07/21/2010 AgreementDANNY L. KOLHAGE
CLERK OF THE CIRCUIT COURT
DATE: July 29, 2010
TO: Dent Pierce, Director
Public Works Division
ATTN.• Beth Leto, Assistant Director
Public Works Division
r
FROM. Pamela G. Hancock . C.
At the July 21, 2010, Board of County Commissioner's meeting the Board granted
approval to award bid and execute Contract for unleaded gasoline and diesel fuel to the second
lowest bidder Dion Oil Company, LLC.
Enclosed is a duplicate original of the above -mentioned for your handling. Should you
have any questions please do not hesitate to contact this office.
cc: County Attorney
Finance
File
CONTRACT
UNLEADED GASOLINE AND DIESEL FUEL/SUPPLIER
THIS AGREEMENT, made and entered into this --),/ l day of 2010 by and between
the MONROE COUNTY, a political subdivision of the State of Floria hereinafter called "County" and
Dion oil__, a Florida corporation, hereinafter called "Vendor".
Company, LLC
WITNESSETH:
WHEREAS, the County maintains gasoline and diesel fueling facilites throughout Monroe County for
purposes of fueling County vehicles; and
WHEREAS, the Vendor is qualifed, properly equipped and is in the business of providing gasoline and
diesel fuel to fueling facilities; now, therefore
IN CONSIDERATION of the premises and of mutual covenants and promises hereinafter contained, the
parties hereto do hereby agree as follows:
DESCRIPTION
A. The Vendor shall deliver the day's lowest priced available Low, Medium, or High Octane
Gasoline as requested by the County and School Board and the day's lowest priced available Ultra Low Diesel
Fuel (Clear and Dyed) to locations in the Key West, Marathon, Plantation Key, and Key Largo areas as
requested by the ordering Monroe County and School Board departments and on the dates requested by such
departments. Fuel shall be delivered the next day if requested by 4:00pm. Orders may be placed and
confirmed via phone, fax, e-mail, etc., as is determined in the County's best interest.
B. Deliveries will be in quantities of less than One Hundred (100) gallons to Seven Thousand
(7,000) gallons (Full Tanks). The Vendor shall have a metered tanker for all deliveries and shall be required to
itemize invoices for each delivery under this provision. Additionally, Vendor shall be able to fuel approximately
60 generators as needed individually with small amounts and invoice each separately.
C. Upon request by the County, Vendor shall provide documentation supporting most recent pump
meter certification.
D. All deliveries must be supervised and delivery tickets must be signed and dated by Monroe
County personnel.
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E. The Vendor shall have the capability to pump fuel into elevated and/or aboveground tanks
through standard quick detachable couplings.
F. The Vendor shall prioritize the County and have ability to provide daily deliveries of gasoline and
diesel to multiple locations after a hurricane, natural disaster, emergency, or other conditions for as long as the
need exists. (Under such conditions, all extra pricing including freight for fuel picked up from Florida terminals
other than Port Evergelades or out of state terminals must be preapproved in writing by the County). The
County reserves the right to purchase from any licensed Vendor's as needed in cases when the Vendor cannot
deliver, or in a case of emergency as deemed best for the interests of the County.
2. TERM OF CONTRACT
A. This Agreement shall be for a period of One (1) year commencing upon the day in which it has
been approved by the Board of County Commssioners, as indicated at the top of page 1 of this Agreement.
B. The County shall have the option to renew this Agreement after the first year, for two (2) additional
one (1) year periods.
