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12/14/1994Section 00500 FORM OF AGREEMENT This agreement is forth as of the th day of in g the year of ,q,,,Iet between the OWNER who is The Board of Y Count Commissioners of Monroe County Florida; and the following ng CONTRACTOR: Name: Coastal g =ectri c Sera; r - . Tnr-_ Address: Rt.l, Box 834, Suite B Big Pine Key. FL�33043 rT Phone: (305) 872-4133 - rmin all of the Work r- equired� by -.he for the purpose of perf o g a Contract Documents for the following PROJECT: TRAFFIC SIGNAL MAINTENANCE AND REPAIR FROM THE SEVEN MILE BRIDGE `DOE DADE COUNTY LINE Monroe County, Florida The Project has been designed by the Monroe County Division of • ' s hereafter referred to Public Works Enaineer�.nq D_epartent who i as the ARCHITECT/ENGINEER and who assumes all duties and responsibilities and has the rights and authority assigned to the ARCHITECT/ENGINEER in the Contract Documents in connection with completion of the Work in accordance with the Contract Documents. The OWNER and the CONTRACTOR agree as set forth .as follows: Article 1 - The Contract Documents The Contract Documents consist of this Agreement, the Conditions of the Contract (General, Supplementary, and other Conditions, the Specifications, all Addenda issued prior to and all Modifications issued after execution of this Agreement. These form the Contract, and all are as fully a part of the Contract as if attached to this Agreement or repeated herein. An enumeration of the Contract Documents appears in Article 7. Article 2 - The Work The Contractor shall perform all the Work required by the Contract Documents and Technical Specifications. However, this Contract does not grant the successful bidder exclusive right to traffic signal maintenance. The County reserves the right to preform routine maintenance with its own qualified personnel or to call in other qualified contractors as deems necessary. Tile Specifications contained herein are considered to be minimum standards 9/94 FORM OF AGREEMENT 00500-1 1 required. All work shall comply with all applicable Federal, State, Local Codes and Ordinances. Article 3 - Commencement of Contract Time; Notice to Proceed The date of letter "Notice to Proceed", shall be the beginning date of the Contract which will last two (2) years (730 days). Article 4 - Contract Sum The OWNER shall pay the CONTRACTOR for the faithful performance of the Work in accordance with the Contract Documents in current funds not to exceed the following amount based upon unit prices and actual quantities: $ Fifty Thousand Dollars $ 50,000.00 (words) (dollars) Article 5 - Payment Procedures The CONTRACTOR shall submit Applications for Payment in accordance with the General Conditions. Applications for Payment will be processed as provided in the General Conditions. Retention will not be withheld due to the nature of the work. The OWNER shall,. within thirty (30) days after receipt of each monthly Application for Payment, either make payment to the CONTRACTOR or return the Application to the CONTRACTOR indicating in writing the reasons for refusing payment. However, the OWNER will require sixty (60) days to process the Final Application for Payment. Article 6 - Contractor's Acceptance of Conditions The CONTRACTOR hereby agrees that he has carefully examined the sites and has made investigations to fully satisfy himself that such sites are correct and suitable ones for this work and he assumes full responsibility therefore. The provisions of the Contract shall control any inconsistent provisions contained in the specifications. All specifications have been read and carefully considered by the CONTRACTOR, who understands the same and agrees to their sufficiency for the work to be done. Under no circumstances, conditions, or situations shall this Contract be more strongly construed against the OWNER than against the CONTRACTOR. 9/94 FORM OF AGREEMENT 00500-2 Any ambiguity or uncertainty in the Specifications shall be interpreted and construed by the OWNER, and his decision shall be final and binding on all parties. The passing, approval, and/or acceptance of any part of the work or material by the OWNER shall not operate as a waiver by the OWNER of strict compliance with the terms of this Contract, and Specifications covering said work; and the OWNER may require the CONTRACTOR and/or his surety to repair, replace, restore, and/or make to comply strictly and in all things with the Contract and Specifications any and all of said work and/or materials which within a period of one (1) year from and after the date of the passing, approval, and/or acceptance of any such work or material, are found to be defective or to fail in any way to comply with this Contract or with the Specifications. This provision shall not apply to materials or equipment normally expected to deteriorate or wear out and become subject to normal repair and replacement before their condition is discovered. Failure on the part of the CONTRACTOR, immediately after Notice to either repair or replace any such defective materials and workmanship shall entitle the OWNER, if it seems fit, to replace or repair the same and recover the reasonable cost of such replacement and/or repair from he CONTRACTOR, who shall in any event be liable to the OWNER for all damage, loss, and expense caused to the OWNER by reason of the CONTRACTOR'S breach of this Contract and/or his failure to comply strictly and in all things with this Contract and with the Specifications. Article 7 - Contract Documents The Contract Documents which comprise the entire agreement between the OWNER and the CONTRACTOR concerning the Work consist of the following: 1. Notice of Award 2. This Agreement (pages 1 to 7, inclusive). 3. Notice to Proceed 4. Bidding Documents - Notice of Calling for Bids, Instructions to Bidders, Bid Proposal, Pre -Bid Substitutions, Scope of Work, Milestone Schedule 5. General Conditions (pages 0 to 31, inclusive). 