
..., " ...... .., __.. ~.-...~ lit ... ...... In .
........-.................af~_.............
. ........
..... J
4. ~ _ n r II ....,....... .....- flI.. as. DOLI'"
.......-:
&~.~
.. "~""ID" II.......
... .. Mal. ... .............,..
lit ... ~ III . .... ...
...... .. ....
~.AfI'~ _n___~.
.... I ~ 1 ~"''''''''.I.
III_e.====:- .- " ......
....... . ... flniII
....~=~J~.'r
to be ..... far .......-'1 ___
.....a-af~...TIIIInIIIL
1IIII!Ir~'" ~..... ~
_ .............. . ~ .. u rJA. ...a,.
=..........--.........-J . - .....
. Lilli .... far.. vl :J ~..
_~._ ... .. 'pq ..~...... II
b. 1\......
(1i1!- .........1II2Ia=R1.1.. .......II1II..
..._ ~U at tD.. ........ ..~.... 1 ~ ... ..... ..
....... - - JI1.... ~.....~
~ .... Mill. ............._~
t!i ..... ., .. DOL ~........ ... TrIInIng
M.6 T 1......
(1)'" .........~:r--...~..
.. )lilt ........ ... lie ..-. II - r....... ...
~ III" ... ,.... ,.,J T 1~. :I
........... 1Ii'i5i.. ............. II _IIJ ..
........ · r.,...............
lie ...... ..... ..".~
~_.. f 1 1 --d."'''. i _t9.ar..
5..- ..~~~..."'~~
... lie ..... .... - ,~ -- till III ....
"'.AA." ... adIIIIj~"."':"-
...... .... .. ..... II ... ... ... .. ...
..... IIr ....... .... ,. ~
II f6 .. ~ Ill.. ..... ...
1I!IIIt J 1 ,..... .... lie
...~_........-L bl....af.......
...... ... ........ .... .......
.....-......~...._..
.......M.M~ fII.. __ MIl Haul'
..... 4
...... 411M.......... II. ....... ... ~-=I-
........._~..._......
JllllllIn r~ ____...... ~-_ ...._........1Ir
~~ _ L_ III ..... __ .... ...... .... ..... .. --
.... ...... - ............
(4) ...._..&~...T.....M.J M..
Ian ~J. Ii......,........ ~ ......1iJ --.r ell'
.111 JL I cto.- .. .. .... .. ......-.. It ... ...... II ...
................................... ~~...
_ ............... II .....vw.4
c.~
I m ...~~.: ~_":'~'~:
dill.'" --ra....................., ... mD......
_1aIII1II..... I PI.2. _.......... _ . -'II". ....
= ..... ..... .... .....,.... -rr-JI..ld....... ......
...........~....... ..~...a.....
......r - .AJ.d\.........., .........
5. ~JJ l III I -........ 1'\........ ef.. u.& DCJI):
!eh- r l................~ r~-.......
~~. ~ tIIIIdI ... .... .. ....... ..
~ ~ ........... lED III ,*Ll 1 . ... FtIIInHIII
........ JlltdI 1~~_......1D..~1 11
ar....................IV. ........................
fat~.................~__..IIIIIi..........
==~~=_~-Jr.,I.:'~.:
I. -W" .,_:
"'~~'I:~--"~-""'''
.. ......... .... DeL ........ ar ... III ..
..... ..... _~..... ...... 1 ......................
.. __ FeIIIIII........... .. _ ~ llIG 1 ..... . ~
alilrFll It. ... - i............DlllII r II-]x~ 1
-.a ~ 1 ........ II..... .,.. - ..... ....... -
IIIIIiIt ........... ,.. __..IIIJ J ~ ~!IIW" .. .. d
",. I I J ,.. pwlIIiaIiJIa ... ... r] · ~ ~ ~
~~I:-~~': 01 ~1 ~-Z..__.......... @II'" ....... ... ~ .. ~ 'IT ~~
............,;~.~_..lIIIif1l............
=:=:a::s;;.~~i l i ~::':.Ja.:'=
I~ r .""'''111..-1 III fII~"'~~~""'"
01...-,...... ...-1Id wIaIIIaIiI.... .......
7. OWdI.-na.. I .-
NIl.... 1 .w..~.~ ~"~far8lf""""
cxm.I ... tIIIIdI .... ...... .. ..... lie ......WLIIII ..
........lMif TL. -'iIU_~........ .......~ ---~
........... ~ ~"'III r ~__I~ 4.... ~....