3. HOLD HARMLESS
Notwithstanding any minimum insurance requirements prescribed elsewhere in this Agreement, Vendor
shall defend, indemnify and hold the County and the County's elected and appointed officers and employees
harmless from and against (i) any claims, actions or causes of action, (ii) any litigation, administrative
proceedings, appellate proceedings, or other proceedings relating to any type of injury (including death), loss,
damage, fine, penalty or business interruption, and (iii) any costs or expenses that may be asserted against,
initiated with respect to, or sustained by, any indemnified party by reason of, or in connection with, (A) any
activity of Vendor or any of its employees, agents, contractors or other invitees during the term of this
Agreement, (B) the negligence or willful misconduct of Vendor or any of its employees, agents, contractors or
other invitees, or (C) Vendor's default in respect of any of the obligations that it undertakes under the terms of
this Agreement, except to the extent the claims, actions, causes of action, litigation, proceedings, costs or
expenses arise from the intentional or sole negligent acts or omissions of the County or any of its employees,
agents, contractors or invitees (other than Vendor). Insofar as the claims, actions, causes of action, litigation,
proceedings, costs or expenses relate to events or circumstances that occur during the term of this Agreement,
this section will survive the expiration of the term of this Agreement or any earlier termination of this Vendor.
The County shall not in any form, defend, indemnify, and/or hold Vendor harmless.
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4. INSURANCE
Prior to execution of this Agreement the Vendor shall furnish the County Certificates of Insurance
indicating the minimum coverage limitations as stated in the General Insurance Requirements for Suppliers of
Goods or Services section of this Agreement.
5. PAYMENT
A. Price per gallon shall reflect Vendor's purchase price from the day's lowest available priced
provider at Port Everglades FL. Terminal.
B. Monroe County may not be charged more than the following prices listed above Vendor's
purchased price from the day's lowest priced available providers at Port Everglades, FL.
Terminal from date delivered.
Unleaded Gasoline (Any Octane)
Ultra Low Sulfur Diesel (Clear and Dyed)
$_.
Key West
$_ �S
Key West
$_
Sugarloaf
$_ i!a
Sugarloaf
$_
Marathon
$_ �Z
Marathon
$_
Plantation Key
$_.1
Plantation Key
$_
Coral Shores
$_
Coral Shores
$_ QS
Key Largo
$_ �L
Key Largo
C. The Vendor shall submit invoices to the County, itemizing the delivery location, the requesting
department, quantity, proof of purchased price per gallon, and the days' proof of price per gallon
from all available providers at the Port Everglades, FL. Terminal.
D. Upon receipt of an Invoice the County shall have thirty days, in accordance with the Florida
Prompt Act, Section 218.73, FS, to render payment to Vendor.
E. Gasoline and Diesel Fuel taxes must be itemized on each invoice.
6. INDEPENDENT VENDOR
At all times and for all purposes under this Agreement the Vendor is an independent Vendor 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 Vendor or any of his/her employees, contractors, servants, or
agents to be employees of the Board of County Commissioners for Monroe County.
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7. ASSURANCE AGAINST DISCRIMINATION
Vendor shall not discriminate against any person on the basis of race, creed, color, national origin, sex,
age, or any other characteristic or aspect which is not job related, in its recruiting, hiring, promoting,
terminating, or any other area affecting employment under this agreement or with the provision of services or
goods under this Agreement.
8. ASSIGNMENT
Vendor shall not assign or subcontract 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 County may deem necessary. This Agreement shall be incorporated by
reference into any assignment or subcontract and any assignee or subcontractor shall comply with all of the
provisions of this Agreement. Unless expressly provided for therein, such approval shall in no manner or event
be deemed to impose any obligation upon the County in addition to the total agreed -upon price of the
services/goods of the Vendor.
9. COMPLIANCE WITH LAW
In providing all services/goods pursuant to this agreement, the Vendor shall abide by all statutes,
ordinances, rules and regulations pertaining to, or regulating the provisions of, such services, including those
now in effect and hereinafter adopted. Any violation of said statutes ordinances, rules and regulation shall
constitute a material breach of this agreement and shall entitle the Board to terminate this Agreement
immediately upon delivery of written notice of termination to the Vendor. The Vendor shall possess proper
licenses to perform work in accordance with these specifications throughout the term of this Agreement.