6. Supplementary Conditions (page 1). 7. Supplementary Insurance Documents (pages 1 to 11, inclusive). Be General Requirements - Measurement and Payment, Application for Payment, Temporary Controls, Construction Cleaning 9/94 FORM OF AGREEMENT 00500-3 9. Technical Specifications bearing the title TRAFFIC SIGNAL MAINTENANCE FROM THE SEVEN MILE BRIDGE TO THE DADE COUNTY LINE and dated . 10. Addenda numbers to inclusive. 11. CONTRACTOR'S Bid Proposal (pages 1 to 16, inclusive). There are no Contract Documents other than those listed above in this Article. The Contract Documents may only be amended, modified, or supplemented as provided in the General Conditions. Article 8 - Liquidated Damages Time is of the essence of this Contract and should the CONTRACTOR fail to complete the emergency repairs within the specified time, or any authorized extension thereof, there shall be deducted from the compensation otherwise to be paid to the CONTRACTOR, and the OWNER will retain the amount of Two Hundred Dollars ($200.00) per calendar day as fixed, agreed, and liquidated damages for each calendar day elapsing beyond the specified time for completion or any authorized extension thereof, which sum shall represent the actual damage which the OWNER will have sustained by failure of the CONTRACTOR to complete work within the specified time; it being further agreed that said sum is not a penalty, but is the stipulated amount of damages sustained by the OWNER in the event of such default by the CONTRACTOR. Article 9 - Termination The performance of work or provisions of goods under this Agreement may be terminated, delayed, or temporarily suspended by the OWNER, in whole or in part, from time to time, whenever the OWNER shall determine that such termination is in the best interest of the OWNER. The OWNER shall pay all reasonable costs incurred by' the CONTRACTOR up to the time of termination, and the CONTRACTOR shall not be reimbursed for any anticipatory profits which have not been earned up tot he date of termination. If the CONTRACTOR fails to fulfill the terms of this CONTRACTOR, or attachments, properly or on time, or otherwise violates the provisions of the Agreement or of applicable laws or regulations governing the use of funds, the OWNER may terminate the Agreement by written notice. The notice shall specify cause. All finished or unfinished supplies or services shall, at the option of the OWNER, become property of the OWNER. The OWNER shall pay the CONTRACTOR fair and equitable compensation f o r expenses incurred prior to termination of. the Agreement, less any amount of damages caused by the CONTRACTOR'S breach. If the damages are more than compensation payable, the CONTRACTOR will remain liable after termination and the OWNER can affirmatively collect damages. 9/94 FORM OF AGREEMENT 00500-4 Article 10 - Independent Contractor At all times and for all purposes under this agreement the CONTRACTOR is an independent contractor and not an employee of the Board of County Commissioners for Monroe County. No statement contained in this agreement shall be construed so as to find the CONTRACTOR or any of his/her employees, contractors, servants, or agents to be employees of the Board of County Commissioners for Monroe County. Article 11 - Discrimination The CONTRACTOR shall not discriminate against any person on the basis of race, creed, color, national origin, sex, age, or any other characteristic or aspect which is not job related, in its recruiting, hiring, promoting, terminating, or any other area affecting employment under this agreement. Article 12 - Assignment The CONTRACTOR shall not assign this agreement, except in writing and with the prior written approval of the Board of County Commissioners for Monroe County, which approval shall be subject to such conditions and provisions as the Board may deem necessary, this agreement shall be incorporated by reference into any assignment and any assignee shall comply with all of the provisions of this agreement. Unless expressly provided for therein, such approval shall in no manner or event be deemed to impose any obligation upon the Board in addition to the total agreed -upon prices of the services/goods of the CONTRACTOR. Article 13 - Compliance In providing all services/goods pursuant to this agreement, the CONTRACTOR shall abide by all statutes, ordinances, rules, and regulations pertaining to, or regulating the provision of, such services, including those now in effect and hereinafter adopted. Any violation of said statutes, ordinances, rules, and regulations shall constitute a material breach of this agreement and shall entitle the Board to terminate this CONTRACTOR immediately upon delivery of written notice of termination to the CONTRACTOR. Article 14 - Notice and Service Any notice required or permitted under this agreement shall be in writing and hand delivered or mailed, postage prepaid, to the other party by certified mail, return receipt requested, to the following: For County: Engineering 5100 College Stock Island Key West, FL Department Road 33040 Article 15 - Professional Responsibility For Contractor: 9/94 FORM OF AGREEMENT 00500-5 The CONTRACTOR warrants that it is authorized by law to engage in the performance of the work encompassed by the project herein described, subject to the terms and conditions set forth in the Plan and Specifications entitled "Traffic Signal Maintenance and Repair from the Seven Mile Bridge to Dade County Line". The provider shall at all times exercise independent, professional judgement and shall assume professional responsibility for the services to be provided. Continued funding by the Board is contingent upon retention of appropriate local, state, and/or federal certification and/or licensure of CONTRACTOR. Article 16 - Funding Source In the event that County funding is partially reduced or cannot be obtained or cannot be continued at a level sufficient to allow for the purchase of