08/18/2010 Agreement
DANNY L. KOLHAGE
CLERK OF THE CIRCUIT COURT
DA TE:
August 23, 2010
TO:
Dent Pierce, Director
Public Works Division
A TTN:
FROM:
Beth Leto, Assistant Director
Public Works Division
Pamela G. Hanc~
At the August 18, 2010, Board of County Commissioner's meeting the Board granted
approval and authorized execution of the following:
Amendment to Agreement (terminating Agreement) with Weathertrol Maintenance Corp.
to a month-to-month basis for central air conditioning maintenance and repair for Lower Keys
Facilities.
Contract Amendment with Weathertrol Maintenance Corp. for a full maintenance
program for the two centrifugal chillers at Jackson Square clarifYing language and increasing the
total annual compensation for repairs.
Interlocal Agreement with City of Marathon for utilization of the County meeting room in
Marathon for 24 City Council meetings.
Agreement with G & K Uniform Services for the Division of Public Works uniform
servIces.
/ Contract with Dion Oil Company, LLC for bio-diesel fuel.
Enclosed is a duplicate original of each 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 I
CONTRACT
BIO-DIESEL FUEL SUPPLIER
THIS AGREEMENT is made and entered into this 18th day of August 2010 by and between the MONROE
COUNTY, a political subdivision of the State of Florida hereinafter called "County" and DION OIL
COMP ANY, LLC hereinafter called "Contractor".
WITNESSETH:
That the parties hereto for the consideration hereinafter names, agree to the following:
1. DESCRIPTION
A. The Contractor(s) shall deliver Bio-Diesel fuel (B20, and must meet ASTM industry standards)
to locations in the Key West, Marathon, and Plantation Key areas as requested by the ordering
Monroe County department and on the dates requested. 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
detelmined in the County's best interest.
B. Deli\'eries will be in quantities of less than One Thousand (1000) gallons to Two Thousand Five
Hun(jred (2,500) gallons (Full Tanks). The Contractor(s) shall have a metered tanker for all
deliveries and shall be required to itemize invoices for each delivery under this provision.
Additionally, the Contractor shall be required to show proof of purchased price per gallon and
the day's proof of price per gallon from all available providers at the Port Everglades, FL.
Temlinal.
C. Upon request by the County, Contractor(s) shall provide documentation supporting most recent
pumI) meter certification.
D. All deliveries must be witnessed and delivery tickets must be signed and dated by Monroe
County personnel.
E. The Contractor(s) shall have the capability to pump fuel into aboveground tanks through
standard quick detachable couplings.
F. The Contractor(s) must have ability and shall be required to provide daily deliveries of regular
diesel fuels 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 Everglades or out of state
ternlinals must be preapproved in writing by the County).
G. The County reserves the right to purchase from any licensed Contractors as needed in cases
when the Contractor cannot deliver, or in a case of emergency as deemed best for the interests of
the <=ounty. Each of our three tanks are 3000 gallon above ground tanks, and located at 3583 S.
Roosevelt Blvd, Key West, FL 33040; 10600 Aviation Blvd., Marathon, FL 33050, and 186 Key
Hei!~hts Dr., Plantation Key, FL 33070.
H. The contractors must bid all locations and items to be considered responsive.
2. TERM OF (~ONTRACT
A. This contract shall be for a period of One (1) year commencing upon the day in which it has been
executed by both parties.
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,
Contractor 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 Contractor or any of its employees, agents, contractors or other invitees during the term of this
Agreement, (B) the negligence or willful misconduct of Contractor or any of its employees, agents, contractors
or other invitees, or (C) Contractor's default in respect of any of the obligations that it undertakes under the
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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 Contractor). 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
Contractor. The County shall not in any form, defend, indemnify, and/or hold Contractor harmless.
4. INSURAN<:E
Prior to execution of this agreement the Contractor(s) 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 contract.
5. PAYMENT
A. Price per gallon shall reflect (Contractor'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 contractor's
purchased price from the day's lowest priced available providers at Port Everglades, FL.
Terrn.inal from date delivered.
B20
$ 0.215 Key West
$0.175 Marathon
$0.135 Plantation Key
Ultra Low Sulfur Clear Diesel Fuel
$ 0.215 Key West
$0.175 Marathon
$0.135 Plantation Key
Ultra Low Sulfur Dyed Diesel Fuel
$ 0.215 Key West
$0.175 Marathon
$0.135 Plantation Key
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C. Upon receipt of an invoice with supporting documentation acceptable to the Monroe County
clerk of Court, the County shall pay Contractor(s) in accordance with the Florida Local
Government Prompt Payment Act. Acceptabililty to the Clerk is based on generally accepted
accounting principles and such laws, rules and regulations as may govern the Clerk's disbursal of
funds.
D. Upon receipt of Invoice the County shall have thirty days to render payment to Contractor.
E. Diesel fuels taxes must be itemized on each invoice.
6. INDEPENDENT CONTRACTOR(S)
At all times 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, Sub-contractor(s), servants, or
agents to be employees of the Board of County Commissioners for Monroe County.
7. ASSURAN<:E AGAINST DISCRIMINATION
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 or with the provision of services or goods under this
agreement.
8. ASSIGNMENT
Contractor 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 provision 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
Contractor.
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9. COMPLIA:~CE WITH LAW
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 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 contract
immediately upon delivery of written notice of termination to the contractor. The Contractor shall possess
proper licenses to perform work in accordance with these specifications throughout the term of this contract.
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:
F or County:
Monroe Cou.nty Fleet Management
3583 S. Roosevelt Blvd.
Key West, FL 33040
With a copy to:
Suzanne A. Hutton
Monroe County Attorney
P.O. Box 1026
Key West, FL 33041-1026
F or Contractor:
Dion Oil COlnpany LLC
P. O. Box 1209
Key West, FI-, 33041
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 level 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 Contractor. The County shall only be
obligated to pay for any goods delivered by the Contractor(s) until the Contractor(s) has received written notice
of termination due to lack of funds.
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12. PROFESSIONAL RESPONSIBILITY
The Contractor 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 provider 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 Contractor.
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 Contractor list. Category Two: $25,000.00
14. TERMINA1~ION
If the Contractor 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 Contractor. The County shall pay the Contractor the contract price for goods delivered but not paid for on
the date of termination, less any amount of damages caused by the Contractor's breach. If those damages are
more that the amount due the Contractor, then the Contractor shall remain liable to the County for the excess
amount.