10. NOTICE REQUIREMENT
Any notice required or permitted under this Agreement shall be in writing and hand delivered or mailed,
postage prepaid, to the other party by certified mail, returned receipt requested, to the following:
For County:
Monroe County Fleet Management
3583 S. Roosevelt Blvd.
Key West, FL 33040
For Vendor:
Y
L° GD ,-x'33�
L,1 I
With a cony to:
Suzanne A. Hutton
Monroe County Attorney
P.O. Box 1026
Key West, FL 33041-1026
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11. FUNDING AVAILABILITY
In the event that funds from Fleet Management Services operating Gasoline and Diesel Accounts are
partially reduced or cannot be obtained or cannot be continued at levels sufficient to allow for the purchase of
services/goods specified herein, this Agreement may then be terminated immediately at the option of the
County by written notice of termination delivered in person or by mail to the Vendor. The County shall only be
obligated to pay for any goods delivered by the Vendor until the Vendor has received written notice of
termination due to lack of funds.
12. PROFESSIONAL RESPONSIBILITY
The Vendor warrants that it is authorized by law to engage in the performance of the activities
encompassed by the project herein described, subject to the terms and conditions set forth in the Notice of
calling for Bids. The Vendor shall at all times exercise independent, professional judgment and shall assume
professional responsibility for the services to be provided. Continued funding by the County is contingent upon
retention of appropriate local, state, and/or federal certification and/or licensure of Vendor.
13. PUBLIC ENTITY CRIME STATEMENT
A person or affiliate who has been placed on the convicted vendor list following a conviction for a public
entity crime may not submit a proposal or bid on a contract to provide any goods or services to a public entity,
may not submit a proposal or bid on a contract with a public entity for the construction or repair of a public
building or public work, may not submit proposals on leases or perform work as a contractor, supplier,
subcontractor, or consultant under a contract with any public entity, and may not transact business with any
public entity in excess of the threshold amount provided in Section 287.017, for CATEGORY TWO for a period
of 36 months from the date of being placed on the convicted vendor list. Category Two: $25,000.00
14. TERMINATION
If the Vendor fails to fulfill the terms of this Agreement, or attachments, properly or on time, or otherwise
violates the provisions of this Agreement, the County may terminate this Agreement upon 7 days written notice
to the Vendor. The County shall pay the Vendor the contract price for goods delivered but not paid for on the
date of termination, less any amount of damages caused by the Vendor's breach. If those damages are more
that the amount due the Vendor, then the Vendor shall remain liable to the County for the excess amount.
15. GOVERNING LAW, VENUE, INTERPRETATION
Governing Law, Venue, Interpretation, Costs, and Fees: This Agreement shall be governed by and construed
in accordance with the laws of the State of Florida applicable to contracts made and to be performed entirely in
the State.
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In the event that any cause of action or administrative proceeding is instituted for the
enforcement or interpretation of this Agreement, the County and Vendor agree that venue will lie in the
appropriate court or before the appropriate administrative body in Monroe County, Florida.
The County and Vendor agree that, in the event of conflicting interpretations of the terms or a
term of this Agreement by or between any of them the issue shall be submitted to mediation prior to the
institution of any other administrative or legal proceeding.
16. ATTORNEY'S FEES AND COSTS
The County and Vendor agree that in the event any cause of action or administrative proceeding is
initiated or defended by any party relative to the enforcement or interpretation of this Agreement, the prevailing
party shall be entitled to reasonable attorney's fees, court costs, investigative, and out-of-pocket expenses, as
an award against the non -prevailing party, and shall include attorney's fees, courts costs, investigative, and
out-of-pocket expenses in appellate proceedings. Mediation proceedings initiated and conducted pursuant to
this Agreement shall be in accordance with the Florida Rules of Civil Procedure and usual and customary
procedures required by the circuit court of Monroe County.