the services specified herein, this agreement may then be terminated immediately at the option of the Board by written notice of termination delivered in person or by mail to the CONTRACTOR. The Board shall not be obligated to pay for any services provided by the CONTRACTOR after the CONTRACTOR has received written notice of termination. Article 17 - Miscellaneous Terms used in this agreement which are defined in Article 1 of the General Conditions will have the meanings indicated in the General Conditions. No assignment by a party hereto of any rights under or interests in the Contract Documents will be binding on another party hereto without the written consent of the party sought to be bound; and specifically but without limitation moneys that may become due and moneys that are due may not be assigned without such consent (except to the extent that th effect of this restriction may be limited by law), and unless specifically stated to the contrary in any written consent to an assignment no assignment will release or discharge the assignor from any duty or responsibility under the Contract Documents. OWNER and CONTRACTOR each binds itself, its partners, successors, assigns and legal representatives to the other party hereto, its partners, successors, assigns and legal representatives in respect of all covenants, agreements and obligations contained in the Contract Documents. Article 18 - Other Provisions In cases of conflict within the described Contract Documents in Article 7 of this Form of Agreement, the order of precedence shall be as follows: 1. This Agreement 2, Bidding Documents with all./any addenda 3. General Requirements 4. Supplementary Conditions 9/94 FORM OF AGREEMENT 00500-6 A 5. Supplementary Insurance Documents 6, General Conditions 74, Technical Specifications IN WITNESS WHEREOF, the OWNER and CONTRACTOR have signed this Agreement in triplicate. One counterpart each has been delivered to the OWNER, CONTRACTOR, and COUNTY ENGINEER. All portions of the- Contract Documents have been signed or identified by the OWNER and CONTRACTOR or by ARCHITECT/ENGINEER on their behalf. This • Agreement will be effective on 'Jed eey�4eye- 19. OWNER: Monroe County BOCC Monroe Co ty,, FL By D NX L KOGE, Clerk Attestel 4 Address for giving notices Monroe County Engineer Dept. 5100 College Road Rey West, FL 33040 AP a 9/94 FORM OF AGREEMENT 00500-7 rev. 4/22/93 GENERAL INSURANCE REQUIREMENTS FOR CONTRACTORS AND SUBCONTRACTORS Prior to the commencement of work governed by this contract (includingthe re -staging of personnel & material), the Contractor P shall obtain her own expense, insurance as specified in the at his/ att ached schedules which are made part of this contract. The Contra ctor will also ensure that the insurance obtained will extend protection to all Sub -Contractors engaged by the Contractor. As an alternative, the Contractor may require all Sub -Contractors to obtain insurance consistWilt iiii the attached schedules* Th e 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 deadlines specified in this contract and any penalties and f failure to perform assessments shall be imposed as if the work commenced on the specified date and time, except for the Contractor's failure to provide satisfactory evidences Th e Contractor shall maintain the required insurance throughout the entire term of this contract and any extensions specified in any attached schedules. Failure to comply with this provision may re sult in the immediate suspension of all work until the required insurance has been reinstated or replaced. Delays in the completion of the work resulting from the failure of the Contractor to maintain the required insurance shall not 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 shall provide, to the County, as satisfactory evidence of the required insurance, either: - Certificate of Insurance OR A Certified copy of the actual insurance policy. The County, at its sole option, has the right to request a certified copy of any or all insurance policies required by this contract. All insurance policies must specify that they are not subject to cancellation, non -renewal, material change, or reduction in coverage unless a minimum of thirty (30) days prior notification is given to the County by the insurer. The acceptance and/or approval of the Contractor's insurance shall 09/11/94 SUPPLEMENTARY INSURANCE DOCUMENTS 00900-1 rev. 4/22/94 not be construed as relieving the Contractor from any liability or obligation assumed under this contract or imposed by law. The Monroe County Board of County Commissioners, its employees and officials will be included as "Additional Insured" on all policies, except for Workers' Compensation. In addition, the County will be. named as an Additional Insured and Loss Payee on all policies covering County -owned property. Any devi ati oris i r ors General ----insurance Requi r eme�its must -be- requested in writing on the County prepared form entitled "Request for Waiver of Insurance Requirements" and approved by Monroe County's Risk Manager. 0 9 J 11 % 9 4 SUPPLEMENTARY INSURANCE DOCUMENTS 0 0 90 0 rev. 4/22/93 INDEMNIFICATION AND HOLD HARMLESS FOR CONTRACTORS AND SUBCONTRACTORS The Contractor covenants and agrees to indemnify and hold harmless Monroe County Board of County Commissioners from any and all claims for bodily injury (including death), personal injury and property damage (including property owned by Monroe County) and any other losses, damages, and expenses (including attorney's fees) which arises nut of, in connection with, or by -services pr vi ['�oN by r lhr� v - of--. its reason of -se� . +..es _ Q . _ N _ -._ .s. .. -_ .. Contractor o.r.