...........:t=-.~~~J --......~
~~ III III ...... 1I.,f ~ _ .... __ II .. iii
___.__...... ~I ill............... ........"--
.... T .~ ..II!I!II...... _____ II . ......... ...
........ _1iII_ .-........fJI..,.................
In __ fl............ ~ L at
I. Vial -
~1ar~~"""""'1L rJM 11.._
~ .., vIaIIiIIII fII" ~ ... .... II ...~M 7........
~~ ....., _ " 114 JII ....1IiIIiIr..........
to............... tar................. ............
Qu..... ...., - -.. AI .... .. ...... ..-..liIIIII_ (In
..... flI................. ....1IIIIIIaI "Call U. ,.
~rrr-~ IJ~ t~-=~~u~~~~~
........... ....... ~t hI.. ~,~ . ~ ....... In
............................. 7. Ii .._ ...,.....
.... ......._..........-~-........~
'-lID .....__,... .........iIIIik..-ll............
.......,... ................ ..,.. ..... .. .......
........ 7.
.. .....r8l1........................v 111
FalIn FHIIA-1273.... He)
II CIlIm....... ~ _ ..... d.",
,. .. DOL ........ .. .... ID be
........ ......, ...._ ......ar............,
.......... ar ......,.............,aIIIf
,..... ....... .. _ ~ '1 1 J {/W, ,. .,., ~
.....~III.. a.e.a__.......
....., ....... II.......,.. _... ......~a.6.
.... _ . lie ~r 1 .. .... III lie .* 11 )J lit ...." ..,
....... II.... ,. ......... far ~........
.,- .. - 1 ... _ pIDIIdIId In .. ...1Il1ai1a In .......~~
. .....
Y. aT., OW Ale MY1a.L8
. ~ ~ai~.................. ~
........... ... ,,~ .....................
P 1--- ... _ IDaII ..... ... .... ~ ..... ..
......)
1. ~a 1 >>- .....e.'.r. Id...-- -,n,caCPIIII:
d.~.l W I......,~_-.- Llld..,......
.... ,. . ........ .., .. ... A1.od1,..1II4 M>~ ~ .-
~.......... 1411...... ~ fII.. ......
..... GallllllalIiIII.......,..~
S1!) .. c= tar.. = ...... ........ ..
~ -y......... _.!...";:A!d..4.. ~ _ ~ af l1li
~ ........ ..... -- .-....
CZ>>...a................... ==~.
~A4'" ............... "PIJjIaI
~....... . ..~........... ....
........, ar , ... IlIA .. cIIdIIctIIN .... ... .....
FcnI FHWA-1273 (Rw. I-IM)
.... ..., ... ....., lain .. .. ~ ....... aIMr ...
.,..~.............. _ _ .........~ 21 CPR 3:
~............. ............... '-II1II'"
::a::-a;;;;;.~':=-==.:.-~
~~ ,...... ~.6 fA ~ 1ncaI""".A.d.... c:annct.
.. """"".1 · .~rI......,___...~
........... __..... ~~... WH-IC7 ....=
.. JIJ.-' .w.. far ~ · · ~ .... ~ T ._. flI Cu..
........., .--.~ III,......... Y.
t: 1M - · - .... ~ .., ,. .. ..... ..-~. ...,
......... .. &. ID.. ,.atmhII........ undIr 11 U.s.c.
101ft ... 31 U.8.C.23t.
~ ,.. --- ,. ~.... .... .... .. ....
~.... J.___~ a rI....... Y................
Ian, ..... -Eli'" ..~... .~_--. - ~..
8IM."'-FIMA,." ... ....~....~-r'"-A~
· lit ....... ...~~ ~ '- - ")aIL ...
.-.... ar ....... III................ .......ID
......... -.... ...IIM," fllIWM. "DOL. .....,....
~ ~ III.. _ 1 .. ~........ ... - ~ ....... ....
_____~fn ...__... 1.1 A..II..,
..... ~ .. J.. lJ I ........ Fua...._..
..... II........... ......... ................
................., lie...... .. ............ ......ID
21 CAt 1.12-
VI. ~..IIA1..lJ\L8.......... Ale ~
t. a."FM ............._..NIIDIIIIII~=
__ ... .... ..,..... __ .. .., - - - fII
...... II................................ _ em
............_-~
... .............. ..taIII....~ tIIII far"-'
.......... ........ 11.- (21 CFR8I5) .." ...- tnrlhll;
& ............... III r6 ~ ........ ...