17. BOOKS, RECORDS AND DOCUMENTS
Vendor shall maintain all books, records, and documents directly pertinent to performance under this
Agreement in accordance with generally accepted accounting principles consistently applied. Each party to
this Agreement or their authorized representatives shall have reasonable and timely access to such records of
each other party to this Agreement for public records purposes during the term of the Agreement and for four
years following the termination of this Agreement. If an auditor employed by the County or Clerk determines
that monies paid to Vendor pursuant to this Agreement were spent for purposes not authorized by this
Agreement, the Vendor shall repay the monies together with interest calculated pursuant to Sec. 55.03, FS,
running from the date the monies were paid to the Vendor.
18. SEVERABILITY
If any term, covenant, condition or provision of this Agreement (or the application thereof to any
circumstance or person) shall be declared invalid or unenforceable to any extent by a court of competent
jurisdiction, the remaining terms, covenants, conditions and provisions of this Agreement, shall not be affected
thereby; and each remaining term, covenant, condition and provision of this Agreement shall be valid and shall
be enforceable to the fullest extent permitted by law unless the enforcement of the remaining terms,
covenants, conditions and provisions of this Agreement would prevent the accomplishment of the original
intent of this Agreement. The County and Vendor agree to reform the Agreement to replace any stricken
provision with a valid provision that comes as close as possible to the intent of the stricken provision.
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19. BINDING EFFECT
The terms, covenants, conditions, and provisions of this Agreement shall bind and inure to the benefit
of the County and Vendor and their respective legal representatives, successors, and assigns.
20. AUTHORITY
Each party represents and warrants to the other that the execution, delivery and performance of this
Agreement have been duly authorized by all necessary County and corporate action, as required by law.
21. CLAIMS FOR FEDERAL OR STATE AID
Vendor and County agree that each shall be, and is, empowered to apply for, seek, and obtain federal
and state funds to further the purpose of this Agreement; provided that all applications, requests, grant
proposals, and funding solicitations shall be approved by each party prior to submission.
22. ADJUDICATION OF DISPUTES OR DISAGREEMENTS
County and Vendor agree that all disputes and disagreements shall be attempted to be resolved by
meet and confer sessions between representatives of each of the parties. If no resolution can be agreed upon
within 30 days after the first meet and confer session, the issue or issues shall be discussed at a public
meeting of the Board of County Commissioners. If the issue or issues are still not resolved to the satisfaction
of the parties, then any party shall have the right to seek such relief or remedy as may be provided by this
Agreement or by Florida law.
23. COOPERATION
In the event any administrative or legal proceeding is instituted against either party relating to the
formation, execution, performance, or breach of this Agreement, County and Vendor agree to participate, to
the extent required by the other party, in all proceedings, hearings, processes, meetings, and other activities
related to the substance of this Agreement or provision of the services under this Agreement. County and
Vendor specifically agree that no party to this Agreement shall be required to enter into any arbitration
proceedings related to this Agreement.
24. NONDISCRIMATION
Vendor agrees that there will be no discrimination against any person, and it is expressly understood
that upon a determination by a court of competent jurisdiction that discrimination has occurred, this Agreement
automatically terminates without any further action on the part of any party, effective the date of the court
order. Vendor agrees to comply with all Federal and Florida statutes, and all local ordinances, as applicable,
relating to nondiscrimination. These include but are not limited to: 1) Title VI of the Civil Rights Act of 1964
(PL 88-352) which prohibits discrimination on the basis of race, color or national origin; 2) Title IX of the
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Education Amendment of 1972, as amended (20 USC ss. 1681-1683, and 1685-1686), which prohibits
discrimination on the basis of sex; 3) Section 504 of the Rehabilitation Act of 1973, as amended (20 USC s.