—.an,, Subcontractor(s) in any tier, occasioned by the negligence or other wrongful act or omission of the Contractor or its Subcontractor(s) in any tier, their employees, or agents. In the event the completion of the project (to include the work of' others) is delayed or suspended as a result of the Contractor's failure to purchase or maintain the 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 the Contractor is for the indemnification provided for above. The extent of liability is in no way limited to, reduced, or lessened by the insurance requirements contained elsewhere within this agreement. 09/11/94 SUPPLEMENTARY INSURANCE DOCUMENTS 00900-3 rev. 4/22/93 MONROE COUNTY, FLORIDA INSURANCE CHECKLIST FOR VENDORS SUBMITTING PROPOSALS FOR WORK To assist in the development of your proposal, the insurance coverages marked with an "X" will be required in the event an award is made to your firm. Please review this form with your insurance agent have him s i gn i t in the p lace n--�� .��`� I t is also is cy,�,iiL ��.a the bidder sign the---fworric &and with each proposal. WORKER'S COMPENSATION AND EMPLOYERS' LIABILITY Workers' Compensation WC1 Employers' Liability WC2 Employers' Liability WC3 X Employers' Liability WCUSLH US Longshoremen & Harbor Workers Act WCJA Federal Jones Act INSCKLST 1 Statutory Limits $100,000/$5001000/$1001000 $500,000/$5001000/$500,000 $1,000,000/$1,000,000/$1,000,000 Same as Employers' Liability Same as Employers' Liability 09/11/94 SUPPLEMENTARY INSURANCE DOCUMENTS 00900-4 rev. 4/22/93 GENERAL LIABILITY As a minimum, the required general liability coverages will include: Premises Operations - Products and Completed Operations Blanket Contractual - Personal Injury Expanded Definition of Property Damage Required Limits: GL1 $100,000 per Person; $300,000 per Occurrence $50,000 Property Damage OR $300,000 Combined Single Limit GL2 $250,000 per Person; $500,000 per Occurrence $50,000 Property Damage OR $500,000 Combined Single Limit GL3 X $500,000 per Person; $1,000,000 per Occurrence $100,000 Property Damage OR $1,000,000 Combined Single Limit Required Endorsement: GLXCU X Underground, Explosion and Collapse (XCU) GLLIQ Liquor Liability All endorsements are required to have the same limits as the basic policy. INSCKLST 2 0 9,/ 11 / 94 SUPPLEMENTARY INSURANCE DOCUMENTS 00 900 - 5 rev. 4/22/93 VEHICLE LIABILITY As a minimum, coverage should extend to liability for: - Owned; Nonowned; and Hired Vehicles Required Limits: VL1 $50,000 per Person; $100,000 per Occurrence $25,000 Property Damage OR -- $1Q0 , 0^vQ Com�biiLed Single Limit— VL2 $100,000 per Person; $300,000 per Occurrence $50,000 Property Damage OR $300,000 Combined Single Limit VL3 X $500,000 per Person; $1,000,000 per Occurrence $100,000 Property Damage OR $1,000,000 Combined Single Limit MISCELLANEOUS COVERAGES BR1 Builders' Limits equal to the Risk completed project. MVC Motor Truck Limits equal to the maximum Cargo value of any one shiipment. PRO1 Professional $ 250,000 per Occurrence PR02 Liability $ 500,000 per Occurrence PR03 $1,000,000 per Occurrence POL1 Pollution $ 500,000 per Occurrence POL2 Liability $1,000,000 per Occurrence POL3 $5,000,000 per Occurrence ED1 Employee $ 10,000 ED2 Dishonesty $100,000 GK1 Garage $ 300,000 ($ 25,000 per Veh.) GK2 Keepers $ 500,000 ($100,000 per Veh.) GK3 $1,000,000 ($250,000 per Veh.) MED1 Medical $ 5001000/$ 11000,000 Agg. MED2 Professional $110001000/$ 31000,000 Agg.- MED3 $5,0001000/$101000,000 Agg. INSCKLST 0 9/ 11/ 94 SUPPLEMENTARY INSURANCE DOCUMENTS 00 900 - 6 rev. 4/22/94 IF Installation Maximum Value of Equipment Floater Installed VLP1 Hazardous $ 300,000 (Requires MCS-90) VLP2 Cargo $ 500,000 (Requires MCS-90) VLP3 Transporter $1,000,000 (Requires MCS-90) BLL Bailee Liab. Maximum Value of Property HKL1 Hangarkeepers ' $ 300,000 HKL2 Liabl' l ity $- 500,000 HKL3 $1,000,000 AIR1 Aircraft $25 , 000 , 000 AIR2 Liability $ 11000,000 AIR3 $ 11000,000 AE01 Architects $ 250,000 per Occurrence/ Errors $ 500,000 Agg. AE02 & $ 500,000 per Occurrence/ Omissions $1,000,000 Agg. AE03 $1,000,000 per Occurrence/ $3,000,000 Agg. INSURANCE AGENT'S STATEMENT I have reviewed the above requirements with the bidder named below. The following deductibles apply to the corresponding policy. POLICY DEDUCTIBLES Liability policies are Occurrence Claims Made Insurance Agency Signature BIDDER'S STATEMENT I understand the insurance that will be mandatory if awarded the contract and will comply in full with all the requirements. Bidder Signature I N S C K L S T 4 0 9/ 11 / 9 4 SUPPLEMENTARY INSURANCE DOCUMENTS 0 0 90 0- 7 rev. 4/22/93 WORKERS' COMPENSATION INSURANCE REQUIREMENTS FOR CONTRACT BETWEEN MONROE COUNTY, FLORIDA AND Prior to the commencement of work governed by this contract, the Contractor shall obtain Workers' Compensation Insurance with limits sufficient to respond to the applicable state' s statutes. In addition, the Contractor shall obtain Employers' Liability Insurance with limits of not less than: $1,000,000 Bodily Injury by Accident $1,000,000 Bodily Injury by Disease, policy limits $1,000,000 Bodily Injury by Disease, each employee Coverage shall be maintained throughout the entire terms of the contract. Coverage shall be provided by a company or companies authorized to transact business in the state of Florida and the company or companies must maintain a minimum rating of A --VI, as assigned by the A.M. Best Company. 