..... ,.. 1" ., III Fan ~ ~ I JIII.-......... ....
UIIiIr.......O.. .. .,......gaWII - ~........~~
FuIIdI.- pdarllt.. ....._......... r6wadt........ CIIIihI:L
b. 1IIInIIIII...... ~ .. taIII CIDII .. .. ........ ...
IIWI!lII ~-- r r r r tar....- ~~Ir"""'" III...... ......,...
_ - /- - ........-.......... ... .......... ... FarIII
AtWA-47. ... II lie ..... ~.. FaIIII FMIPr47.
'~r~"'~~~. III=::
In tit .-- lit ...... ... ...... . .... ......
~iJI........ walk .~... taIir.............
.. taIII............
2. ,......,.,.~.. ..~..... ..................
.. ......1Ial............... ~..... ..._-=Ii
.......~.... be ........
VI. .....-r..- ....111.,.,.. CGI11W:r
1."" ...w.~....~..........__. - .C11111r81:1
-.It... _1D1Ial.......~(..___~_~
....... ITll r 1 1 .. .. ~ .. llelalil ~ GDIIDI:I
~...:a. :t.~:.::r::..'-~
.. ......., -,:: 1IIIf..... 11 f.....1IIIII
................. !a~ .- .............~
ID lie ...l..... "'''Qw6vt =~ .......... CD CAt &B).
.. ...... ~Iw&.i .... .. CDIIIInIId II>> ~ anIJ
..... _~ ... .... ___ .., .. ..-. ~~.~ &.tla ...
....... a.iId ........ ..,.. ..... ...6 ~~. ... ........
~..L ........... II1II....... ................. ~
......
. ~.a....... ar ...,......... QQlI....
b. II......... be .......11I.. ........--
......... I.. - ~~~~ .......
::::=... _..'C..._...:..~~.:.:
be.....lII. .~ f6.......
2. 11Ie~lINlI""""'''~''''''''
'*~ ~T.. t flI VlII.:J 1 t......... CIIII,.........
... R_ .. '" .Dd ~ _ID lie.................
..,.." 1~ ..aaIIIr.t~1lL
~..... ....a..:.&1~~..::
....~ _a.. WIlli III . J1..~ ... .. ..... ~
............ "'.. ALJI1. T ~4L...~ ~flI
....~.. ...M........,...--__... - ...
==r ... ~I L-:~~-==)::
....._~,. ........,
==:. No fJI __.............~......
fJI ...._....._........~
.- -4-11l ..,.......~~=
.... ..... iii....... __J.. .. ~ fJI..,
Iar..~- J ..~ -..............-r
...... 11M .....11II.... ~ J1LA .. ........ iii
~_.... ..........~... .............
~.. .....
VII. IIAFEIY:~ rw4I~
1.. III.. "'.... aaIIIr.t...... "wr ....-W
=: ~~.....,..~~t.
".11 J.. ....... ... r- '" ~....... ....IJIIJ
aIIIi"..... . .- T ll.. . . .... '" .
=~af ..:.....~.._:I:l'=-...
~~.,.. III ~ 1 DIlM.... .....~.___ ..__
2. .... fII.......... ....... lie ...... ......
01.... .......~. &. ....IIID~III....
~..... ........., ----.............
~........ III "'iii........ II Quit ..........
........a ....._...~~__......
... lit ....... . ....... . _..... _lIT ...... ...........
~~cf.....~~~=~~~~
Walt..... 'A~ w.Ad{40U.8.C.III).
I. Pl.-ijCFR ................-..............
=-~~.. ar..::,~J~=.::
.. LL '" .. ~- L~lL ~..~.=:..__...
..... *'&.~ II ...,....... "'..IL..... ....
__ ta7 '" ...... __..... ... ....., ....... Ad.
(41 U.8.C. III).
.. ........1 IIICDIItIILl..8_YP1K1.1ECr8
III anIIrlll .......-.......... ......... III aaaIar-
_ .... ........ ... l' r - - ~~ ... . ~ ..... fJI
...... ail ~... 4- II '" - d.....-;-....-...
.......... .........,. II 11 ....~,...,
.......... . II alL'MI..............~
....... ........................ -.
r . tf -# 11,. ._...~ID..,....
.......... . ......".......... To ~ IJIr
.. MIk L ..1. fJI_ ... .....
.... .. .... ... .. ....... an .... ~ . ....