15. BOOKS~ RECORDS~ AND DOCUMENTS
Contractor shall maintain all books, records, and documents directly pertinent to performance under this
Agreement in accordance with generally accepted accounting principles consistently applied. Each party to this
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
6
momes paid to Contractor pursuant to this Agreement were spent for purposes not authorized by this
Agreement, the Contractor shall repay the monies together with interest calculated pursuant to Sec. 55.03, FS,
running from the date the monies were paid to Contractor.
16. 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.
In the event that any cause of action or administrative proceeding is instituted for the
enforcement or interpretation of this Agreement, the County and Contractor agree that venue will lie in the
appropriate court or before the appropriate administrative body in Monroe County, Florida.
The County and Contractor 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.
17. 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 Contractor agree to reform the Agreemept to replace any stricken provision with a
valid provision that comes as close as possible to the intent of the stricken provision.
18. ATTORNE''''S FEES AND COSTS
The County and Contractor agree that in the event any cause of action or administrative proceeding is initiated
or defended by any party relative to the enforcement or interpretation of this Agreement, the prevailing party
shall be entitled to reasonable attorney's fees, court costs, investigative, and out-of-pocket expenses, as an
award against the non-prevailing party, and shall include attorney's fees, courts costs, investigative, and out-of-
pocket expenses in appellate proceedings. Mediation proceedings initiated and conducted pursuant to this
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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.
19. BINDING EFFECT
The terms, covenants, conditions, and provisions of this Agreement shall bind and inure to the benefit of the
County and Contractor 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 F()R FEDERAL OR STATE AID
Contractor 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 Contractor agree that all disputes and disagreements shall be attempted to be resolved by meet and
confer sessions between representatives of each of the parties. If no resolution can be agreed upon within 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 Contractor agree to participate, to the extent
required by the other party, in all proceedings, hearings, processes, meetings, and other activities related to the
substance of this Agreement or provision of the services under this Agreement. County and Contractor
8
specifically agree that no party to this Agreement shall be required to enter into any arbitration proceedings
related to this Agreement.
24. NONDISCRIMINATION
Contractor 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.
Contractor agrees to comply with all Federal and Florida statutes, and all local ordinances, as applicable,
relating to nondiscrimination. These include but are not limited to: 1) Title VI of the Civil Rights Act of 1964
(PL 88-352) which prohibits discrimination on the basis of race, color or national origin; 2) Title IX of the
Education Amendment of 1972, as amended (20 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. COVENAN'"r OF NO INTEREST
County and Contractor 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 only interest of
each is to perform arId receive benefits as recited in this Agreement.
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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 infonnation.
27. NO SOLICITATION/PAYMENT
The County and Contractor 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
Contractor 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 AC~CESS
The County and Contractor 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 Contractor in conjunction with this Agreement; and
the County shall have the right to unilaterally cancel this Agreement upon violation of this provision by
Contractor.
29. NON-WAIVER OF IMMUNITIES
Notwithstanding the provisions of Sec. 768.28, Florida Statutes, the participation of the County and the
Contractor in this Agreement and the acquisition of any commercial liability insurance coverage, self-insurance
coverage, or local government liability insurance pool coverage shall not be deemed a waiver of immunity to
the extent of liability coverage, nor shall any contract entered into by the County be required to contain any
provision for waiver.
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30. PRIVILEG.ES 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-RELIJ\NCE 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 Contractor agree that neither the County nor the Contractor 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
Contractor 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 PERSC)NAL 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. EXECUTIC)N IN COUNTERPARTS
This Agreement may be executed in any number of counterparts, eac~ 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 CONTRACTOR 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.
12
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In witness wher.eof, the parties hereto have executed this agreement the day and year first above written,
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Deputy Clerk
CONTRACTOR:
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BOARD OF COUNTY COMMISSIONERS
MONROE COUNTY, FLORIDA
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13
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 hislher 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 ofthe 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
~eduction 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.
14
GENERAL LIABILITY
INSURANCE REQUIREMENTS
FOR
CONTRACT BIO-DIESEL FUEL SUPPLIER
BETWEEN
MONROE COUNTY, FLORIDA
AND
Dion Oil Company LLC
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
15
WORKERS ' COMPENSATION
INSURANCE REQUIREMENTS
FOR
CONTRACT BIO-DIESEL FUEL SUPPLIER
BETWEEN
MONROE COUNTY, FLORIDA
AND
Dion Oil Company LLC
Prior to the comme:ncement 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 nlaintained 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 BIO-DIESEL FUEL SUPPLIER
BETWEEN
MONROE COUNTY, FLORIDA
AND
Dion Oil Company LLC
Recognizing that the work governed by this contract requires the use of vehicles, the Contractor(s), 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
17
HAZARDOUS CARGO TRANSPORTERS LIABILITY
INSURANCE REQUIREMENTS
FOR
CONTRACT BIO-DIESEL FUEL SUPPLIER
BETWEEN
MONROE COUNTY, FLORIDA
AND
Dion Oil Company LLC
Prior to the commencement of work governed by this contract, the Contractor(s) 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
18
~y
PRODUCER
CERTIFICATE OF LIABILITY INSURANCE
I ~TE fMMIDDIYYYY)
OP ID KK
DIONOrL 04/20/10
THIS CERnFICATE IS ISSUED AS A MATTER OF INFORIIAnoN
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERnFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY TlfE POUCIES BELOW.
:Norris & Reyno1d.s Inc.
14821 South Dj.xie Highway
Niaai FL 33176
Phone:305-238-1000 Fax:305-255-9643
INSURED
INSURERS AFFORDING COVERAGE
Dion Oi~ C~y et:aJ.
~. SUZ~. Dion Banks
Post Offj.ce Box 1209
Key West FL 33041-1209
J
COVERAGeS
INSURER A:
INSURER B:
S~.ich AlMricaa x.a.~UMHt co.
As.oc1at:ed IDdlut..ri... In. Co
HAle ,
16535
23140
INSURER C: Azi. specialty In_rancII Co.