794), which prohibits discrimination on the basis of handicaps; 4) The Age Discrimination Act of 1975, as
amended (42 USC ss. 6101-6107) which prohibits discrimination on the basis of age; 5) The Drug Abuse
Office and Treatment Act of 1972 (PL 92-255), as amended, relating to nondiscrimination on the basis of drug
abuse; 6) The Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of
1970 (PL 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; 7)
The Public Health Service Act of 1912, ss. 523 and 527 (42 USC ss. 690dd-3 and 290ee-3), as amended,
relating to confidentiality of alcohol and drug abuse patient records; 8) Title VIII of the Civil Rights Act of 1968
(42 USC s. et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; 9)
The Americans with Disabilities Act of 1990 (42 USC s. 1201 Note), as maybe amended from time to time,
relating to nondiscrimination on the basis of disability; 10) Any other nondiscrimination provisions in any
Federal or state statutes which may apply to the parties to, or the subject matter of, this Agreement.
25. COVENANT OF NO INTEREST County and Vendor covenant that neither presently has any interest,
and shall not acquire any interest, which would conflict in any manner or degree with its performance under
this Agreement, and that the only interest of each is to perform and receive benefits as recited in this
Agreement.
26. CODE OF ETHICS County agrees that officers and employees of the County recognize and will be
required to comply with the standards of conduct for public officers and employees as delineated in Section
112.313, Florida Statutes, regarding, but not limited to, solicitation or acceptance of gifts; doing business with
one's agency; unauthorized compensation; misuse of public position, conflicting employment or contractual
relationship; and disclosure or use of certain information.
27. NO SOLICITATION/PAYMENT The County and Vendor warrant that, in respect to itself, it has neither
employed nor retained any company or person, other than a bona fide employee working solely for it, to solicit
or secure this Agreement and that it has not paid or agreed to pay any person, company, corporation,
individual, or firm, other than a bona fide employee working solely for it, any fee, commission, percentage, gift,
or other consideration contingent upon or resulting from the award or making of this Agreement. For the
breach or violation of the provision, the Vendor agrees that the County shall have the right to terminate this
Agreement without liability and, at its discretion, to offset from monies owed, or otherwise recover, the full
amount of such fee, commission, percentage, gift, or consideration.
28. PUBLIC ACCESS The County and Vendor shall allow and permit reasonable access to, and inspection
of, all documents, papers, letters or other materials in its possession or under its control subject to the
provisions of Chapter 119, Florida Statutes, and made or received by the County and Vendor in conjunction
8
with this Agreement; and the County shall have the right to unilaterally cancel this Agreement upon violation of
this provision by Vendor.
29. NON -WAIVER OF IMMUNITY Notwithstanding the provisions of Sec. 768.28, Florida Statutes, the
participation of the County and the Vendor in this Agreement and the acquisition of any commercial liability
insurance coverage, self-insurance coverage, or local government liability insurance pool coverage shall not be
deemed a waiver of immunity to the extent of liability coverage, nor shall any Agreement entered into by the
County be required to contain any provision for waiver.
30. PRIVILEGES AND IMMUNITIES All of the privileges and immunities from liability, exemptions from
laws, ordinances, and rules and pensions and relief, disability, workers' compensation, and other benefits
which apply to the activity of officers, agents, or employees of any public agents or employees of the County,
when performing their respective functions under this Agreement within the territorial limits of the County shall
apply to the same degree and extent to the performance of such functions and duties of such officers, agents,
volunteers, or employees outside the territorial limits of the County.
31. LEGAL OBLIGATIONS AND RESPONSIBILITIES: Non -Delegation of Constitutional or Statutory
Duties. This Agreement is not intended to, nor shall it be construed as, relieving any participating entity from
any obligation or responsibility imposed upon the entity by law except to the extent of actual and timely
performance thereof by any participating entity, in which case the performance may be offered in satisfaction of
the obligation or responsibility. Further, this Agreement is not intended to, nor shall it be construed as,
authorizing the delegation of the constitutional or statutory duties of the County, except to the extent permitted
by the Florida constitution, state statute, and case law.
