Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
01/21/2015 Agreement
AMY REAVILIN, CPA CLERK OF CIRCUIT COURT &COMPTROLLER MONROE COUNTY, FLORIDA DATE: February 3, 2015, TO: Dent Pierce, Director Public Works Division ATTN.• Alice Steryou FROM: Lindsey Ballard, D. CV At the January 21, 2015 Board of County Commissioner's meeting the Board granted approval and execution of Item C41 Contract with Amy Chan for artwork to be installed in the Drug Court Offices at the Freeman Justice Center. This Contract is Funded by Court Facilities. Enclosed is a duplicate original of the above mentioned executed on behalf of Monroe County for your handling. Should you have any questions, please feel free to contact me. cc: County Attorney Finance File -,/ 500 Whitehead Street Suite 101, PO Box 1980, Key West, FL 33040 Phone: 305-295-3130 Fax: 305-295-3663 3117 Overseas Highway, Marathon, FL 33050 Phone: 305-289-6027 Fax: 305-289-6025 88820 Overseas Highway, Plantation Key, FL 33070 Phone: 852-7145 Fax: 305-852-7146 • Monroe County Art in Public Places Award Agreement This AGREEMENT dated the 21" day of January, 2015 is entered into by and between the BOARD OF COUNTY COMMISSIONERS FOR MONROE COUNTY, hereinafter "County", and AMY CHAN hereinafter "Artist", WHEREAS, the Art in Public Places Ordinance #022-2001, codified at MCC §2- 322(A), provides for an appropriation of 1 % of the construction costs for new construction exceeding $500,000 and renovations exceeding $100,000; and WHEREAS, the Ordinance established an Arts in Public Places (AIPP) Committee to advise the County Commission regarding art to be acquired and installed in each public construction project subject to the AIPP allocation; and WHEREAS, the AIPP Committee has selected and recommended to the BOCC one or more artists for this project; and WHEREAS, the Board of County Commissioners of Monroe County have determined that it is in the interest of the promoting the understanding and awareness of the visual arts to contract for the creation and installation of artwork in the Drug Court Offices at the Freeman Justice Center; NOW, THEREFORE, in consideration of the mutual covenants and payments contained herein, the parties have entered into this agreement on the terms and conditions as set forth below: l . AGREEMENT PERIOD: This agreement is for a period of ninety (90) days after notice to proceed to execute and complete their work. This agreement shall remain in effect for the stated period unless one party gives to the other written notification of termination pursuant to and in compliance with paragraphs S, 12, and 13 below. All work for which AIPP funds are to be expended must be completed by the stated termination date. 2. SCOPE OF AGREEMENT: The Artist shall provide five original acrylic paintings on canvas, two paintings 18"x 18" and 18"x 30"for the corner in the lobby, and 3 paintings, 24" x 30"for the meeting room. These paintings will be installed and hung with security hangers provided by the Arts Council. Artist shall confer with and coordinate activities with Elizabeth Young of the Arts Council in order to insure that there is as much cooperation and cohesiveness in the incorporation of the art into the building so that there shall be the least amount of interference between the Artist and Court Personnel. 3. AMOUNT OF AGREEMENT AND PAYMENT: The County shall provide an amount not to exceed $4,100.00 for materials and services used to create and Art in Public Places — Drug Court Offices install the project. The Board of County Commissioners assumes no liability to fund this agreement for an amount in excess of this award. Monroe County's performance and obligation to pay under this agreement is contingent upon an annual appropriation by the BOCC. Pursuant to Florida's Prompt Payment Act, upon receipt by County of an Invoice in a lump -sum amount of $4,100.00 after installation of the artwork and acceptance by the County, and documentation to satisfy the Clerk, payment shall be made. Eligible costs and expenditures for the project and the total award include, but are not limited to: A. Artist's design fee B. Labor, materials, contracted services required for production and installation C. Artist's operating expenses related to the project D. Travel related to this project, pursuant to statutory limitations (see above paragraph 3, item 2) a.) E. Transportation of the work to the site (see above paragraph 3, Item 2) a.) F. Installation to the site G. Permits and fees necessary for the installation (applicable for exterior projects which also require HARC review) H. Legal costs directly related to the project 1. Liability costs of artist Payment shall be made upon presentation of an original invoice and documentation necessary to support the completion of the work. Artist shall also provide a release of lien if applicable. Payment request must be submitted no later than 60 days after the completion of the project. 