INSURER 0: Admiral Insurance Company
INSURER E:
THE POUCles OF INSURANCE USTEO BELOW HAVE BEEN ISSUED TO THE INSUREO NAMED ABOVE FOR THE POliCY PERIOD INDtCATED. NOTWITHSTANDING
ANY REQUIREMENT. TERM OR CONOmON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH T~S 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
POUCfES. AGGREGATE UMITS SHOVVN MAY HAVE BEEN REDUCED BY PAID CUJMS.
lTR "SRI: . TYPE OF INSURANCE POLICY NUMBER DATE(U__, I DX~ lMiwotvvvv) UMrTS
GENERAL LIA8I.nY EACH OCCURRENCE S 1 , 000 I 000
f--- =~ES lea DCCUWlC8)
A X COMMERCIAL GENERAL lIABILITY CP0945166702 01/01/10 01/01/11 s 100,000
i-- :J CLAIMS MADE ~ OCCUR
MSD EXP (Any one person} $ 5,000
--
PERSONAl & AOV INJURY $ 1 ,000 I 000
----
GENERAL AGGREGATE S 2 , 000 t 000
~
GEN'l AGGREGATE UMrr APPLIES PER: PRODUCTS - COMP/OP AGG S 2 ,000 1000
n POUCY n ~ fil LOC
AUTOIlOllLE UA8UTY COMBINED SINGlE UMIT S 1,000 1000
-
A ANY AUTO CP0945166702 01/01/10 01/01/11 fEe aeddIInt)
-
X ALL OWNED AUTOS IRCL MSC90 BODlL.Y INJURY
- S
SCHEOU1..EO AUTOS IMCL CUa.'-IIIOMm8D JIOL (F-. peraon>
~
X HIRED AlJTOS BOOIL Y INJURY
~ S
X NON-OtNNEO AUTOS (Per a:iclent)
- COMP/COLLISION ., 01/01/11
A X CP09451667-HIRED AD TOOl/Ol/10 PROPERTY DAMAGE
- C' ^ ( s
1000/1000 PER sce lAX ~ 'CO, 000 &AC8 AO!O (Pw 1CddIInt)
GARAGE LIABIUTY .....: .: , ,~Ui_~ ~ AUTO ONlY - EA ACaDENT S
q ANY AlITO CO OTHER THAN EA ACe s
:1-'\S- AUTO ONLY: AGG S
EXCESS' UMBRELLA LIABILITY (' EACH <XCURRENCE $ 5 I 000 ,000
C [JOCCUR o ClAIMS MADE EAU736621012010' · 01/01/10 01/01/11 AGGREGATE $ 5,000,000
PROD AGG \ s 5,000,000
=1 0EDucn~ S
RETENnON sO $
WOA KERB N X I ToRY LIMITS I lU~~
AND'EIIPL.OYIIts- UAMJTY YIN
B ANY PROPRIETORIPARTNER1EXECUTIVD AWCl005219 04/01/10 04/01/11 E.L EACH ACCIDENT S 500,000
OFFlCEMlEMBER EXCLlJDEO?
CIIa".ory. NH) E.L DISEASE - EA EMPLOYEE S 500 I 000
g.qsCt~~~ below E.L. DISEASE - POUCY LIMIT S 500 I 000
OllER
D EXCESS LIABILITY EXOOOO107640S 01/01/10 01/01/11 10,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
*10 Days for. Nonpayaant of Preaium
Pe.tr~1eua Distributor - State of F~or.ida *except 10 days for nonpayment of
pr8lll.1um Monroe County Board of County CoDaai.ss.ioners are .Addi tiona1 Xnsured
on Li.abil.:i.t:y Pol.icies as their interest may appear with respect to contract
.for fuel. deJ..ivexy services
CERnFICATE HOLDER
~
)J)NR0E8
CANCELLAnON'
SHOULD ANY OF THE ABOVE DESCRIBED POUClIS III! CANCEI.l.ED BEFORE 1lIE EXPIRA 110N
IMTE THEREOF, THE ISSUING INSURER WIlL ENDEAVOR TO MAIL 30 * DA va WRI'I1EN
NOTICE TO THE CER1FICATE MOLDIER NAIlED TO 1lIE LeFT. BUT FALURE 10 DO 80 SHALL
_POSE NO OBI.IGA TION OR UAIIIUTY OF ANY KIND UPON 1HE INSURER. ITS AGENTS OR
MPRIiSENTATIVES.
AUTHORIZED
N. All rights .....rved.
Monroe County BOCC
Risk Managment
1100 Simonton Str.et
W..t: FL 33040
ACORD 25 (2001I01)
o
The ACORD IIIIIIMt .nd logo are n.glstered marks of ACORD
BID-PWD-187-178-2010-PUR/CV
LOBBYING AND CONFLICT OF INTEREST CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO. 010-1990
MONROE COUNTY, FLORIDA
ETHICS CLAUSE
Suzanne D. Banks
(Company Officer/Partner/1 ndividual)
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,c-ommission, percentage, gift, or consideration paid to the former Countyoffic-er or
employee".
7/2 / 1 0
Date:
Suzanne D. Banks Vice President of Larry DioD
Corp., General Partner for Dion Partnership L
Ltd., Managing Member of Dion Oil Company LLC
STATE OF:
Florida
COUNTY OF:
Monroe
Subscribed and sworn to (or affirmed) before me on
7/2/]0
(date) by
Suzanne D. Banks
(name of affiant). -++e/She is personally
known to me 'ar h~;) JJI ud ucea 3&
identific~tig~. (~(r~ "f irJAntifj~~tinn) '~
Simons
]/25/11
22
BID-PWD-187-]78-2010-PUR/CV
NON-COLLUSION AFFI DAVIT
I, S u z ann e D. Ban k s of the city of Key W est, F lor i d a
my oath, and under penalty of perjury, depose and say that:
according to law on
1. I am Vie e Pre sid e n t 0 f La r r y D ion Cor p ., G en era 1 Par t n e r for
Dion Partnership Ltd., Manag~ng Member
of the firm of D ion 0 i 1 Com pan y L L C
making the Bid for the services/work/project described in the Request for Bids for:
Mnnrnp COllnty BID-PWD-187-17892010-PUR/CV and that I
executed the said Bid with fuff authority to do so:
2. The prices in this bid/Bid have been arrived at independently without collusion, consultation,
communication or agreement for 1:he purpose of restricting competition, as 1:0 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 futl knowledge that
Monroe County relies upon the truth of the statements contained in this affidavit in awarding
contracts for the project/services/work.