~ ___ CPR _ III _.... ....... . II
...., iIiiIIIiI* ........~... lilt pIa)Ict
1ICJIII21D M.L fBJ .'IOIft! If ~ I - TV _.-....
I....y~
18 U.s.c. 112D..... _ ~
"1tIIK~1 n: ~ ....,. or .~ 1#" ,...,
= or"""OIT~ ._JL. ........~
~, ... ~I!., ..........."..... .......
IIIMt .......~..III....IIJDf-JD..dw.~. ~
~.
~ "..111..".,."., .-dtJIlII,............."
___III.. -*~**,.ID"',.aw.t." Gall""'"
"~""14 r .~t1I~....~-~....
~ r-~ or....III.Jlllu ~.. "'~."""""1/IfJIId
~ .u tlr"""""a... ~lIIIfyiJI1fa~..... 01'
.....................,...... .. .. -I r 1C, ..... ~......
... .......,.,..~..... ~ID" ~ r ~..c_. ~
...,. ".... III.., __ ~ or IE>> .. MJt...... tII
~ LlrlJ1JIlJI ... be .......... In 4XIfa,rJlN .. ..
~~T III .., ,..., . """,., I/IfJIId .,..., II, ..
......., atn~ll) p ~..
........................... r'" r 1*'......,.--.
... _ lit 1IIIIIiIIIM-" .... "'.. J IlL '*~ tit' ~
A . t ~ II>> ~. t# .. FifA..4fl.", ..... ..
."."." ... 1. 1"& (31 SlIt. 35IJ, _ -*d .., .....
.......
.... be"." 110I...."., '14000 or"""""" naI_ ...
5,........ ·
x. -W TITATDI,.CLIIMMtM:r AIm__
wa1Bl1IGI..I.UIDI c.urrRaLM:r
~1D..,....zllId.......... canDdI...ID..........
......... ,...........-.)
Br Ii 1 · · 1 '" .... IIId .. .. ~..... fJI ... canad. ar
- L ~ l.w.. -rr-+.... .. ......... '~A.... .........
........,. . [~ l L ...... ......_..- I I ............ID...
~--rll._~
1. 1111I..,................... .......~-*~....
...... ................... ........... a..NI Act.-
........ f42 U.8.C. 111711...... II III WI.., NIa.L Ittie
... ...............WIIiii'....~-7--...
~~=~i.~~!~...., ..~..naI
...... .. .. ... .. .... ---. _ .. I!rMw......L I 111
~..... (EllA) LIII ~ \IIaIIIng ...... "",,-ID 40
Z. 1111I.........11I............... III .....~...... ..
..~fiI....114i1..a..,.Id.........
,... ....... .... PaIaIan QIIIIIaJ Ad ... .. ........... ...
........ .............
3. 1111I............... naIry.. 8HA~" ~,. ~
~.~ - .............. c-. _...... ,..-.:.. EM.
....... 11III. .... ... .. 11I''' .. ...... ... .. ....... II
.....~~~.ID............EPA UIIaf\1aIIIng........
4. 1111I........ lit ....... .. .... ... be ........ ..
......__11111,. r-:-~"'" t ~ 4 flI......... X In ~
IDlI I II_ 1 J.-'l.............................
.--llAWd..,...... __~~...............
XL~.:~~~8lIIJ.IIIDIl
1. i.A 11.na...c...a"ll ."""c...I1L__l.l
1-=
~ II" FedImI.... canncII- 41 a:R 21)
L ~..~... M.L-.............. ~
......, pnMdIng .. ..ILA;.. -.I cd biIIaIi.
b. 1IIe ......,... ~ 11"'---" ~~...aut
.... .. .. wall LL~ _ In dIIIIII ~ ..ItaiM In ....
.... .. ~~ 1IIj.........................
~ -.-1 rIM.....,. ~~...................
1tiI...........~'1 ill:..... CI ... ~..~ I ~L....
.. '11..... .......11111 · 1 Tn...................
.... -_ ...............~l~~...l..
ID........~ --_. JlT J11. .....
..... lain ~ -. -"""'T III.... "r & Ie
C. ,.. ~......... II........ ~!IIr""""~
,. lid = ..... _ .. ..... ....... rlJ ..... ar
..... a1 111111 ...... "'1_ A.... .11i..... dIIIr-
.................~L.-1T t Jlnl~.........
.~~ II.................. 1It.......-.........II..
F.-... Q........~ .. IIJI'~.i ar.........., ...".......