4. OWNERSHIP and RIGHTS: Upon the installation of the artwork, County shall own the artwork and all rights related thereto fully and completely. The artist hereby acknowledges that this work is not site specific and waives any rights as to changes in installation and placement sites for the work by the County. 5. RECORDS: The Artist shall keep such records as are necessary to document the performance of the agreement and give access to these records at the request of the County, the State of Florida, 'or authorized agent and representative of said government bodies. The Artist understands that it shall be responsible for repayment of any and all audit exceptions which are identified by the Auditor General for the State of Florida, the Clerk of Court for Monroe County, the Board of County Commissioners for Monroe County, or their agents and representatives. 6. MODIFICATIONS AND AMENDMENTS: Any and all modifications of the terms of this agreement shall be only amended in writing and approved the Board of County Commissioners for Monroe County. 2 Art in Public Places — Drug Court Offices 7. INDEPENDENT CONTRACTOR: At all times and for all purposes hereunder, the Artist is an independent contractor and not an employee of the Board of County Commissioners of Monroe County. No statement contained in this agreement shall be construed as to find the Artist or any of its employees, contractors, servants or agents to the employees of the Board of County Commissioners of Monroe County, and they shall be entitled to none of the rights, privileges or benefits of employees of Monroe County. 8. COMPLIANCE WITH LAW: In carrying out its obligations under this agreement, the Artist shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating the provisions of this agreement, including those now in effect and hereafter adopted. Any violation of said statutes, ordinances, rules or regulations shall constitute a material breach of this agreement and shall entitle the County to terminate this agreement immediately upon delivery of written notice of termination to the Artist. 9. MOLD HARMLESS/INDEMNIFICATION: The Artist hereby agrees to indemnify and hold harmless the BOCC Florida Keys Council of the Arts, AIPP Committee and Monroe County and any of their officers and employees from and against any and all claims, liabilities, litigation, causes of action, damages, costs, expenses (including but not limited to fees and expenses arising from any factual investigation, discovery or preparation for litigation), and the payment of any and all of the foregoing or any demands, settlements or judgments arising directly or indirectly under this agreement. The Artist shall immediately give notice to the County of any suit, claim or action made against the County that is related to the activity under this agreement, and will cooperate with the County in the investigation arising as a result of any suit, action or claim related to this agreement. 10. ANTI -DISCRIMINATION: The Artist agrees that they will not discriminate against any of their employees or applicants for employment or against persons for any benefit or service because of their race, color, religion, sex, national origin, or physical or mental handicap where the handicap does not affect the ability of an individual to perform in a position of employment, and to abide by all federal and state laws regarding non-discrimination. 11. ANTI -KICKBACK: The Artist warrants that no person has been employed or retained to solicit or secure this agreement upon an agreement or understanding for a commission, percentage, brokerage or contingent fee, and that no employee or officer of the County has any interest, financially or otherwise, in the said funded project; except for general membership. For breach or violation of this warranty, the County shall have the right to annul this agreement without liability or, in its discretion, to deduct from the agreement price or consideration, the full amount of such commission, percentage, brokerage or contingent fee. Q Art in Public Places — Drug Court Offices 12. TERMINATION: This agreement shall terminate pursuant to Paragraph 41. Termination prior thereto shall occur whenever funds cannot be obtained or cannot be continued at a level sufficient to allow for the continuation of this agreement pursuant to the terms herein. In the event that funds cannot be continued at a level sufficient to allow the continuation of this agreement pursuant to the terms specified herein, this agreement may then be terminated immediately by written notice of termination delivered in person or by mail to Artist. The County may terminate this agreement without cause upon giving 90 days written notice of termination to Artist. The County shall not be obligated to pay for any services or goods provided by Artist after Artist has received written notice of termination. 