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 Contractor's status. The Contractor shall be required to submit a Letter of Authorization issued by the Department of Labor and a Certificate of Insurance, providing details on the Contractor's Excess Insurance Program. If the Contractor participates in a self-insurance fund, a Certificate of Insurance will be required. In addition, the Contractor will be required to submit updated financial statements from the fund upon request from the County. WC3 09/11/94 SUPPLEMENTARY INSURANCE DOCUMENTS 00900-8 rev. 4/22/93 GENERAL LIABILITY INSURANCE REQUIREMENTS FOR CONTRACT BETWEEN MONROE COUNTY, FLORIDA AND Prior to the commencement of work 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: Premises Operations Products and Completed Operations Blanket Contractual Liability Personal Injury Liability Expanded Definition of Property Damage The minimum limits acceptable shall be: $1,000,000 Combined Single Limit (CSL) If split limits are provided, the minimum limits acceptable shall be• $ 500,000 per Person $1,000,000 per Occurrence $ 100,000 Property Damage 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 reported should extend for a minimum of twelve (12) months following the acceptance of work by the County. The Monroe County Board of County Commissioners shall be named as Additional Insured on all policies issued to satisfy the above requirements. GL3 09/11/94 SUPPLEMENTARY INSURANCE DOCUMENTS 00900-9 rev. 4/22/93 VEHICLE LIABILITY INSURANCE REQUIREMENTS FOR CONTRACT BETWEEN MONROE COUNTY, FLORIDA 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: Owned, Non -Owned, and Hired Vehicles The minimum limits acceptable shall be: $1,000,000 Combined Single Limit (CS,L) If split limits are provided, the minimum limits acceptable shall be: $ 500,000 per Person $1,000,000 per Occurrence $ 100,000 Property Damage The Monroe County Board of County Commissioners shall be -named as Additional Insured on all policies issued to satisfy the above requirements. VL3 09/11/94 SUPPLEMENTARY INSURANCE DOCUMENTS 00900-10 rev. 4/22/94 GENERAL LIABILITY INSURANCE REQUIREMENTS FOR CONTRACT BETWEEN MONROE COUNTY, FLORIDA. AND Recognizing that the work governed by this contract involves either underground exposures, explosive activities, or the possibility of collapse of a structure, the Contractors General Liability Policy shall include coverage for the XCU (explosion, collapse, and underground) exposures with limits of liability equal to those of the General Liability Insurance Policy. GLXCU 09/11/94 SUPPLEMENTARY INSURANCE DOCUMENTS 00900-11 MEMORANDUM TO: David S. Koppel, County Engineer FROM: Desiree Peacock, Project Engineer DATE: December 01, 1994 RE: Traffic Signal Maintenance and Repair from the Seven Mile Bridge to the Dade Co. Line On December 01, 1994 bids were opened for the above referenced project. Two bidders responded: Designed Traffic Installation Co. in the amount of $391,108,00 and Coastal Electric Service in the amount of $339,410.00. I recommend awarding the contract to the lowest bidder Coastal Electric Service in the amount of $339,410.00. DVP/jl TSMR.DK Y 01 if w MONROE COUNTY PURCHASING DEPARTMENT RECAP OF BID OPENING REBID FOR TRAFFIC SIGNAL MAINTENANCE 7 MILE BRIDGE TO DADE COUNTY DECEMBER 1, 1994 AT 10:00 AM VENDOR - GRAND TOTAL II Coastal Electric Service, Inc. $3392410.00 Designed Traffic Installation, Co. $3911108.00 Bid Committee Present: R.M. Cofer and Yvette Estrada - PUR, Desiree Peacock - ENG, Robert Normand - Coastal Electric Service, Inc. I do hereby certify that this is a true and correct copy of said opening. Dated this 1 day of December 1994. VVEMDOMMA _LL�-�_- aoWu�or� ra.a�� � Notary Public ��O��. "Offers from the vendors listed herein are the only offers received timely as of the above opening date and time. All other offers submitted in response to this solicitation, if any, are hereby rejected----, as late." t 4e.0 V IC �Th 110 Monroe County Board of County Commissioners Director of Purchasing At tn: R.F. Cofer Re; Traffic Signal Maintenance and repair from the Seven Mile Bridge to the Dade County line Dear Mr . Cofer, Enclosed please find our bid for the above referenced maintenance contract. .-.As I'm sure you are aware Coastal Electric Service , Inc. , has been 'providing... all of the repairs and maintenance of the traffic signals within this geographic area under contract with Monroe County since 1989 and has prided itself on our level of service to the public safety Our record stands as evidence of our firms successful contractual experience and along with my certification by the International Municipal Signal Association, at "Traffic Signal Technician, Level II" (copy enclosed), it also testifies to our technical experience in this extremely technical and important field. Please accept our proposal for consideration for the continuance of our ser ice t Monroe County,, Sincerely Rober Nor nd, President Coastal Elect is Service, Inc. State Certified EC-0001277 RJNmn enc . ROUTE I, BOX 834 SUITE B, BIG PINE KEY, FL 33043 TEL. (305)8724133 • 1-800-273-7299 • FAX (305) 872-2162 .t, MID, ell �• \tiff • } •, � ./•. • l/a a /r• •h• Y' z ; ��' , :fit . . ,..� Y �• ,�� S�� ti�},1i�W'�• • �� �of N N I •�• `W?.1 ti •+ " { •t4�,� . ,{,. •�' t '*'. "y' . I j ri '' . ; � �� �� ��� 1 � ,j .`ri • � I ,I �!� jt'' S.V,;"'' `••\ \ '�� •►1 , 1 tt � j � � � � ;• . i � • � � ` � 1 � � \) t � ' I i � �,l � • ` � f � ; .('� 1 i� i ��,,`�` Ii�j� t�' , •- •��/l�y.�'•"'.�+ +�"`r•: a . I I ; • I j}) j., . ,1� • :I.t. 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NAME -i"; r r-111ALl T l": MUNG ''V.Z E,RY�It..paie . 0 "T l"'-i2;COASTAL ';P-Elt'CTRI t E T-, YrNORMAND t"ROBE'R �','PRE TOTAL "ADDRESS".. R T 1 8 0 X .118 3 4 B BIG 0 18-000 .40 :1 ,,. ,, _. ,f;t:. ;�;M�t *� ,.�:� �, t maxim CLW CA co -Q 'n ELEC.'.:CONT `ohm, .Y� ENE C) r �y M1 .: C:l %0 %0 o;o cl THIS BECOMES A W H A R R Y F" .'KNIGHT" C F C ba TAX'"COLLECTOR"" RECEIPT WHEN VALIDATED p 0 129 'V�U,Y 33041-1 W9'�­:� 0000000000 0000001800 0000301400010287 1001 7 AC # STATE OF FLORIDA 4n- R r, 17 6 4 9 DEPARTMENT OF BUSINESS AN© PROFESSIONAL REGULATION sY ELECT CONTRACTORS LICENSING BD LICENSE NO. BATCH NO. 09/05/941 EC 0001277 94900740 '­=-3=2�q THE ELECTRICAL CONTRAC11IR"'* o T P NAMED BELOW IS CERTIFIED UNDER TH�Lpj31 9g QVISIONS . .7 F.S., FOR THE YEAR EXPIRING NORNAND:0 E �. :. COASTAL: ROUTE 5 B a' x t., Y =n� .� � BIG PINCe. L 3 LAWTON CHILES GEO E STU T, JR. GOVERNOR DISPLAY IN A CONSPICUOUS PLACE SEC ETAAYv B.P.R. •: ♦t tt t♦ttt:.. ♦♦ ♦ ': s}t;'} � �h�;';} ti' �'•:iti S.';3' }�:}:;::•: �ti {:�'�::.titi s �}:tiv;: ;�:�t'•�:' :;. .s ...titi titi�:� ................... ttii,r.'fr •�z�.; ... s , r .... .r� .t� :.; ... v. J. '_ [ t, ••'t : �;x' •' • .