32. NON -RELIANCE BY NON-PARTIES No person or entity shall be entitled to rely upon the terms, or any
of them, of this Agreement to enforce or attempt to enforce any third -party claim or entitlement to or benefit of
any service or program contemplated hereunder, and the County and the Vendor agree that neither the County
nor the Vendor or any agent, officer, or employee of either shall have the authority to inform, counsel, or
otherwise indicate that any particular individual or group of individuals, entity or entities, have entitlements or
benefits under this Agreement separate and apart, inferior to, or superior to the community in general or for the
purposes contemplated in this Agreement.
33. ATTESTATIONS Vendor agrees to execute such documents as the County may reasonably require, to
include a Public Entity Crime Statement, an Ethics Statement, and a Drug -Free Workplace Statement.
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34. NO PERSONAL LIABILITY No covenant or agreement contained herein shall be deemed to be a
covenant or agreement of any member, officer, agent or employee of Monroe County in his or her individual
capacity, and no member, officer, agent or employee of Monroe County shall be liable personally on this
Agreement or be subject to any personal liability or accountability by reason of the execution of this
Agreement.
35. EXECUTION IN COUNTERPARTS This Agreement may be executed in any number of counterparts,
each of which shall be regarded as an original, all of which taken together shall constitute one and the same
instrument and any of the parties hereto may execute this Agreement by signing any such counterpart.
36. SECTION HEADINGS Section headings have been inserted in this Agreement as a matter of
convenience of reference only, and it is agreed that such section headings are not a part of this Agreement
and will not be used in the interpretation of any provision of this Agreement.
37. MUTUAL REVIEW This Agreement has been carefully reviewed by the Vendor and the County,
therefore this Agreement is not to be construed against either party on the basis of authorship.
THE REMAINDER OF THIS PAGE HAS BEEN INTENTIONALLY LEFT BLANK.
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In witness whereof, the
(Seal)
Attest: DANNY L.
Deputy Clerk
VENDOR:
BY,¢�
DATE: '
(Corporate Seal)
Attest:
have executed this agreement the day and year first above written,
BOARD OF COUNTY COMMISSIONERS
MONROE COUNTY, FLORIDA
By:
Mayor/Chairman
COUNTY ATT I
VEIL AS TO
COUN
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RISK MANAGEMENT
POLICY AND PROCEDURES
CONTRACT ADMINISTRATION
MANUAL
General Insurance Requirements
for
Other Contractors and Subcontractors
As a pre -requisite of the work governed, or the goods supplied under this contract (including the pre -staging of
personnel and material), the Contractor shall obtain, at his/her own expense, insurance as specified in any
attached schedules, which are made part of this contract. The Contractor will ensure that the insurance
obtained will extend protection to all Subcontractors engaged by the Contractor. As an alternative, the
Contractor may require all Subcontractors to obtain insurance consistent with the attached schedules.
The Contractor will not be permitted to commence work governed by this contract (including pre -staging of
personnel and material) until satisfactory evidence of the required insurance has been furnished to the County
as specified below. Delays in the commencement of work, resulting from the failure of the Contractor to
provide satisfactory evidence of the required insurance, shall not extend deadlines specified in this contract
and any penalties and failure to perform assessments shall be imposed as if the work commenced on the
specified date and time, except for the Contractor's failure to provide satisfactory evidence.
The Contractor shall maintain the required insurance throughout the entire term of this contract and any
extensions specified in the attached schedules. Failure to comply with this provision may result in the
immediate suspension of all work until the required insurance has been reinstated or replaced. Delays in the
completion of work resulting from the failure of the Contractor to maintain the required insurance shall 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 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.
Any deviations from these General Insurance Requirements must be requested in writing on the County
prepared form entitled "Request for Waiver of Insurance Requirements" and approved by Monroe County
Risk Management.