13. TERMINATION FOR BREACH: The County may immediately terminate this agreement for any breach of the terms contained herein. Such termination shall take place immediately upon receipt of written notice of said termination. Any waiver of any breach of covenants herein contained to be kept and performed by Artist shall not be deemed or considered as a continuing waiver and shall not operate to bar or prevent the County from declaring a forfeiture for any succeeding breach either of the same conditions or of any other conditions. 14. ENTIRE AGREEMENT: This agreement constitutes the entire agreement of the parties hereto with respect to the subject matter hereof and supersedes any and all prior agreements with respect to such subject matter between the County and the Artist. 15. CONSENT TO JURISDICTION: This agreement, its performance, and all disputes arising hereunder, shall be governed by the laws of the State of Florida, and both parties agree that the proper venue for any actions shall be in Monroe County. 16. ETHICS CLAUSE: Artist warrants that he has not employed, retained or otherwise had act on his behalf any former County officer or employee in violation of Section 2 of Ordinance No. 10-1990 or any County officer or employee in violation of Section 3 of Ordinance No. 10-1990. For breach or violation of the provision the County may, at its discretion terminate this agreement without liability and may also, at 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 or present County officer or employee. 17. PUBLIC ENTITY CRIME STATEMENT: A person or affiliate who has been placed on the convicted vendor list following a conviction for public entity crime may not submit a bid on an agreement to provide any goods or services to a public entity, may not submit a bid on an agreement with a public entity for the construction or repair of a public building or public work, may not submit bids on leases of real property to public entity, may not be awarded or perform work as a contractor, supplier, sub -contractor, or consultant under an agreement with any 4 Art in Public Places — Drug Court Offices 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. Artist represents that Artist is not on the Convicted Vendor list. 18. AUTHORITY: Artist warrants that it is authorized by law to engage in the performance of the activities encompassed by the project herein described. Each of the signatories for the Artist below are authorized to contract Artist's services. 19. LICENSING AND PERMITS: Artist warrants that he or she shall have, prior to commencement of work under this agreement and at all times during said work, all required licenses and permits whether federal, state, County or City. 20. INSURANCE: Artist agrees that it maintains in force at its own expense a liability insurance policy which will insure and indemnify the Artist and the County from any suits, claims or actions brought by any person or persons and from all costs and expenses occurring during the agreement or thereafter that results from performance by Artist of the obligations set forth in this agreement. At all times during the term of the agreement and for one year after acceptance of the project, unless the requirement is waived by the Monroe County Risk Manager, Artist shall maintain on file with the County a certificate of the insurance of the carriers showing that the aforesaid insurance policy is in renewal, material change or reduction in coverage unless a minimum of thirty (30) days prior notification is given to the County by the insurer. Acceptance and/or approval of Artist's insurance shall not be construed as relieving Artist 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 Inured" on all policies except worker's compensation. Any deviations from these General Insurance Requirements must be requested in writing on the County form titled "Request for Waiver of Insurance Requirements" and must be approved by Monroe County Risk Management. The following coverages shall be provided prior to commencement of work governed by this contract: 1. Workers Compensation if, and as required by Florida Statutes 2. General Liability Insurance. Coverage shall be maintained through out the life of the contract and include, as a minimum: • Premises Operations • Products and Completed Operations • Blanket Contractual Liability • Personal Injury Liability 5 Art in Public Places — Drug Court Offices 21. 