FalIn FlWfA.127J .... Mt)
Ir~"'__""'"
-~.-r:-.Ii' ~-=='i.~"'~
&t.. "" .....JI.;II...~....~...
.. ~~ ......... .... .. ... beaaIne
....... br ....... cInu......
.. ,... ........~.....~.~.
-. - f. ....... ..... L r --",. )-~II,. ·
....,..... .~Ll rw "\j-')fl' I ra ...~
~~---Irll.- .................~1. .........
D n.~_... .....~.-k..11..~...
0IdIr 121& ......... J ~ ............. wIItII
::=Z::::-Ia .. r · I ~ "alllllnlnga cqIIJ~""
~...~~~~~
... ........ ......, ...........--
:-.=:c:::: ":'I~.~ ~../,;~~ L 1[:-:;
...... ~JII.t..."''' dIi.w-~.i.......,......InID....
.~
ILA
...ILA.. fJI .
~-" .~.....
....... -
_/ - ...
~;~
.-
canpIid ..,..
L
:err.... ..
iIIII bcL. r
~~........
III . ....... L .~ .., ~ upan .
.- i. ~ r II .. . .... lit .....
II LJ J ~\........~ .. ~
..... l_ .. ,..... -. ..... l1li ..
... A.......m..................
.............. . ~..~ 1JJ. ....
:11'1~--1D; .,..~L~~~::
::r::::.~~ ' IJII) ..... II
III .. ....... .... be aaIIIIIIUId ID
". ~ ".... .. ....ID ........
==~J..~....~-==c
tar. ................ .. ...., -- ~
.....
Fann FHWA-1213 (RIv. 3-14)
~~IIIIpI!Iw,~~~~~
1. TIIe~ 1IIIIIIn~ __ID.. bell,...
Ia1cMIIdgIi 1IIIIf.1III.'" .. ..a~
.. ". IIlIl r:= ........ ..-.-- ... ......... ..
................ 1..~.."""'Iain"'"
~~-A... br..,"'" ~,~... .......-=r:
It. .....1IlIl..... a ==...... ~ .... ~
...........1:6....... 111.......~... far
~_. · -4r fII....... aImIiII....... III ~ 1 --~-.aGlMllt-
.. ................ .. ..........Ji.. . --= ~ .... ..
~.....................~~ r .=i.......~
,..................... .(Ih I lT~( fII ~
.... ....,......,. - · - ~L_" ......... ,....... ......
.....1IIIiIniInII. .............. pRIpIIIr:
c. Alenat.......IIIIIIcIId..............L... arclllly
....-.. ... . JIIII ~~......... ~ ....,. ~ ...
..~ .-' ~ .... ~ ..!:.===::..a loa .'11>> ~
~.. ...... ~____.-.. . UI
till ....IL&... ....
II. .............. ~ ..... ~ .... .....
....,........_ __ ~-~ I r ~- . (FtiIInII. .... ar
1aCIII)"....... far.... ar.....
2. ......~I r...~~..........,~1D
~.,.. 1 1 It....... ~I ....~~...-....
.......... .....~ lit ilia.......
.....
2.... r ..~I..fn......1IIrc:...l1lt... 1111
-=
~ ........,.. .......... ~ ..... ... aII.-....
...._ ~ _~_.._-.a=R28)
L 11M.............. -~ ~ 1.... ...... .. --~~
...... ~..-... ..-&A;.. .......... ...........
b. n. ~..... III........ II........ ..~~.
d...... wIM ...... .. ~ .... ....IiJ r - - ..
......... .1 II.... III r 11 J ilia .....-:= IJ [f. .......
~ 11 ~Mi · ~. ........A... ~.&~ - ~-
II>> aIIir __ ilillllllllI..,..... Sa_I ..........
~.~::L..~~I~ ..::.;.r~=-"'"
c. 1IIe ........................~.........
__ ........~ III........ ~II ....A.d W
II ~ ... .. ....-4... ...... ~ .... ... ..
'-'.-.....~ -~ ..,.-.~.....~..~
cL "............... .~.-~ l".~.
a.~""'l -'.~11tl....~.
.~-...~ T ..~a ~l.."""""
.......1 ~ ...........0 I.~...~
..... 1:6......... ... ~ .. 0IdIr ~ v....,
............................ ........ IIfDr J · 1 ...
.. aIIIIInIng . aw (I'" ..........
.. ..........~....... ' ~..,~ -.
... ......-.... -*' .. ..... .. 1 r ~ bi
........-....... ...........,...........