12
GENERAL LIABILITY
INSURANCE REQUIREMENTS
FOR
CONTRACT UNLEADED GASOLINE AND DIESEL FUEL SUPPLIER
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.
GI-3
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WORKERS' COMPENSATION
INSURANCE REQUIREMENTS
FOR
CONTRACT UNLEADED GASOLINE AND DIESEL FUEL SUPPLIER
BETWEEN
MONROE COUNTY, FLORIDA
AND
70iUiA Oil 6-,P L-�
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 statutes.
In addition, the Contractor shall obtain Employers' Liability Insurance with limits of not less than:
$500,000 Bodily Injury by Accident
$500,000 Bodily Injury by Disease, policy limits
$500,000 Bodily Injury by Disease, each employee
Coverage shall be maintained throughout the entire term of the contract.
Coverage shall be provided by a company or companies authorized to transact business in the state of Florida
If the Contractor has been approved by the Florida's Department of Labor, as an authorized self -insurer, the
County shall recognize and honor the Contractor's status. The Contractor may be required to submit a Letter
of Authorization issued by the Department of Labor and a Certificate of Insurance, providing details on the
Contractor's Excess Insurance Program.
If the Contractor participates in a self-insurance fund, a Certificate of Insurance will be required. In addition,
the Contractor may be required to submit updated financial statements from the fund upon request from the
County.
WC2
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VEHICLE LIABILITY
INSURANCE REQUIREMENTS
FOR
CONTRACT UNLEADED GASOLINE AND DIESEL FUEL SUPPLIER
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 (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
The Monroe County Board of County Commissioners shall be named as Additional Insured on all policies
issued to satisfy the above requirements.
VL3
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HAZARDOUS CARGO TRANSPORTERS LIABILITY
INSURANCE REQUIREMENTS
FOR
CONTRACT UNLEADED GASOLINE AND DIESEL FUEL SUPPLIER
BETWEEN
MONROE COUNTY, FLORIDA
AND
Prior to the commencement of work governed by this contract, the Contractor shall purchase Pollution Liability
Insurance which extends to the hauling of toxic and hazardous material by motorized vehicles. In compliance
with the Motor Carrier Act, the policy should be endorsed with an MCS-90 Endorsement, demonstrating
financial responsibility for spills and clean-up. Any pollution exclusion limiting coverage under this policy shall
be removed.
The minimum limits acceptable shall be:
$1,000,000 per Occurrence
VLP3
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LOBBYING AND CONFLICT OF INTEREST CLAUSE PUP,- IcV
ETHICS CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO. 010-1990
MONROE COUNTY, FLORIDA
(Company Officer/Partner/Individual)
warrants that he/it has not employed, retained or otherwise had act on his/its behalf any former County officer
or employee in violation of Section 2 of Ordinance No. 010-1990 or any County officer or employee in violation
of Section 3 of Ordinance No. 010-1990. For breach or violation of this provision the County may, in its
discretion, terminate this Agreement without liability and may also, in its discretion, deduct from the Agreement
or purchase price, or otherwise recover, the full amount of any fee, commission, percentage, gift, or
consideration paid to the former County officer or employee".
(Signature)
Date:-
. L, C r ► `i l) fit°' 4u-
STATE OF:
COUNTY OF: (Y) ul)
Subscribed and sworn to (or affirmed) before me on -- --1
(date) by 1,�1 �� 1��t1�t� . �{ '11i�S (name of affiant). hW[She is personally
known to me------�-
identification., (tape, of id -ntifi .at%013 -
;+P`"jh`' `'!•`• ,jUDITH KcATHERINE SIMONS
MY COMMISSION # DD633382
EXPIRES January 25, 2011
(407)398-0753 FiohdallotarySerwoe.00m
NOTARBLIC
My commission expires:
17
NON -COLLUSION AFFIDAVIT
of the city of ��Ai
''���,w ��� i'� , according to law on
my oath, and under penalty of perjury, depose and say th t:
am V, C_ > (ff (:L "J t; i
1�
o he firm of Y-V ci�L_
making the Bid for the services/work/project described in the Request for Bids for:
M NVWY, f :uLrTrv1 �t'�-uf:-a{�� _%J�Q _CLX-(? .. Y.:i �:zL, - .4 ►) - and that
executed the said Bid with full authority to do so:
P4.A.fz ICu'
2. The prices in this bid/Bid have been arrived at independently without collusion, consultation,
communication or agreement for the purpose of restricting competition, as to any matter relating to
such prices with any other bidder or with any competitor.