�., ♦♦ti DATE (MM ..:. :b ..10/24/94 THIS CERTIFICATE IS ISSUED AS A MATTER ' OF INFORMATION ES ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE RAY HAMPSON & ASSOCIAT HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR INSURANCE AGENCY _ ' ALTER THE COVERAGE AFFORDED BY THE POLICES BELOW. 102481 'OVERSEAS MlY COMPANIES AFFORDINGCOVERAGE KEY LARGO FL 33037 coMPMY A BANKERS INSURANCE COMPANY INSURED COMPANY COASTAL ELECTRIC SERVICE, INC. B AND ROBERT & MELANIE NORMAND COMPANY RT 1 BOX 834 SUITE B C BIG PINE KEY, FL 33043 COMPANY D . L. •.Y •J : Y •. ..•.. ..� �,•' 'rti'• 'ti � :•'• :'fi:•:vr '� s .L'•'fi:- s::•'• :•:tip • :•:ti{} ' 'h, '•�:tiz :•�� � '�:{'� ti vs • � s '� •. t'�: tit't' 's . s ' � s :sh$;., .t�� s'+..�','.s��;� t; ��':;:: �.�t.;.tti•'• t'.t t .} tymak rs tti 's:t t�} '{ r s. '.{G t; •r n{r• : ; J ssti❖.• ��A : st ti tti.S�. "t'�ti• 's'�r'•:•.�.s't s '•.•'� v stiff. ti•.ti• s 'sv,'k; 'k''h•R's ,r rtii.• }. ti,. an t'�t'ti1•:ti't''%t'..titi'�ti�♦t~nt.�:ti1,}.in'•'.t �7 �.�rinss'•r• 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 OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CID POLICY EFFECTIVE POLICY EXPIRATION LTRTYPE OF IfSURANCE POLICY NUMBER DATE (MMIDDAM DATE (MMIDDIM LIMITS GENERA. LIABaITY CP P 0 9 2 7 5 0 0 9 0 0 2 0 7 0 3 9 4 0 7 0 3 9 5 GENERAL. AGGREGATE $10,000t000 X COMMEACUL GENERAL. UABUTY PRODUCTS • COMPIOP AGG i 1. f 0 0 Ot. 0 0 0 CLAIMS MADE a OCCUR PERSONAL do ADV INJURY i 1 0 0 0 0 0 0 OWNER'S & CON`rPA OR'S PROT EACH OCCURRENCE i 1 000t. 000 FIRE DAMAGE (Any one Are) i 50,000 MED EXP (Any one person) i 51000 AUTOMOBILE LIABILITY BA0 9 2 7 5 0 0 910 2 0 7/ 0 3 9 4 0 7 0 3 9 5 COMB1, 000, 000 X ANY AUTO COMBINED SINGLE OMIT i ALL OWNED AUTOS BODY INJURY SCHEDULED AUTOS (Per Person) X HIRED AUTOS BODILY INJURY X NON -OWNED AUTOS (Pow aoc WW4 i PROPERTY DAMAGE i GARAGE LIABILITY AUTO ONLY - EA ACCIDENT i ........................................ ........................................ ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT i AGGREGATE i EXCESS LIABLITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE i OTHER THAN UMBRELLA FORM i WORKERS COMPENSATION AND STATUTORY LIMITS EMPLOYERS' LIABILITY EACH ACCIDENT i THE PROPRIETORI INICL DISEASE - POLICY LIMIT i PARTNERStEXECUTIVE OFFICERS ARE: EXCL DISEASE - EACH EMPLOYE i OTHER DESCRIPTION OF OPERATIONSJLOCATIONSNEHICLES/SPECUIL ITEMS ELECTRIC SERVICE STATE OF FLORIDA CONTRACT FOR TRAFFIC SIGNAL MAINTENANCE .� .. .�.:•. * j. 0 i........................ ...........�..................................... ...........� ...� ..................................... .......... * ..t . �������• . r.: .:•. .•.•.•:::: .:•.•.•:.•::::.•:::.•::.•.•:: �.rr : :"TIC'R�•lSy:''M.::•.:.:..............J:.::............:..r..•.•::..:::.�r..:.......................:....:......::...............................v. :...................:........:t.t.:.......:...............:...:..:..:J::::r.•.•:r.:r::.:: r..::.. :•J.r:r........................................ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE MONROE CTY BOARD OF CTY EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAL COMMISIONIERS ,�Q_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 5100 COLLJ2GE ROAD BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY KEY WEST FL 33040 OF ANY KIND UPON THE COMPALITS AGENTS OR REP ENTATIVES. IV AUTHORIZED REPRESENTATIVE BARBAR.A S TULLE ........................1.................................................................................:..:......:.........:•::::::..:.......:.:::.�:.�:.:f.::::.:.�:::::.�:.:�.:� .....:...:..:..::. •:.:: ........ .....:::•...::.:.:• . :: i.1 SECTION .00I10 t! U PROPOSAL FORM BID TO: MONROE COUNTY BOARD OF COUNTY COMMISSIONERS c% PURCHASING DEPARTMENT PUBLIC SERVICE BUILDING, ROOM 002 5100 COLLEGE ROAD, STOCK ISLAND KEY WEST, FLORIDA 33040 BID FROM: COASTAL ELECTRIC SERVICE INC* RT. 1, BOX 834, Suite B BIG PINE KEY, FL. 33043 The undersigned, having carefully examined the Work and reference Specifications, Proposal, and Addenda thereto and other Contract Documents for.: • TRAFFIC SIGNAL _ MAINTENANCE AND REPAIR FROM THE SEVEN MILE BRIDGE TO THE DADE COUNTY LINE Monroe County, Florida and having carefully examined the site where the Work is to be performed, having become familiar with all local conditions including labor affecting the cost thereof, and having familiarized himself with material availability, Federal, State, • and Local laws, ordinances, rules and regulations affecting performance of the Work, does hereby propose to furnish all labor, mechanics, superintendents, tools, material, equipment, transportation services, and all incidentals necessary to perform and complete said Work and work incidental hereto, in a workman -like manner, in conformance with said Drawings, Specifications, and other Contract Documents including Addenda issued thereto. The undersigned further certifies that he has personally inspected the actual location of where Work is to be performed, together with the Local sources of supply and that he understands the conditions under which the Work is to be performed. The successful bidder shall assume the risk of any and all costs and delays arising from the existence of any subsurface or other latent physical condition which could be reasonably anticipated by reference to documentaryinformation provided and made available, and from inspection and examination of the site. 10/02/92 BID PROPOSAL 00110 — 2 6 . Y i v t R • The . undersigned -shall perform the work at the -Unit Price ' Indicated on .the Bi-d Form. Further, it is understood ' . that the .. Bid Form Quantities are . estimated for : evaluation --,- purposes and to -'determine the low bidder. The ' actual dontract. price will be set -at $50,000.00. Payment will be determined ' from • the actual quant i•t i es measured and the unit prices indicated on the Bid - Form in accordance wi th the Contract Documents. ' The undersigned agrees .to accept in full • compensation* therefor the unit prices for the i t ems named in the following schedule, It is understood that the unit prices quoted or established for a • particular item are -to be used for computing the amount to be paid to the Contractor. In addi.tion, the Contractor is to be reimbursed for the actual cost to him of any parts and . materials . Bidders Certificate of Competency No. EC-0001277 ' International Municiple Signal Association Certifiacte VBE*20512 Bidders -Occupational License -No. 30140-0010287 . I w 10 / 0 / 9 2. BID PROPOSAL 00110 - 3 • i .1w Ch o m w O O O Cc)O O O. _O O O COD O O O o tu O O• O O O O O. O O O O O. O O O O O O O O O O O O U , , . . , , . O O O O O O O O O O O- O 0. 