~;:)~~ 7/2/10
(Signature f Bidder) (Date)
STATE OF: Florida
COUNTY OF: Monroe
PERSONALLY APPEARED BEFORE ME, the undersigned authority, S]1 7. ~ T) n e D ~;:! n ls" ~ WhO,d i dafter
first being sworn by me, (name of individual signing) affixed M6/her signature in the space provided above on
this ~ n d day of J u 1 y 20~. ,,\ fH'<s;,;.>,.P.-Ul,.o) ~_ <..r, .40 ('/U.... 'I
_M~~"-""'.._. ~...
~
k?
..~~v~~, JUOITH KATHERINE SIMONS
g~~.i:"E MY COMMISSION # 00633382
':.~Jtj,..'SIf EXPtRES January 25, 2011
',1, ..~.~", I
1(407) 3Q8-0153 FloridaNotaryServlC8.com _
Simons
My Commission -Expires:
]/25/] I
23
BID-PWD-]87-]78-2010-PUR/CV
DRUG-FREE WORKPLACE FORM
The undersigned Contractor/bidder/responder in accordance with Florida Statute 287.087 hereby certifies that:
Dion Oil COIDonav LLC
(Name 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 availab1e drug counseling, rehabilitation, and employee assistance programs, and
the penarties 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 underbid, the employee wil1 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
89_3 (Florida Statutes) or o.f any controfJed substance Jaw of the United States or any state, for a violatio_n
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, I certify that this firm complies fully with the above
requirements.
~~~~
7/2/10
Bidder's i.gnature Date
Suzanne D. anks Vice Presdient of Larry Dion Corp., General Partner for
Dian Partnership Ltd., Managing Member of Dion Oil Company LLC
STATE OF: Florida
COUNTY OF: Monroe
PERSONALLY APPEARED BEFORE ME, the undersigned authority, S 11 ?: R n n p n. Ran k ~ whorl i dafter
first being sworn by me, (name of individuaJ signing) affjxed _fher sjgnature in the space provided above on
this 2 n d day of J u 1 y 20 ~. \,' pe,r,,>c)j'-l.ta~f \~.4-"{'" ~;'l\ e. l.
NO
Ju th Katherine Simons
My Commission Expires: I / 2 C) / I I
24
BID-PWD-187-17882010-PUR/CV
,"
, LOCAL PREFERENCE FORM
A Vendors claiming a local preference according to Ordinance 023-2009 must complete this form.
Name of Bidder/Responder D ion 0 i 1 Com pan y L L C
Date: 7 / 2 / 1 0
1. Does the vendor have a valid receipt for the business tax paid to the Monroe County Tax Collector dated at
least one year prior to the notice or request for bid or proposal? YE S (Please furnish copy. )
2. Does the vendor have a physical business address located within Monroe County from which the vendor
operates or performs business on a day to day basis that is a substantial component of the goods or services
being offered to Monroe County? YES
638 United Street, Key West, Florida, 33040
List Address:
Telephone Number:
305-296-2000
B. Does the vendor/prime contractor intend to subcontract 50% or more of the goods, services or construction
to local -businesses -meeting the criteria above as to .Iicensing and .Iocation? No.
If yes, please provide:
1. Copy of Receipt of the business tax paid to the Monroe County Tax Collector by the subcontractor dated at
feast one year prior to the notice or request for bid or proposal. -
2. Subcontractor Address within Monroe County from which the subcontractor operates:
N/A
Tel. Number
~;:)~
Print Name: Suzanne D. Banks
'Signature and Titl of Authorized 'Signatory for
Bidder/Responde
Suzqnne D. Banks Vice President of Larry Dion Corp., General Partner for
Dio~ Partnership Ltd., Managing Member of Dion Oil Company LLC
STATE OF F lor ida
COUNTY OF
Monroe
On this ~ day of J u 1 Y ,20 I 0 , before me, the undersigned notary public, personally appeared
S u z ann e D. Ban k s , known to me to be the person whose name is subscribed above <Gf "IRg
PfOduced ~.~dcAtific3tiOll, and acknowledged that befshe is the person who
executed the above Local Preferenc~ Form for the purposes therein contained.
\"' ~Cl~~ \~u..X"", ~ l~ t,
Simons
Print Name
.~l~. JUDITH KATH!"'Nli tlMONe
{.~6:"'5 MV COMMISSION # 00633382
~"a.~ EXPIRES January 25. 2011
'H" ,
(407) 39S..Q 153 FlortdaNotaryServlce.com
My commission expires: ] / 2 5 / ] ]
Seal
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6
Larry Dion Corporation
Post Office Box 1209
Key West, FL 33041
Phone(305)296-2000 FAX (305)296-0635
7/2/10
Please see listed below a breakdown of the corporate structure to show the
relationship and ownership between the governing entitie. for Dlon 011 Company LLC.
Dion Partnership, LTD. is the managing member of Dion Oil Company LLC.
Larry Dion Corporation is general partner of Dion Partnership, LTD.
Suzanne D. Banks is the Secretary and Vice President of Larry Dion Corporation.
Sincerely,
) ~\~
it K. Simons c:J
r S nne D. Banks
Dion Corporation
Dion Oil Company, LLC
P.o. Box 1209
Key West, FL 33041-1209
305-296-2000
RE: Monroe County, Florida
BID-PWD-187-178-2010-PURlCV
10. Content of Submission
B. The following information
(1&2). A list of the person's shareholders with five (5) percent or more of the stock or, if
a general partnership, a list of the general partners; or, if a limited liability company, a
list of its members; a list of the officers and directors of the person:
Lawrence Dion and Suzanne D. Banks are shareholders.
Dion Partnership, Ltd is the managing member of Dion Oil Company, LLC.
Dion Partnership, Ltd's general partner is Larry Dion Corporation.
Lawrence Dion, President of Larry Dion Corp. whose address is 1615 Atlantic
Avenue, Key West. Florida, 33040.
Suzanne D. Banks, Vice President & Secretary of Larry Dion Corp. whose
address is 21071 6th Avenue E, Cudjoe Key, Florida, 33042-4031.
3. The number of years the person has been operating and, if different, the number
of years it has been providing the services, goods, or construction senrices called
for in the bid specifications; 62 years.
4. The number of years the person has operated under its present name and any
prior names; 62 years.