22 • Expanded Definition of Property Damage The minimum limits acceptable shall be: $300,000 Combined Single Limit (CSL) If split limits are provided, the minimum limits acceptable shall be: $200,000 per Person $300,000 per Occurrence $200,000 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. NOTICE: Any written notice to be given to either party under his agreement or related hereto shall be addressed and delivered as follows: For Artist Amy Chan 3208 Rosewood Avenue Richmond, VA 23221 For County: Florida Keys Council of the Arts 1100 Simonton Street Key West, FL 33040 and County Attorney P.O. Box 1026 Key West, FL 33041-1026 PUBLIC RECORDS: The Artist agrees to comply with all requirements of Chapter 119 of the Florida Statutes and specifically: (a) Keep and maintain public records that ordinarily and necessarily would be required by the public agency in order to perform the service. (b) Provide the public with access to public records on the same terms and conditions that the public agency would provide the records and at a cost that does not exceed the cost provided in this chapter or as otherwise provided by law. (c) Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law. (d) Meet all requirements for retaining public records and transfer, at no cost, to the public agency all public records in possession of the artist upon termination of the contract and destroy any duplicate public records that are exempt or confidential and Art in Public Places — Drug Court Offices 0 exempt from public records disclosure requirements. All records stored electronically must be provided to the public agency in a format that is compatible with the information technology systems of the public agency. IN WITNESS WHEREOF, the parties hereto have caused this agreement to be executed the day and year first above written. Date: BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA By: M /Chairman WITNESS TO ARTIST: By: Print Name: (De 4X Date: STATE OF V �n� 4{ / COUNTY OF f + On this ?jA day of Dar 449_, before me, the undersigned notary public, personally appeared ! M 4 h known to me to be the person whose name is subscribed above or who produced a n`il r i G l-nf6 as identification, and acknowledged that he/she is the person who executed the above contract with Monroe County for the artwork in the Drug Court Offices at the Freeman Justice Center for the purposes therein contained. Notary P lic A Name f My Commission Expires Stephen M. Randolph Commonwealth of Virginia Notary Public Commission No. 7023277 My Commission Expires 1131/2018 MONROE COUNTY ATTORNEY PROVEDA�iO F M:/ N TILEENE VN CASSEL ASSISTAr,' (11iN''Y ATTORNEY Date - �O 201r - 7 Art in Public Places — Drug Court Offices (1} U 00 O Q •� W x ,. oT0 Q ca cz U 4t 0 0 co w� cc oo Q r- (� r U M a7 E1r) X n t AMY CHAN amybchan@gmail.com www.amychan.org PROPOSAL I would like to introduce myself and present my work for consideration for the Freeman Justice Center Drug Court Lobby and Meeting Room Project. I have created public commissions for the Johns Hopkins Children's Center in Baltimore, the Scottsdale Civic Center Mall and Virginia Commonwealth University. I earned my BFA from Rhode Island School of Design and my MFA from Virginia Commonwealth University. My work has been shown at venues such as Pierogi 2000 and Wave Hill, with grants from the Pollock Krasner Foundation and the Virginia Commission for the Arts. In July of 2013 I was a resident at The Studios of Key West.. During my residency I developed a body of work based on the underwater landscape I explored with my snorkel gear. The influence of vibrant fish patterns, complex coral forms, and the atmospheric underwater palette remains an important part of my work today, For the Freeman Justice Center I would like to create two abstract paintings that further explores this body of work, taking visual cues from the Keys ecosystem, The paintings will use bright layers of tropical shapes, patterns and colors to form playful abstract compositions that encourage life and positivity in the space. The interlocking shapes will create a surface that meanders between flat and deep space, with colors that reflect the patterns of light underwater. The size and palettes of the paintings will relate to each other to help visually connect the spaces. The paintings I propose are acrylic on canvas, filling areas #2, 3 and 4. The first painting would round the corner between areas #2 and 3, activating both walls simultaneously. This piece would consist of two canvasses (18" x 18" and 18" x 30") that touch at the corner to create the feel of a single piece. The second painting would fill area #4 with three connected canvasses sized 24" x 30". If given the opportunity, I hope to create work for the Freeman Justice Center that will evoke the unique Key West landscape, while positively enriching the experience of visitors to the space. BUDGET Canvas, supplies, hardware Packing and crating Shipping AMY CHAN amybchan@gmail.com www.amychan.org $400 $250 $250 Pickup at destination and installation $200 Artist Fee $3000 TOTAL $4100 Monroe County Art In Public Places REQUEST FOR PROPOSALS Application Cover Sheet Freeman Justice Center Drug Court Lobby & Meeting Room Date: Applicant Contact Information: Name: 61 V_ /_/_ 1414/V Address: 3':3L6'y ► 6 5 E X Oon i I- � %'%�1 IV /4 p f r� Phone(s): 7 LYl - F1 � E-Mail: Website: (,UL.t.J u-) - Monroe County resident: Yes No _ j, (If yes, please attach proof of residency.) Total Budget/Cost: - " 1 D 0 Total Number of Art Pieces included in proposal: Please briefly describe the following if applicable; if not applicable indicate with N/A. Special lighting required: N ©AJ C_ Other special requirements: ` W O U_.