.. I r 11 t& ... . ~ ... i OIL .... 11 I; 1 '~.......
.......- .. __ 1 ......................... III .....
'It 1 r Itr , ..... . II J L4 _ .. ......... 01 ...... ...
........ ._~ ............
...Jr..~==..'==:.;~...,~~
~~~..Li~~Jll r. ~~~~~:-,
.. .........-d.. ~........ ~& ~611r"""
.....~~..bA&
.. A ~ tl r ~ In . ..... ..~. ..., ., upan .
~~ GI . ....... ........ In . .... lit .......
.~ -.b4.....iIal~. ~l 1II1........~~
...... lain .. ...... l_ r i7~ ..... -. ..... ... lie
~..... II....... A ....~...,...................
~7
~",""'.".."_"""'flI"e= E8ch
[;...-_...,. buill _.........-...... ......
IL .... III .. ....... .... .. ......... III
~ ". ~ _...... ......11>> ........
~ .... .. ....... .., ......... 11Ie..........
ind... T 1 ~,. _11_ ~ ID ..............
....., .., . ....... ...... .. .. ....., ~ ,.
buIII-.IiI......
._ 1 &~..................... _- qI
8r-1 \I r ~"."""l 1 ~~
1Iir...... M.~ ... . ~ ... ..
InlUT ... w.IL ~.. ....... tan
............ 1 filA r -.
1Ie'1f J .~. .lltil..............
... ..- ...... ......... including
~,.~ r I ~~t..~ii.a:Cir ~~1L.:-l;{I"'l
1. n........................,....~~,.
... l1li . ...... ~ II ..........
tar A -- ......... ......
c~~ ..... ~ - .~. ~"'r:.dR
~..... .
2. .....E ........................~
to ,. .. III .... ........ .... ..........
:.:r.:.... - L -..-Al r-~ID....~
..... .
.. w..~"" ___...,.COII'IRM:T.....
...~
~ tit .. FedII...... .~ ..... ... ID ..
ftIIiIii.....*-*.......... 11111_ - 41 CFR 20)
1. ".~ .:..,... ~..........,..................
.... MIl ar ........ ID .. .... ~.... .............. ... bIIIt
tIIII:
.. NIt F..-.. ~................. ... be
...... ..,........ar ...........ID..,...................
... ~ ~. lit..... -... Gr ~ flI5
1IIJIIIICr. 811i111111r_C.~~ ....... ....~flI
. _ .........~ flI . ....... flI C l _ "*' III ~..I II~ ..
= -,................... _- F..-........
.. . J-',........... ........ ... _9 ~...
...-z: ~ nl ~J.l~t I - -........-::.::=:
.1iI ~... ~ ,. .., F..-.. ....... .... .... ar (;12 ItJ .....
..,....a
b. . ...u..... ...... ,......~ ..... ...
.................ID~~...~.~.~..
lit............. -=="5 ~..............
flI~_""'. ~ ..._~flI
.........~.. .. ,......~
.....~~~A...,.j J1 L- J r....
.............~~.L ~,..ID__ -In
......... .. lalnllluclanL
2. TIIII..- - -..........~~ 1 - ._IId.....~
.................... r -1 ................
.. A r..a.........- _. ".it-~. - III_A] __..~
InID ....,1- - ~s: u.ac. 1111. _ ~ wIlD
................ ...... ........ 1M.....
_NII.......,CIIIO...... -.. S""'" Ix'.........
......
1IIda...~~~~7'''~'::~''::::=
--~................... ~ .. .............
..... ... ... II .... .....,. .... ..., ... cIIIIbe
__6..
FalIn FHWA-1273 ,... Ht)
ATrIa_rr A- ~..... _--*2~
~..~
CA....-a ~~ lit ."',,~ ~. ......... anIr.)
1. ~.. d........... .. ......... .......
..... dIi ... . r ]. r 1_ ..., ... ... _ .....
==c: ~t~r.:"~~
~L'" ....==r-......an.....
.. To" ............ ..... ......,............
.. -- -.............
b. :a--..... fJI.. .... 10""'"
~. ..11h::~~..~'*111 .ID__
_....l ill...... WaItt.
c:. ,.... . af"_"'lDaIrIr.~.~"1D
ra ........ - .. .... .. · ...... ~~
'~"'...J.;:~~
.. --- ~ -~......,.. ....
anr.:I..er. _.......... ~...4 Wa..
2. n.ai~--""""~
..... .... I.... - *Nt ,. .. ........