5. Answers to the following questions regarding claims and suits:
a. Has the person ever failed to complete work or provide the goods for which it
has contracted? No.
b. Are there any judgments, claims, arbitration proceeding or suits pending or
outstanding against the person, or its officers or general partners? No.
c. Has the person, within the last five (5) years, been a party to any lawsuit or
arbitration with regard to a contract for services, goods or construction
services similar to those requested in the specifications? No.
d. Has the person ever initiated litigation against the county or been sued by the
county in connection with a contract top provide services, goods or
construction services? No.
e. Whether, within the last five (5) years, an officer, general partner, controlling
shareholder or major creditor of the person was an officer, general partner,
controlling shareholder or major creditor of any other entity that failed to
perform services or furnish similar to those sought in the request for bids; No.
RE: Monroe County, Florida
BID-PWD-187-1 78-20 lO-PURlCV
Content of Submission (continued)
f. Customer references:
Florida Keys Aqueduct Authority, 1100 Kennedy Drive,
Key West, Florida, 33040; phone: 1-305-296-2454
Monroe County School Board, 242 Trumbo Street, Key
West, Florida, 33040; phone: 1-305-293-1400
Florida Keys Mosquito Control, 5224 College Road,
Key West, Florida, 33040; phone: 1-305-292-7190
g. Credit references:
Citgo Petroleum, P.O. Box 75065, Charlotte, NC, 28275
Phone: 1-800-554-4075
ExxonlMobil, P.O. Box 101537, Atlanta, GA 30392
Phone: 1-877-566-3478
h. Any information requested by the county department involved in soliciting
the bids related to the financial qualifications, technical competence, the
ability to satisfactorily perform within the contract time constraints, or other
information the department deems necessary to enable the department and
board of county commissioners to determine if the person bidding is
responsible. Available upon request.
DION'S QUIK MARTS, INC~
EXHIBIT "1"
DRUG FREE WORKPLACE STATEMENT
NOTICE TO ALL EMPLOYEES AND JOB APPLICANTS
I. COMPANY POLICY. It is the position of Dion Oil Co., LLC that the use of drugs, which by definition
includes alcohol, is strongly discouraged. As a condition to employment with this employer, you must refrain from
taking drugs on or off of the job. This employer perfonns drug testing. If there is a positive confmned drug test, you
will be denied employment with this Company or if presently employed, you will be immediately terminated. If
there is a positive confirmed drug test and you are injured on the job, workers' compensation benefits will be denied.
Section 440.102, Florida Statutes, and Florida Administrative Rules 38F-9.00l through 38F-0.013 provide for Drug
Free Workplace Program requirements.
II. REQUIRED TESTING. You are advised that Dion Oil Co., LLC will conduct the following types of drug
tests for those drugs identified by brand names or common names as well as chemical names in Exhibit "Aft attacbed
to this po Hcy statement:
a.
Job Applicant Testing.
Job applicants will be tested for the presence of drugs.
b. Current Employee Testing. It shall be a condition of continued employment, with a 60 day notice beginning
on May 13, 1992 for all current employees to submit to a drug screen.
c. Reasonable Suspicion Testing. If there is a reasonable suspicion that any employee is using or has used
drugs in violation of this Company's policies, drug testing will be required. Testing under this provision may be
conducted if: you are observed using drugs; exhibit -symptoms -or manifestations of being under -the influence -of
drugs; exhibit abnormal conduct or erratic behavior while at work; there has been a significant deterioration in your
work performance; you have been reported using drugs by a reliable and credible source, which has been
independently corroborated; you tamper with any drug test during your employment with this Company; you cause
or contribute to an accident while at work; where there is evidence that you have used, possessed, sold, solicited, or
transferred drugs while operating our vehicles, machineI)' or equipment or while on our property, on or off duty.
d. Routine Fitness for Duty Testing. Drug testing shall be a part ofa routinely scheduled employee fitness-for-
duty medical examination if your job description requires one. This examination may be held routinely for all
persons employed by this Company in such classifications or groups.
e. Follow Up Testing. If during your employment with this Company, you enter into an employee
assistance program for drug related problems, or an alcohol or drug rehabilitation program, you will be required to
submit to a drug test as a follow up to such program and also on a quarterly, semiannual or annual basis for up to two
years thereafter.
f. Worker's Compensation. If you are injured in the course and scope of your employment and test positive,
you forfeit eligibility for medical and indemnity benefits under the Worker's Compensation Act upon exhaustion of
the remedies provided in Florida Statute _440.102(5). As of Februmy 1, 1993 ALL employees with Worker's
Compensation injuries will be required to submit to a drug screen.
g. Extended Absences. You will be expected to submit to a drug screen on return from extended
absences. All employees will be required to submit to a drug screen upon the return from any leave of absence of 60
days or more or if they are rehired after a voluntary termination of 30 days or more. Employer required testing is at
the employer's expense.
1
III. REFUSAL TO SUBMIT TO TESTING. Refusal to submit to a drug test may be the basis for refusing
to hire you. If already hired, such refusal will preclude further employment with this Company. If injured on the job,
refusal to test will be the basis for your forfeiture of being eligible for medical and indemnity benefits under the
Workers' Compensation Act and will result in termination.
IV. REPORTING OF PRESCRIPTION OR NON-PRESCRIPTION MEDICATIONS. Employees and
job applicants have the right to report to the employer the use of prescription or non-prescription medications both
before and after being tested. Certain drugs may alter or affect a drug test. Such report shall be made to the person
or persons listed in paragraph 6 below. A list of such medications by brand name or common name, as well as by
chemical name, where applicable, as developed by the Department of Health and Rehabilitative Services is attached
to this policy statement and is found in Exhibit "B". In the space provided below, list all medications that you have
taken or other information which in your opinion might or will alter or affect a drug test. Y our statements, written
or otherwise, in regards to information provided pursuant to this paragraph shall be held strictly confidential, unless
you specifically authorize the release of this information.
v. EMPLOYEE ASSISTANCE, ALCOHOL AND DRUG REHABILITATION
PROGRAMS. You are advised that, within this community, there are employee assistance programs and alcohol and
drug rehabilitation programs. The names, addresses, and telephone numbers of these agencies are attached to this
policy statement.