(�!) D SO kA c o yv r` -T-v Type/amount of project access desired: /'Co N C-7 Installation time required: c,-:) C4t LKkS Maintenance requirements: /�_D d Ili F t T. Artist maintains a $300,000 liability insurance policy(; Yes No If no, please explain. Please check the following items to indicate they are attached: o' 'written proposal. c Itemized budget. W Concept drawings; 5 pages maximum (8.5" x 11") including color sketch or digital rendition. Digital images PDF or JPG not exceeding 75dpi - 5 images maximum. D If 3-dimensional art proposal, one small model. Note: Support materials will not be returned to the applicant without prior pre -paid shipping, or that all information provided for this application is true and correct. I of organization Type or print name I 1996 Edition MONROE COUNTY, FLORIDA Request For Waiver of Insurance Requirements It is requested that the insurance requirements, as specified in the County's Schedule of Insurance Requirements, be waived or modified on the following contract: Contractor: 4fild C�ha-vi Contract for: Address of Contractor: 3,;?o F i ose L--r-)c.)od TTU Cic h mr-d, W Phone: Fz) `i - Crl �/ " 93--S d Scope of Work: S 4r 1001ro-6 CO�n� � cd car! I � c. �oa ��► ��� (�Q cw lye 1�' �/� Reason for Waiver: a,66i �' Policies Waiver re fi, � � Cab will apply to: L4,*11.r1s Z �N/V� vrl'I/j i7e, N• l ltST?cLi. Signature of Contractor: Not Approved Risk Management: Date: 1 ^ jt County Administrator appeal: Approved Not Approved Date: Board of County Commissioners appeal: Approved Not Approved Meeting Date: Administrative Instruction WAIV REQ.DOC #4709.3 — (1} U 00 O Q •� W x ,. oT0 Q ca cz U 4t 0 0 co w� cc oo Q r- (� r U M a7 E1r) X n t keys FLORIDA KEYS Awf COUNCIL OF TFTHE arts COUNCIL December 10, 2014 We Support * We Connect • We Promote e We Give Amy Chan 3208 Rosewood Avenue Richmond, Virginia 23221 804-814-9550 amybchan@gmail.com Dear Amy, www.keysarts.com Monroe COUP 00117fles Qe�elo off• UPS TIME: _ t� Congratulations! Your work has been recommended for purchase and installation in the Drug Court lobby and meeting room at the Freeman Justice Center in Key West, Florida. The Monroe County Art in Public Places Committee will recommend your proposal to the Monroe County Board of County Commissioners at their January 2015 meeting. When approved, your contract will state the following as you proposed to the Committee: Five original acrylic paintings on canvas (see attached images), two paintings 18"x18" and 18"x 30" for the corner in the lobby, and 3 paintings, 24" x 30" for the meeting room. These paintings will be installed and hung with security hangers (provided by the Arts Council). The paintings will use bright layers of tropical shapes, patterns and colors to form playful abstract compositions that encourage life and positivity in the space. The interlocking shapes will create a surface that reflects the patterns of light underwater. The total commission price is $4,100. To begin the process, please complete the enclosed Vendor File Request Form and W-9, and send both to Ms. Ann Riger. She is your contact for contracts, invoicing and payment. Her address is: Ann Riger, Contract Administrator Facilities Development 1100 Simonton Street # 2-216 Key West, FL 33040 Please provide proof of insurance naming the Board of Monroe County Commissioners as an additional insured. The proof of insurance or waiver must be attached to the contract before it can be approved. Ask your insurance agent to send an ORIGINAL declarations page to Ann Riger. Alternatively, if you do not have insurance, or prefer to request a waiver and are willing to accept all personal liability, and expect very minimal exposure to risk, you may complete the enclosed "Request for Waiver of Insurance Requirements and return it to Ann Riger with the other forms noted above. Historic Gato Building • 1100 Simonton Street, Suite 2-263 • Key West, Florida 33040 305-295-4369 • Fax 305-295-4372 • info@keysarts.com Your art budget will become official after a contract is drawn up, signed by you, approved by the County Commission and signed by the County Mayor. An executed copy will be returned to you. After this approval is acknowledged, you may submit an invoice to Ms Riger on behalf of the Board of Monroe County Commissioners for your first payment. Your first invoice will be for one third of the commission as your "Design Fee". You are required to include a copy of your proposal showing your plans/design and the agreed -upon price. The second invoice should include receipts for materials and an appropriate fee for labor. The third and final invoice must include photographic proof of completion. Please send all invoices to Ann Riger and copy me by email. (More specific details will be in the contract.) Please note: the Committee requests that you do not make any announcements or release