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L.L � W� COV W COU � I H- a. ..... w . � � _ _ O W W � . p � �" V ._..I- < LL W CO lt. op �O • Q -- w u.. w Z U U Q IL w Z O . oc O Q a J f� S� Z Q J iL W O -J W W OC H • �0.�~ acvU ��zZ--�D jwa.rrit 6 'z �-- . cc z >- }- U o i w��w �'"'UUwwO—w°CwWw0WW�O w 'W O'�"2v�'�F—C�3C30Q }acUVUF-UV �QLLv)z�"-�ZCC ZZZaco�--="� �W �WF- Z co w C'3 L' -- O . Q Q — w � Z z n. ~ a. �-- a. a. to v H 0-0. � J X 8�___� m W O O W O W W W W W' ,.! o C). - d Q I-- Q �-- co U U �- O ac U x z cc a ac Wr • ac LL . U o . o o co 0) 0) 0) 0) to co co o m . a� 0 o 0 0 o co .. o 0 0 N Ct) 10), N d' r r- LO to LO 2 Q i-. W d } ~ i� co o) o T- CV CO It to co O z O co co ca t` t` t` t` . oC � � a r-4 w O . •, rM �> • O z • J LLJ Q W O V 0 Z. 0 U Q W -' � Z CL • Z D Q CO d w F- w O O 0 w U (L v Z w a. D .0 w 0 Z Q tr O m i °C c O LL Ic co O U � .J � U O - C 4/•. `. I acknowledge receipt of Addenda . No •.� s� ,.��1 r A. I have included pages 1 through 16 of ; -the', S1.i entails •the - Proposal Form , the ,Lobby i rf. Interest 'Clause_, the Sworn Statements' !of �swhich ..> . i Ir ct-%;0f € � n. 'ity • 1 J. � 1•C111�L Crimes_, the Non -Collusion Affidavit �zr aria • �e Fe re Work 'Place For r'.., ,r #1,{• Mailing Address: Phone Number: )ove as ' a emi ' ,r that the are '• c uded Tr�, 6jj 0&t - S.,;Nv t Rt I i�> re)c 3 G `E � 3 Date • Signed. GQ01MCAr\ (Name) (Title) y . y• Witness: (Seal) DENISE,.. N*AL.EPA io/o2/92 BID PROPOSAL 00110 - 9 SECTION 0110 SWORN STATEMENT UNDER SECTION 287.133(3)(a), FLORIDA STATiJTES, ON PUBLIC ENTITY CRIMES THIS FORM DUST BE SIGNED IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICER AUTHORIZED TO ADMINISTER OATHS. 1. This sworn statement is submitted to (print name of the public entity) by (print individual's name and title) for (print name of entity submitting sworn statement) whose business is and (if applicable) it Federal Employer Identification Number (FEIN) is (If the entity has no FEIN, include the Social Security Number of the individual signing this sworn statement: ,) 2. I understand that a "public entity crime" as defined in y Paragraph 287.133(1)(g), Florida Statues, means a violation of any state or federal law by a person with respect to and directly related to the transaction of business with any public entity or with an agency -or political subdivision of any other state or of the United States, including, but not limited to, any bid or contract for good or services to be -provided to any public entity or an agency or political subdivision of any other state or of the United States and involving antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material misrepresentation. 3_. I understand that "convicted" or "conviction" as defined in Paragraph 287.133(1)(b), Florida Statues, means a finding of guilt or a conviction of a public entity crime, with or without an adjudication of guilt, in any federal or state trial court of record relating to charges brought by indictment or information after July 1, 1989, as a result of a jury verdict, nonjury trial, or entry of a plea of guilty or nol o contendere . 4. I understand that an "affiliate" as defined in Paragraph 287.133(1)(a), Florida Statutes, means: 1. A predecessor or successor of a person convicted of a public entity crime: or 08/31/94 BID PROPOSAL 00110 - 10 2. An entity under the control of any natural person who is active in the management of the entity and who has been convicted of a public entity crime. The term "affiliate" includes those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in the management of an affiliate. The ownership by one person of shares ' constituting a controlling interest in another person, or a pooling of equipment or income among persons when not for fair market value under an arm' s length agreement, shall be a prima facie case that one person controls another person. A person who knowingly enters into a joint venture with a person who has been convicted of a public entity crime in Florida during the preceding 36 months shall be considered an affiliate. 5. I understand that a "person" as defined in Paragraph 287.133(1)(e), Florida Statues, means any natural person or entity organized under the laws of any state or of the United States with the legal power to.enter into a binding contract and which bids or applies to bid -on contracts for the provision of goods or services let by a public entity, or which otherwise transacts or applies to transact business with a public entity. The term "person" includes those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in management of an entity. 