VI. CONTESTING DRUG TESTING RESULTS. If you receive a positive confirmed drug test result,
you have the right to legally or adniinistratively contest the result or explain the resUlt to the person in charge of the
employee drug test program for the Company whose name, address and telephone number is as follows:
Director of Human Resources
Dion Oil Co., LLC
638 United StreetlP.O. Box 1209
Key West, Florida 33041-1209
305) 294-4685
This must be done within five (5) working days after you are given written notification of a positive
confirmed drug test result. The employee or job applicant will be notified in writing if the explanation or challenge
is unsatisfactory to the Company. The written notice will be given to the employee or job applicant within 15 days of
receipt of the explanation or challenge, and will include why the employee's or job applicant's explanation is
Wlsatisfactory, along with the report of positive results. If you are refused employment or terminated from
employment even after your explanation, you may still contest the drug test result pursuant to rules adopted by the
Florida Department of Labor and Employment Security. In order to administratively challenge a drug test, you must
file a daim with a Judge of Campensation Claims within 30 days of being advised that this employer rejects your
explanation of the positive drug test if in fact there is such a rejection. You must notifY the testing laboratory of any
administrative or civil action brought pursuant to this policy to retain any sample taken and advise the laboratory of
the need to retain any sample taken until the case or administrative appeal is settled. The name, -address, -and
telephone number of the testing laboratory is listed on your copy of the chain of custody form and is one of the
following:
2
SmithKline Beecham Clinical Lab
4225 East Fowler Drive
Tampa, Florida 33617
(813)972-7100
American Medical Laboratories
8549 Parkline Blvd.
Orlando, FL 32809
(407)857-8188
Lab Corp. of America Toxicology
5610 LaSalle Street
Tampa, FI 33607
(800) 877-7134
Nichols Institute
7470 Mission Valley Road
San Diego, CA 92108
(800)848-4225
You have the right to consult the testing laboratory for technical information regarding prescription and
non-prescription medication or in regard to any other information you desire. -v ou shall bave the right to a copy of
the drug test results upon request, and to have a portion of any sample or specimen taken to be retested, at your
expense, at another laboratory licensed and approved by the Department of Health and Rehabilitative Services (RRS
certified), chosen by you. This testing must be performed within 180 days after written confirmation of a positive
test result. The second laboratory test must test at equal or greater sensitivity for the drug in question as the fIrst
laboratory. The fITst laboratory which performed the test for the employer shall be responsible for the transfer of the
portion of the specimen to be retested, and for the integrity of the chain of custody during such transfer.
VTI. The Company reserves the right to suspend employees without pay pending the results of any drug test
investigation.
VIII. CONFIDENTIALITY. You are advised that all information, interviews, reports, statement, memoranda,
and -drug test results, written or otherwise, received by the -employer through these drug testing programs are
confidential communications and may not be used or received in evidence, obtained in discovery, or disclosed in any
public or private proceedings, except in accordance with Section 440.102, Florida Statues, or in determining the
-compensability -of workers' -compensation -claims. This -company, any laboratory, employee assistance programs,
drug and alcohol rehabilitation programs or their agents who receive or have access to information concerning drug
test results shall keep all information confidential. Release of such information under any other circumstance shall
be solely pursuant to a written consent by a hearing officer or a court of competent jurisdiction pursuant to an appeal
or unless deemed appropriate by a professional or occupational licensing board in a related disciplinary proceeding.
Information on drug test results shall not be released or used in any criminal proceeding against you as an employee
or applicant for employment. Information released contrary to this section shall be inadmissible as evidence in any
criminal proceeding. However, the employer, agent of the employer, or laboratory conducting a drug test shall not
be prohibited from releasing any such information when consulting with legal counsel in actions brought under or
related to Section 440.102, Florida Statutes, or when such information is relevant to its defense in a civil or
administrative matter.
3
By the signing of this statement, I understand the employer's drug testing program and consent to its terms. I further
understand that the program has been publicly posted in an appropriate and conspicuous place on the employer's
premises and copies of this policy are available for inspection by me or the general public in the employer's
personnel office or other designated place during regular business hours. By the signing of this agreement, I
herewith acknowledge that I have read this instrument and fully understand my rights, duties, and obligations under
this Drug Free Workplace Program. I further understand that the employer can establish reasonable work rules
related to any possession, use sale or solicitation of drugs, including conviction for drug related offenses, and can
terminate my employment or deny employment for such conduct.
Applicant For Employment or Employee
Date
Witness
Date
Witness
Date
This is to certifY that I have explained this form and the employer's Drug Free Workplace Program to the
above listed employee -or applicant for employment. He/She has acknowledged tome -that he/she -has -read this form
and understands it contents. Ifhe/she cannot read, he/she has advised me of this fact and I have personally read this
form to himlher. In addition, I have orally explained the contents of this form and all aspects of the employer's Drug
Free Workplace Program.
Management for DioD Oil Co., LLC Date
4
EXHIBIT "Aft
The following is a list of the drugs, common names and cut off levels (levels equal to or exceeding the following
will be reported as positive) which may be tested for in the initial test. However, other drug ( s) may be tested for in
cases of reasonable suspicion where another drug may be thought to have been used:
Alcohol
Booze, hootch, drink, beer, liquor, wine, moonshine
.05g1dl
Amphetamines
Bennies, black beauties, crystal, speed, uppers, crank, ice,
Biphetamine, Desoxyn, Dexedrine
IOOOnglml
Cannabinoids
marijuana, hashish, hash, hash oil, dope, pot, roach,
grass, weed, reefer, spliff: joint
100ng/ml
Cocaine
coke, blow, nose candy, snow, flake, toot, crack
300nglml
Phencyclidine
PCP, angel dust, hog
25nglml
Methaqualone
Ludes, qualude, optimil, parest, somnafac, sopor
300nglml
Opiates
Heroin, horse, smack, powder, opium, dovers powder,
Paregoric, Parepectolin
300ng/ml
Barbiturates
Barbs, rainbows, downers, goofballs, reds,
yellows, blues, Phenobarbital, Tuinal, Amytal
300nglmI
Methadone
Dolophine, Methadose
300nglml
Benzodiazepines
Ativan, Azene, Clonopin, Dalmone,
Diazepam, Halcion, Librium, Paxipam,
Restoril, Serax, Tranxene, Valium,
Verstran, Xanax
300nglmI
Propoxyphene
Darvocet, Darvon N, Dolene
300nglml
5
EXHIBIT "B"
OVER THE COUNTER AND PRESCRIPTION DRUGS WHICH COULD
AL TER OR AFFECT THE OUTCOME OF A DRUG TEST
Due to the large number of obscure brand names and constant marketing of new products, this list, as follows, cannot
and is not intended to be all-inclusive.