3. Unless otherwise required by law, the prices and percentage of return which have been quoted in
this bid/Bid have not been knowingly disclosed by the responder and will not knowingly be
disclosed by the responder prior to bid/Bid opening, directly or indirectly, to any other
bidder/responder or to any competitor.
4. No attempt has been made or will be made by the bidder/responder to induce any other person,
partnership or corporation to submit, or not to submit, a bid/Bid for the purpose of restricting
competition.
5. The statements contained in this affidavit are true and correct, and made with full knowledge that
Monroe County relies upon the truth of the statements contained in this affidavit in awarding
contracts for the project/services/work.
(Signature f Bidder) (Date)
STATE OF:
COUNTY OF:
PERSONALLY APPEARED BEFORE ME, the undersigned authority, who, claafter
first being sworn by me, (name of individual signing) affixed *is/her signature in the space provided above on
this ' day of \� wt�d 20�L
JUDITH KATHERINE SIMONS ?
MY COMMISSION # DD633382
NOTAR UBLIC
EXPIRES January 25. 2011 �� q
(407) 398-0163 FloridallotarySerwcexom (\4-
My Commission Expires:
t)"It1
18
DRUG -FREE WORKPLACE FORM
The undersi ed Contractor/bidder/responder in accordance with Florida Statute 287.087 hereby certifies that:
i;
(NarAe of Business)
1. Publishes a statement notifying employees that the unlawful manufacture, distribution, dispensing,
possession, or use of a controlled substance is prohibited in the workplace and specifying the actions that will
be taken against employees for violations of such prohibition.
2. Informs employees about the dangers of drug abuse in the workplace, the business's policy of maintaining
a drug -free workplace, any available drug counseling, rehabilitation, and employee assistance programs, and
the penalties that may be imposed upon employees for drug abuse violations.
3. Gives each employee engaged in providing the commodities or contractual services that are under bid a
copy of the statement specified in subsection (1).
4. In the statement specified in subsection (1), notify the employees that, as a condition of working on the
commodities or contractual services that are under bid, the employee will abide by the terms of the statement
and will notify the employer of any conviction of, or plea of guilty or nolo contendere to, any violation of Chapter
893 (Florida Statutes) or of any controlled substance law of the United States or any state, for a violation
occurring in the workplace no later than five (5) days after such conviction.
5. Imposes a sanction on, or requires the satisfactory participation in a drug abuse assistance or rehabilitation
program if such is available in the employee's community, or any employee who is so convicted.
6. Make a good faith effort to continue to maintain a drug -free workplace through implementation of this
section.
As the person authorized to sign the statement,
requireme ts._�
/
Bidde 's Signature
I certify that this firm complies fully with the above
iJZ
Date
L>illtc-til
�ki'r11�'�s v utA �
STATE OF:
COUNTY OF:
PERSONALLY APPEARED BEFORE ME, the undersigned authority, .;ZIAY ;e '-) T;,aI1Ys:� who, kj after
first being sworn by me, (name of individual signing) affixed his/her signature in the space provided above on
this 40 day of 200.
S
i
JUDITH KATHERINE SIMONS
"? MY COMMISSION # DD633382
EXPIRES January 25, 2011
(407)398Otb3 FlorldeNotaryService.com
NOT Y PUBLIC
My Commission Expires:
19