6. Based on information and belief, the statement which I have marked below is true in relation to the entity submitting this sworn statement. (Indicate which statement applies.) Neither the entity submitting this sworn statement, nor any of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, nor any affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, or an affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. y �7 08/31/94 BID PROPOSAL 00110 11 M 1 l The e � t • entity submit ing this sworn statement'. or }; one or more of its officers directors, executives, partners; shareholders, employees, members, or agents who are active _ in the management -of •. the enti ty,� • or. -an-affiliate of f i 1 fate " o f the ent i t <. has been charged with and cony'Y _ ' � acted o f . a public entity crime'. . subsequent .. to July 1, 1989. However, there has been subsequent proceeding before a Hearing officer of the State of Florida,' Division . •Hearings ,.,• � ..,... ion of Administrative Hearin s and t e Final Order entered by , the Hearing Officer determined that ' it was not in the public interest to place the entity :. submitting this sworn statement on the convicted vendor list. (attach a copy of the final order) I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR THE PUBLIC ENTITY IDENTIFIED IN PARAGRAPH 1 (ONE) ABOVE IS FOR THAT PUBLIC ENTITY ONLY AND, THAT THIS FORM IS VALID THROUGH DECEMBER 31 OF THE CALENDAR YEAR IN WHICH IT IS FILED. I ALSO UNDERSTAND THAT I AM REQUIRED TO INFORM.THE PUBLIC ENTITY PRIOR TO ENTERING INTO - A CONTRACT IN EXCESS OR "THE THRESHOLD AMOUNT PROVIDED IN SECTION 287.017, FLORIDA STATUES FOR CATEGORY TWO OF ANY CHANGE IN THE INFORMATION CONT INED IN THIS FORM. fgnature) (date) ' STATE OF COUNTY OF PERSONALLY APPEARED BEFORE ME, the undersigned authority, RN who, after first being sworn by me (name of individual signing) _ affixed his/her signature in the space provided above on this �J day of A-s,,,A C) 19 9,`-1 f NOTARY PUBLIC My c ommi s s i on t: city-�'r OF FLORIDA _ �ISELEAXP. �Fn. �� s��95001"DED HRU L"NERAI. INS. UM. Form PUR 7068 (Rev. 04/10/91) 08/ 31/ 94 BID PROPOSAL 00110 - 12 I " SECTION 00110 - •. Y rt NON -COLLUSION AFFIDAVITTLC& Gof the city of accordin to ' g law on my oath, and under pe nalty nalty of perjury.. depose ' and say that; of the firm of the bidder making the Proposal for the r 'for:'*_ project described in the notice f'or calling ing for bids for: . and that I executed the said proposal with full authority to do so; 2.) the prices in this bid have been arrived at independently without collusion, consultation, communication or agreement for the purpose of restricting competition ti on -•• to any matter relating to P as • g such proces with any other bidder or-�wi th any competitor; 3.) unless otherwise required b law, the ' Y prices which have been quoted in this bid have not been knowingly the bid disclosed b Y der and will not knowingly be disclosed by the bidder and will not be knowingly disclosed by the bidder prior to bid opening, di e6ct l y or indirectly, Y, to any other bidder or to any competitor; and 4.) no attempt has been made or will be m • made by the bidder _ to induce any other person, partnershipor corporation to submit, or not to orporation submit, a bid for the purpose of restricting competition; 5.) the statements contained in this a ' ffidavlt are true and correct, and made with full knowledge that Monroe County relies upon the truth of the statements contained in this affidavit in awarding contracts for said ' pro]ect. 08/31/94 BID PROPOSAL _ ti ;; 0 0110 - 13 f;;:. r t i � ji AQ '1M t c � 1t, , (Sig re oBidder) ." f Bidder �+ ""A�•` . r r ' . ".. ; � 'F � (Date ' i... .• _ .I':,_a ,r •�i STATE OF: •:. ` COUNTY OF : n C' ��-�. _ r _ • ` ` �`�� t. PERSONALLY APPEARED BEFORE ME, the undersigned authority, who, after first being sworn by me, Ae • of individual signing affixed his/her signature in the space provided.above on this day of 19 r/ NOTARY PUBLIC DENISE NALEPA My commission expires: , F NOTW'� f L'^LIC STATE OF FLORIDA +j MY COMMISSION EXP. AFIR.17,1995 OONMO TNRO GZNERAL INS, UN0 . r i w :1 46 SECTION 00110 lid '� # LOBBYING AND CONFLICT OF INTEREST CLAUSE r`~` SWORN STATEMENT UNDER ORDINANCE NO. - 010-1990 MONROE COUNTY, FLORIDA . •MIS +•'� �'�. yl •� j •. .,...... . • , CaS C�'f1C S�C�/�C,� C.. it C �1 �ti-e n y (Company) warrants that it has not employed, retained or otherwise had kvact on its behalf any former County officer or employee subject to the prohibition of Section 2 of Ordinance No. 01.0-1990 or any ;County officer or employee in violation of Section 3 of Ordinance No. 010-1990. For breach or violation of this. provision the County may, in its discretion, terminate this contract without liability and may also, in its discretion, deduct f rom - the _contract or purchase price, or otherwise recover, the full amount of any fee, commission; percentage, gift, or conside , tion paid to the former County officer or employee".LOOF ignature) (Date) 't STATE OF COUNTY OF 1\f PERSONALLY APPEARED BEFORE ME, the undersigned authority, who, after first being _ r n b m affixed A/her si nature t� savor yg (name of individual signing) in the space provided above on this day of 19 a NOTARY PUBLIC DENISE My commission expires: res :PNALAP A NOTAU Fl,MIC STATE OF FLORID IV COMMMION EXP. APn.17,1995 08/31/94 BID PROPOSAL 00110-15 + ' i dw SECTION 00110 DRUG -FREE WORKPLACE FORM :s• :.,j.... The undersigned yContractor in accordance with Florida Statute 287,087 hereby certifies that: �Z),5 IF-k Q S-QCNJIc %--L (Name of Business) i . 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 such employees about the dangers • ot' 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 employees will abide -by the terms of the statement and wi l 1 notify the employer'of any conviction of, or plea of guilty or nol'o contendere to, any violation of Chapter 893 (Florida Statutes) or of any controlled substance law of the United States sor any state, for a• violation occurring in the workplace no later than five (5) days after such conviction. 5. Impose a sanction on, or require the satisfactory participation in a drug abuse assistance or rehabilitation program if such is available in the employee's community, or any employee who is so convicted. 6 . Make a good faith effort to continue to maintain a drug -free , workplace through implementation of this section. As a person authorized to sign the statement, I certify that this firm complies fully with the above requirement Bid i s Signature MCP#5 Rev. 6/91 Date