Alcohol
All liquid medications containing ethyl alcohol (ethanol). Please read the
label for alcohol content. As an example, Vick's Nyquil is 25% (50 proof)
ethyl alcohol. Comtrex is 20% (40 proof). Contact Severe Cold
Formula Night Strength is 25% (50 proof) and Listerine is 26.9% (54 proof).
Am:phetamines
ObetroI, Biphetamine, Desoxyn, Dexedrine, Didrex, lonamine, Fastin.
Cannabinoids
Marinol (Dronabinol, THC).
Cocaine
Cocaine HC 1 topical solution (Roxanne).
Phencyclidine
Not legal by prescription.
Methaqualone
Not legal by prescription.
Opiates
Paregoric, Parepectolin, Donnagel PG, Morphine, Tylenol with Codeine, Emprin with
Codeine, APAP with Codeine, Aspirin with Codeine, Robitussin AC, Guiatuss AC,
Novahistine DR, Novahistine Expectorant, Dilaudid (Rydromorphone), M-S Contin and
Roxanol (morphine sulfate), Percodan, Vicodin, Tussi-organidin, etc.
Barbiturates
Phenobarbital, Tuinal, Amytal, Nembutal, Seconal, Lotusate, Fiorinal, Fioricet, Esgic,
Butisol, Mebaral, Butabarbital, Butalbital, Phrenilin, Triad, etc.
Benzodiazepines
Ativan, Azene, Clonopin, Dalmane, Diazepam, Librium, Halcion, Paxipam, Serax,
Tranxene, Valium, Verstran, Xanax, Restoril, Centrax, etc.
Methadone
Dolophine, Metadose.
Propoxvphene
Darvocet, Darvon N, Dolene, etc.
6
EMPLOYEE ASSISTANCE PROGRAMS
MONROE COUNTYMENT AL HEALTH SERVICE
Guidance Clinic of the Upper Keys
92140 U.S. 1
Tavernier, Florida 852-3284
Guidance Clinic of the Middle Keys
3000 41st Ocean
Marathon, Florida 745-1647
Rice, David P Ph.D.
133 Mockingbird Lane
Marathon, Florida
743-7643
Richmond Fellowship of America, Inc.
Therapeutic Community
1320 Coco Plum Drive
Marathon, Florida 743-4129
Southern Psychological Associates
11400 Overseas Highway
Marathon, Florida 743-2254
Ersay, Molly A MA
3706 N. Roosevelt Blvd.
Key West, Florida 294-8777
Hellmann, Ricbard Ph.D.
513 Fleming Street
Key West, Florida 294-1469
DRUG ABUSE & ADDICTION TREATMENT
Guidance Clinic of the Middle Keys
3000 41 St. Ocean
Marathon, Florida 745-1647
Delphos at DePoo Hospital
1200 Kennedy -Drive
Key West, Florida 294-5531
Care Center for Mental Health
1205 4th Street
Key West, Florida
292-6843
Narcotics Anonymous
296-7999
ALCOHOLISM TREATMENT CENTERS
Guidance Clinic of the Upper Keys
92140 U.S. 1
Tavernier, Florida 852-3284
MARC House
11287 Overseas Highway
Marathon, Florida
743-6551
Alcoholics Anonymous
81650 U.S. 1 Highway
Islamorada, Florida
664-8683
AI-Anon Family Group Mid-Keys
2401 Overseas Highway
Marathon, Florida 743-5698
Alcoholics Anonymous
Marathon, Florida
743-3262
CareUnit Program
Toll Free
800--854-0318
Delphos at DePoo Hospital
1200 Kennedy Drive
Key West, Florida
294-5531
800--233-3911
Anchors Aweigh Club
404 Virginia Street
Key West, Florida
296-7888
Guidance Clinic of the Middle Keys
3000 41 Street, Ocean
Marathon, Florida 754-1647
Alcoholics Anonymous
Key Largo, Florida
852-6186
7
EMPLOYEE ASSISTANCE PROGRAMS
DADE COUNTY
Alcoholics Anonymous
1240 North Krome Avenue
Homestead, FI 33030 246-1796
Catholic Community Services, Inc.
St. Luke's Center CDC Services
3290 NW 7th Street
Miami, Fl33125 643-4040
Betterway Foundation, Inc.
229 NE 24 Street
Miami, FI 33137
573-6279
Charter Hospital of Miami
11100 NW 27th Street
Miami, FI 33172
591-3230
-Chi-South Dade 'Community Mental
Health Center, Inc.
10300 SW 216th Street
Miami, F133190 252-4840
Coral Reef Hospital
9333 SW 152nd Street
Miami, Fl33190 251-2500
Division of Vocational Rehabilitation Department of
Labor & Employment Security
401 NW 2nd Avenue
Miami, Fl33128 637-6483
Economic Opportunity Family Health Center, Inc.
"Department of Addictions & 'PreventiveHealth
Services
5361 NW 22nd Avenue
Miami, FI 33142 637-6483
Family Counseling Services of Greater Miami, Inc.
75 SW 8th Street, Suite 302
Miami, FI 33130 379-5730
Glenbeigh Hospital of Miami
4425 W. 20th Avenue
Hialeah, FI
558-9999
Here's Help, Inc. South Program
] 1645 S. Dixie Highway
Miami, Fl 33156 238-8500
HCA Grant Center Hospital
20601 SW 157thAvenue
Miami FI 33142 800--238-8500
Lock Towns Community Health
Center, Inc.
18475 NW 2nd Avenue
Miami, FI33169 653-6594
Metatherapy Institute, Inc.
27200 Old Dixie Highway
Miami, F133156 247-4515
Metro-Dade Department of Human Resources Office
of Rehabilitative Services
2500 NW 22nd Avenue
Miami, Fl33142 63'8~6540
Miami Mental Health Center
2141 SW 1st Street
Miami, Fl33135 643-1650
New Life Substance Abuse Outpatient Program
1644 NE 148th Street
Miami, F133181 949-1661
North Miami Community Mental Health Center, Inc.