:::.r..... f6 . r=':.-=:-!~~
FalIn FHWA-1273 (Rw. Ht)
(c).................... · I...~....~
...Id)................~... r... ......~
............ =.1:" )lilt........ ". Jab....., tie
=........ .~......~...,........
......__flI.._ 1J1 .......... 11' ~L........_
.. ....... III .. ....... ~ __ II - -- 1 ..,........ hit
........., "'''lIIIi a.............
3. n. (M.~ .... .... III ~",""'ID II ..... Jab
~. ....... .. --III" .... ............... .....
.111 L~ 11............111 ~""""'ID ..,JaII_
=~........... jdIIIn............,.
.. .,.... 1 __ ~ ..= af. Jab anIIr.., ..
.-.... wA......&~,.... .............,....
............10.......1 ~.....,.Io........
..... ..... .. .. .....-..r . .. ..... &l~,II~
.... .. ...... . ~...... .. ~.... ~& -...
....~ JJr .... .........................01
.. ~ 1- 1111 ~ __ ..........,.....
~I .. ....C1a~ 1-......~........dDnaf~
....... III ....... _lit . ~ ..... ..,.. ~
~..... ........ ~,,~ I ~....1c......
5. ,....... [IIi111'............ ~_ ~ ..... 1
.......4~....~A.....,.....~tar........ II.
ar~_................ ...
,... .
ATfACBMENT D
STATE CJF FLORIIM IEPARTIENT CJF TRANSPORTATION
NOTlFlCAnoN TO FOOT OF EEO OFFICER
275-CR1-13
EQlW.. OPPORT\NTY
O1m
FOOT uaI 0
· 0tIice
Mail signed original to:
605 Suwannee Street-MS 65
T_ R 32399-0450
SectIon 1: COMPANY IDENTlFlCA nON
L fEll) 10.:
20-2058265
.. .... ~ ...... AddI-= CcIr. ..... ZIp))
Hanover, M) 21076
L"~
410-850-4111
No
SectIon 2: EEO OFFICER IDENTlFlCA nON
.. EEO CIIIcII's WarIdng TIll:
Recrui · .
11. Work AddI-. flI &EO 0IIIcer: (dr. ...... zip)
Hanover, M) 21076
13. EEO 0IIIaIr r=. .....-..:
410-650-4111
M6~
sabraham@structural.net
SectIon 3: SIGNATURE OF CORPORATE OFFICIAL
As required in Equal Employment Opportunity Special Provisions included in Federaly Funded
Highway ConstrucIion Cot.tracts. and as required in the Equal Employment Opportunity
Requirements included in 81 State funded highway consbuction conb'acts. this official notice of EEO
0fIicer appointment (and/or update) is made to the Rorida Department of Transportation and the
U.S. Federal Highway Administration (FHWA). I understand that additionallnfonnation reganfq th8
EEO 0fIicer. the EEO parleY and other aspecIs of the construction contract compliance program may
be found in the EEO Construction Contract CompOanee' Workbook.
tl. ~ -..-..- · 'IT 10111:W1laj 1 ..
tl. DIll: (lllllllJlYr.)
I
tl. ..,.,. CIIIIIIIId)
(This SectIon For FOOT Use) SectIon 4: Processing of NotIfIcation
11. PIa ~ 1.I,d by: ... l.8II.....)
2D. DIll PI DE 1111 -L (1NIMIJiJr)
DIS1RIIJ11ON:
lJIDATEACTDt
QWInIIID FDOT c.nnI EO c-. fill; CapJ: MIIId to CanneD'
In BIt
275GZ1-1I
BlUM. 0PPQRTUtI1Y
0'UIJ7
StaIB of florida o.p.rtment of T.....portatIon
EEO 0IIIcer NotIIIcIIIIon
This form is used by COI dractDrs to COII1I1U1icatB the ~Ib IMNIt of an EEO Officer and to provide
EEO 0IIIcer Cont8ct data. The form Is also used to updaIB that 8Ilronnatlon in the event of new
appoilless, name ch8nges or conIact d8Ia ch8nges. Refer to the EEO Construction Cu..bact
CompIi8nce Workbook and the FOOT ~dlact for compliance program ~ and _.
The _ mails original of the completed form to
FOOT Equal 0pp0ItLI1ily 0IIIce
605 SUW..... Street MS 65
Tall8hBlIIS, FI 32399-0450
A copy of the form Is returned to the ~dradDr upon compIeIion of processing by FOOT
0.-1: ComDlet8.-1 box.. each time tilt. form -- submltl8d
feitIon 1:
Box 1 ContraCtor tt.ne - The name of the contracIDr.