any information to the Press without prior approval of the Executive Director at the Arts Council. Additionally, once the County Commission approves this commission, the Committee requests that no copies of these original paintings are made and sold to the general public orpsoted on your website until the installation is complete. Thank you for being a part of the Monroe County Art in Public Places Project at the Freeman Justice Center. If we can assist you with any additional questions or information, please let us know. :he Arts Susann D'Antonio, Chair Art in Public Paces Committee Monroe County cc: Ann Riger, Facilities Development, 305-292-4439 Riger-Ann @ MonroeCounty-FL.GOV NON -COLLUSION AFFIDAVIT 1,A, of the city of _ according to law on my oath, and under penalty of perjury, depose and say that; l.) I am C, the bidder making the Proposal for the project described as follows: 2.) the prices in this bid have been arrived at independently without collusion, consultation, communication or agreement for the purpose of restricting competition, as to any matter relating to such prices with any other bidder or with any competitor; 3.) unless otherwise required by law, the prices which have been quoted in this bid have not been knowingly disclosed by the bidder and will not knowingly be disclosed by the bidder prior to bid opening, directly or indirectly, to any other bidder or to any competitor; and 4.) no attempt has been made or will be made by the bidder to induce any other person, partnership or corporation to submit, or not to submit, a bid for the purpose of restricting competition; 5.) the statements contained in this affidavit are true and correct, and made with full knowledge that Monroe County relies u the truth of t e statements contained in this affidavit in awarding contracts f r s 'd project. fgnature of Bidder) STATE OF Vi rQ 1 /1; d1 COUNTY OF PERSONALLY APPEARED BEFORE ME, the undersigned authority, A4 q Ch Cz411 who, after first being sworn by me, (name of individual signing) affixed his/her signature in the space provided above on this Z,a day of �N_r 201�. •�� NO 2� cs7• • R"BLI •••..G NOTARY PUBLIC REG # 72 My Commission Expires: 4911t01-7 - MY COMMISRPIRSS 51 C LT" �F��i•`�` !!'/e0#/1111`� SWORN STATEMENT UNDER ORDINANCE NO. 10-1990 MONROE COUNTY, FLORIDA ETHICS CLAUSE 4M (4 04 warrants that he/it has not employed, retained or otherwise had act on his/its behalf any former County officer or employee in violation of Section 2 of Ordinance No. 10-1990 or any County officer or employee in violation of Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County may, in its discretion, terminate this contract without liability and may also, in its discretion, deduct from the contract or purchase price, or otherwise recover, the full amount of any fee, commission, percentage, gift, or consideration paid to the,. rmer County officer or employee. (signature) Date: / 0-/ 36 STATE OF V � In ;,',N COUNTY OF � V �2 o-�-?-;CinWVw j PERSONALLY APPEARED BEFORE ME, the undersigned authority, xM"f � tleft C h who, after first being sworn by me, affixed his/her signature (name of individual signing) in the space provided above on this _ day of -Dtlt— , 20 I1-. NOTARY PUBLIC My commission expires: t b�?%1 Z 01 OMB - MCP FORM #4 %0 NUR /'A.,� ` crj'.+''�RQB RY •. 1 �Z REG # 7267165 .?-� COMMISSION EXPIRES �..1013112017 '• 4 `A F �! •ai r," 16 iv4,� DRUG -FREE WORKPLACE FORM The undersigned vendor in accordance with Florida Statute 287.087 hereby certifies that: (Name of 1. Publish a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the workplace and specifying the actions that will be taken against employees for violations of such prohibition. 2. Inform employees about the dangers of drug abuse in the workplace, the business's policy of maintaining a drug -free workplace, any available drug counseling, rehabilitation, and employee assistance programs, and the penalties that may be imposed upon employees for drug abuse violations. 3. Give each employee engaged in providing the commodities or contractual services that are under bid a copy of the statement specified in subsection (1). 4. In the statement specified in subsection (1), notify the employees that, as a condition of working on the commodities or contractual services that are under bid, the employee will abide by the terms of the statement and will notify the employer of any conviction of, or plea of guilty or nolo 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. Impose a sanction on, or require the satisfactory participation in a drug abuse assistance or rehabilitation program if such is available in the employee's community, or any employee who is so convicted. 6. Make a good faith effort to continue to maintain a drug -free workplace through implementation of this section. As the person authorized to sign the statement, I certify that this firm complies fully with the above requirements. Bi der's Si e Date OMB - MCP#5