-9400 NW 12th Avenue
Miami, F133150 691-0091
Public Health Trust of Dade
County, me.
1660 NW 7th Court
Miami, Fl33150
Hot Line
545-2355
324-8166
Spectrum Programs, Inc.
11055 NE 6th Avenue
Miami, F133161 754-1783
Up front Drug Information, Inc.
570 1 Biscayne Blvd., Suite -602
Miami, Fl33147 757-2566
8
Dion Oil Company IDion Oil Co., LtC
Job Applicant Acknowledgment of Receipt and Understanding
I, the undersigned;l hereby acknowledge that I have read a summary of the Company's Drug Free Workplace Policy, a summary of the
drugs which may alter or affect a drug test and a list of local Employee Assistance Programs and Drug and Alcohol treatment programs. I
have had an opportunity to have all aspects of this material fully explained. 1 also understand that I must abide by this policy asa condition
of employment ifhired, and any violation of this policy will result in discharge.
Further, I understand that if I am hired;l during my employn1ent I may be required to submit to testing for the presence of drugs or alcohol. I
understand that submission to such testing isa -condition -of employment with the Company, and -discharge will result if: 1) I refuse to
consent to such testing, 2) I refuse to execute all forms of consent and release of liability as are usually and reasonably attendant to such
examinations, 3) I refuse to authorize release of the test results to the Company, 4) The tests establish a violation of the Company's drug
free workplace policy, 5) I otherwise violate the policy.
If I am injured in the course and scope of my employment and test positive, I understand that I will be automatically terminated from
employment and I forfeit my eligibility for medical and indemnity benefits under the Workers' Compensation Act upon exhaustion of the
procedures in Florida Statutes 140.102 (5).
As a prerequisite to employment, I shall hereby allow the Company to have urine samples collected from me to determine the presence of
illegal drugs in my body. By signing this form, I -hereby release to the -Company results of the testes) to which I have consented. I further
authorize the Company to discuss the results with the medical personnel/physicians collecting the specimen, the testing facility, its
directors, -officers, -agents, and employees responsible for administering this test( s) -or evaluating the results of said teste s). The test results
may be used as defense to any legal action to which I am a party.
I understand that the results of the drug testing of my urine, if confirmed positive, will remove me from consideration for employment I
also understand that if I refuse to consent, I will be terminated.
I further release any testing facility or any physici~s, who have tested me, from any liability arising from a release of any results, written
reports, medical records, and data concerning my test( s) to the appropriate Company officials.
I further agree that a reproduced copy of this pre-employment consent and release fonn shall have the same force and effect as the original.
I have read the foregoing and fully understand its contents. I acknowledge that my signing of this consent and release form is a voluntary
act on my part and that I have not been coerced into signing this document by anyone.
I also understand that the Drug Free Workplace Policy and related documents are not intended to constitute a contract between the
Company an me.
I., hereby CONSENT to testing for the presence of drugs and/or alcohol and to have the results released to DioD Oil Company/Dion Oil
Co., LLC~
Job Applicant Signature
Date
Social Security Number
Witness Signature
Date
I, hereby REFUSE to consent to testing for the presence of drugs and/or alcohol which terminates the application process.
Job Applicant Signature
Date
Social Security Number
Witness Signature
Date
9
.DionOil Co., Ltc
Dioo Oil Company
638 United Street
Key West, Florida 33040
Phone: 305-295-4685
FAX: 305-296-0635
Post Office Box 1209
Key West, Florida 33041-1209
Phone: 305-296-2000
o
David L. Parsons, D.O., P.A.
2855 Overseas Highway
Marathon, FL 33050
305-743-2253
T-esting Hours:
Monday - Friday
9:00-11:30 a.m. OR 1:30-3:30 pm
D
Independent Medical Laboratory
Mario Martinez M.T.
3412 Duck Ave. (Poinciana Plaza)
Key West, FL 33040
305-296-3146
Testing Hours:
Mon- Thurs: 9am-Noon or 1:30pm-5:00
Friday.: 9am-Noon or 1:30pm-4:00
Dion Oil Co., LLC/Dion Oil Company hereby requests that:
Name
Home Telephone
be seen for the following:
Reason For Test:
D New Hire (HRS-5)
D Routine Fitness (NIDA)
DReasonable Suspicion (HRS-IO)
D Rehab Follow-up (HRS-10)
D Accident on the Job (HRS-IO)
D Return From Leave (HRS-5)
D Other
o HRS Drug Screen (5 Panel)
o Blood Alcohol Testing
o NInA Drug Screen (5 panel) (DOT)
o HRS Drug Screen (10 Panel)
o Medical Exam (Worker's .Compensation)
o Physical Exam (DOT)
Authorized
Signature
Date:
STORE #:
10
BID-PWD-]87-]78-2010-PUR/CV
SECTION TWO: BID RESPONSE AND COUNTY FORMS
SUBMISSION RESPONSE FORM PART I
Sio-Diesel Fuel Suppliers for Monroe County, Florida
BID TO:
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
clo PURCHASING DEPARTMENT
.GATO '~UILDING, ROOM 1-213
1100 SIMONTON STREET
KEY WEST, FLORIDA 33040
The undersigned, having carefully examined the specifications, bid and addenda thereto and other bid
documents for:
Bio-Diesel Fuel Suppliers for Monroe County, Florida
in ,conformance with said specifications and other bid documents including Addenda ,issued thereto.
I acknowledge receipt of Addendum (a) No.(s)
;+-
Delivery : j days.
nla
I have included:
o The Su'bmission Response Form Parts 'I and 11 xx
o Lobbying and Conflict of Interest Clause Form XX
o Non-Collusion Affidavit xx
o "Drug -Free "Workplace "Form xx
o Local Preference Form ..x.x......
(Check mark items above, as a reminder that they are included.)
Company Name:
Dion Oil Company LLC
Maifing Address:
P.O. Box ]209
Telephone: 305-296-2000
Key West, Florida 33041
Fax:
305-296-0635
Name:
D. Banks
Date: 7/2 / 1 0
Signed:
~-;:)'c6~
Title:
Suzanne D. Banks Vice President of Larry Dion Corp., General Partner fOJ
Dion Partnership Ltd., Managing Member of Dion Oil Company LLC
Applicable License(s) 'Number:
]002866
Federal LD. #
65-]049]26
Type:
Fuel Pollutants License
6