Box 2 FElD No. -The contractDr's Federal identification Number
Box 3 ~ Home 0IIIce IIaIlng AcIdreIIa (Sb~ - The contractor's home office street
address; if the business' home office is outside of florida, indicate the address of the Florida
Home Office.
Box 4- Home 0IIIce IIaIllng AcIdreIIa (City, __, ZIp) - The contractor's home otIice city,
state and zip code; if the business' home office is outside of FIorkla, indicate the address of
the florida Home 0IIIce.
Box 5 IIIIIn Phone No. - Area code and phone number contractor's main business phone
Box 8 Fax Number No. - Area code and phone number contractor's main fax
Box 7 What Ie BeIng Changed? - Mark 'Yes' or 'No. to indicate if this is the company's
initial submission of EEO 0IIIcer information; If a new person has been appointed as EEO
Officer, If the appointee of record had a name change, and if the appointee's contact data is
being updated.
SectIon 2: EEO ~ ~,tlt]cdon
Box 8 N8me oJ EEO 0IIIcer - FIrSt name, rnildle initial and last name of EEO OfIicer
Box I EEO orIIcer'. WOltdng TItle - Job title if the EEO 0IIicer has other duties (e.g.
Treasurer, Manager of Contract Services, etc)
Box 10 Work A~ of EEO OIIIcer (Street) - Address of EEO Officer's office
Box 11 Work AcIdreIIs of EEO 0IIIcer (City, .... ZIp) - Address of EEO Officer's office
Box 12 EEO QnIcer Phone M....ber - Area code and phone number for EEO Officer
Box 13 EEO C)rIIcer FIIX tUn_ - Area code and fax number for EEO 0IIIcer
Box 14 EEO 0IIIcer .....1 MIdI... - EEO Officer Emal address
of CoIuo._ 0IIIBl
Box 11 AppoInting OIIIcWs S..... - Signature of Company 0IIicia1 responsible for
EEO Officer Appointment
Box 18 Dat8 ~IY"" - Date appointing official signs this Notification form
Box 17 OIIIcIaI'. N8me (prlnIIMI) - Printed first name and last name of person signing Box
15
Box 18 OIIIcIaI'. TItle (prlntBd) - Printed title of person signing Box 15 (e.g. President.
CEO, etc)
JIslIon~ ~.... ~~
ThIll section III campldld by FOOT
Box 18 Proc__.ed by - Rrst and last name of person processing the Notification
Box 20 Dat8 Proc.... - Date processing is completed
STATE OF FlJRMDEPARI1EN1'''~ATK>>I
RECORD OF 8UPERVI8ORY AND OFFICE PER8ONNB.
EEO IEETING OR INDIVIDUAL ORIENTATION
275GZ1-CI5
EQUAL OPPORTUNITY
DUI7
L COMPANY NAME: 2- DAD OJ' MUTING (MIDIY):
3- PDD lOR IDOT VENDOIlI: 4- NAME OF EEO On1CE1l:
5- CIIECJ( TYN OF MUTING: 6- ADDRJ:SS WIIERE MEETING HELD:
o INDIVIDUAL ORIENTATION
o Em"':~lmG
1. Em 0 ~ ~I....ICA'DON:
..... ~...,. .,.... C..,.~'. Em 0tIker II ~...... dIat _ ......... on.,.~t'" or ..... ... ..... ....
...... .IIKJ..................... ....... .. ................. tit .M.. .. apedI erou..... -,..,...............,
(DO) oIrIIptIa. ..... -Jer..... wen 1lIId..-I... allped ........ee ....nt....1Dde.
SlGNATIJRE:
. Em On1CER
L MAJOa TOPlCSADDP~
./ EEO PoIicJ .... Aftia...aive Action PIa
./ I.L...:~ ofEEO 0fIicer
./ EquaI~"'" Oppu.bmily ... .~.dtmeat
./ W... ... PaymIIs
./ lJt1,htdinn of · &."I.f rei
./ BuDetiD BoRa
./ IDbniews by S1IIIe _ Pedenl.~~~
./ T....~....
./ ec.pIIIiDtI
,. ATlENDEES:
PRJN'ID) NAME AND U1LE S1GNATUIIE
.A7T.ACII ADDIrIONAL PAGES IF JIIlC&\SaT