Item C32
Revised 2/95
BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date: January 19-20,2000
Division: Public Safety
Bulk Item: Yes ~ No
Department: Fire-Rescue
AGENDA ITEM WORDING: Approval ofthe Renewal Agreement dated 12/18/96 between Municipal
Services Taxing District #6 and Fire Tech Repair Service, Inc, concerning testing, maintenance and repair of fire
rescue apparatus.
ITEM BACKGROUND: On December 18, 1996, the Board approved a contract with Fire Tech Repair
Service, Inc, for maintenance of fire apparatus, including preventative maintenance, unscheduled Maintenance
and annual pump testing. The original contract provided for annual renewal for up to three (3) one-year periods,
with approval ofthe District's governing Board.
Weare requesting approval to exercise that renewal clause for the third one-year period, commencing on
December 18, 1999 and ending on December 31, 2000.
PREVIOUS RELEVANT BOCC ACTION: On December 10, 1997 the Board approved the first one-year
renewal period through December 31, 1998. On November 12, 1998 the Board approved the second one-year
renewal period through December 31, 1999.
STAFF RECOMMENDATION: Approval.
BUDGETED: Yes X No
REVENUE PRODUCING: Yes
No X
AMOUNT/MONTH
YEAR
APPROVED BY: County Attorney Yes OMB/Purchasing Yes" Risk Management
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DIVISION DIRECTOR APPROVAL:. fi'~ \ ... . /of?
res 'R. "Reggie" Paros ---
Included: ~ To Follow: Not Required:
Yes
DEPARTMENT HEAD APPROVAL:
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DOCUMENT A TION:
1<~2-
DISPOSITION:
Agenda Item #:
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MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract #
Contract with: Fire Tech Repair Service, Effective Date: 12/18/99
Inc.
Expiration Date: 12/31/00
Contract Purpose/Description:Renewal of agreement dated 12/18/96 for scheduled semi-annual
inspections and preventative maintenance of fire rescue vehicles, annual PUffi{J tests and for
unscheduled maintenance and repair resulting from equipment failure or malfunction.
Contract Manager:Ross Willman
(Name)
6006
(Ext. )
Fire Rescue
(Department)
for BOCC meeting on 1/19.20100
Agenda Deadline: 01/05100
CONTRACT COSTS
Total Dollar Value of Contract: $1,840..00
Budgeted? Yes~ No 0 Account Codes:
Grant: $
County Match: $
Current Year Portion: $
12500-530-460-_-
12500-530-462-_
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ADDITIONAL COSTS
Estimated Ongoing Costs: $_/yr For:
(Not included in dollar value above) (eg. maintenance, utilities, janitorial, salaries, etc.)
CONTRACT REVIEW
Changes
Dat9 In Needed /' i
Division Director 'I t/ I A'va YesO No0
~~gement \ <-'"2-\~~ YesD NO~ 1,
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O.M.B./Purch~mg /2/,19'1 YesO NolZI
County Attorney Y esO NO~
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OMB Form Revised 9/11/95 MCP #2
RENEWAL AGREEMENT
This AGREEMENT dated the day of , 1999, by and between
the Board of County Commissioners of Monroe County, Florida, a acting as the governing board for Municipal
Services Taxing District 6, hereinafter called the "District" and Fire Tech Repair Service, Inc., whose mailing
address is Post office Box 1570, Key Largo, Florida 33037hereinafter called the "Contractor".
WITNESSETH
WHEREAS, the parties hereto did enter into an agreement dated December 18, 1996 for scheduled semi-
annual inspections and preventative maintenance of fire rescue vehicles, annual pump tests and for unscheduled
maintenance and repair resulting from equipment failure or malfunction; and
WHEREAS, said agreement provided an option to the District to renew the contract for three additional
one year terms; and
WHEREAS, the DISTRICT has elected to exercise said option for the continuation of scheduled semi-
annual inspections and preventative maintenance of fire rescue vehicles, annual pump tests and for unscheduled
maintenance and repair resulting from equipment failure or malfunction; how, therefore
IN CONSIDERATION of the mutual convenants and obligations contained herein, the parties agree as
follows:
1. The District elects to renew the contract for an additional year pursuant to paragraph 1 of the
agreement entered December 18, 1996.
2. The effective date of this amendment is December 18, 1999 and shall extend through
December 31, 2000, under the same terms and conditions of the contract dated December 18,
1996.
3. Attachment I, as amended, reflects the current schedule of fire rescue vehicles,
4. All other terms and conditions of the contract dated December 18, 1996 shall remain in full
force and effect.
Attest: DANNY L. KOLHAGE, CLERK
BOARD OF COUNTY COMMISSIONERS,
Municipal Services Taxing District 6
By:
Deputy Clerk
By:
Mayor/Chairman
WITNESS:
~ERVICE' INC.
Authorized Representative
APPROVED AS TO FORM
A U Y.
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MAINTENANCE OF FIRE/RESCUE VEHICLES
AGREEMENT is made and entered into by the Board of
Commissioners, acting as the governing board for the Municipal
Services Taxing District 6, Monroe County, Florida, hereinafter
(DISTRICT), and Fire-Tech Repair Service, Inc., hereinafter
( CONTRACTOR) .
RECITALS
A. The DISTRICT advertised a notice of calling for bid for
MAINTENANCE OF FIRE/RESCUE VEHICLES on the 29th day of June and
the 6th day of July 1996 in the Florida Keys Keynoter, on the
30th day of June and the 7th day of July 1996 in the Key West
Ci tizen and on the 4th day of July anq the 18th day of July
1996 in The Reporter;
B. The successful FY 1997 bidder was Fire-Tech Repair
Service, Inc.;
C. The initial FY 1997 .contract provides for a renewal of
the contract for three additional one-year terms.
D. This contract is an agreement between parties.
NOW, therefore, the parties agree as follows:
1. CONTRACT PERIOD AND RENEWAL - The contract term is a
period of one year from the date on which it is signed by the last
of the two parties to sign. This contract may be renewed for three
additional one year terms.
2. CONTRACT TERMINATION - This contract may be terminated
for any reason by either party on 30-day written notice without
cause.
3. SUBJECT MATTER OF CONTRACT This contract is for
scheduled semi annual inspections and preventative maintenance of
fire rescue vehicles, annual pump' tests and' for unscheduled
maintenance and repair resulting from equipment failure or
malfunction.
4. RATES - The hourly rate shall be $52.00 per man-hour
with no travel time or mileage charge. Jobs requiring more than
one technician will be charged at the rate of $30.00 per man-hour
for the second man. Semi Annual inspections and annual pump tests
are at quoted flat rates and excluded from hourly rate.
5. OVERTIME AND HOLIDAYS Rates :=p~r man-hour for
emergency repairs called outside normal business hours and federal
holidays shall be one and one half. times the normal rate.
6. SEMI-ANNUAL INSPECTIONS - During the year Contractor
shall perform two inspections on vehciles described in Attachment
1 (Level I and Level II Preventative Maintenance. Service) at an
annual total cost of: .
Rescue-type vehic~es, without pump
Pumpers
Aerials
$360.00
$490.00
$640.00
Exception shall be if a vehicle has been used 1,000 hours prior
to yearly preventative maintenance service, Level I and II
Preventative Maintenance Service shall be performed and charged the
above rate,
Level I: 250 Hours or 6 months (whichever comes first)
Full vehicle inspection as per attached semi-annual.inspectlon
schedule plus: .. :
- Engine oil and filter change
- Fuel filter change (every 6 months)
- Air filter inspection and replacement if necessary
- Chassis lubrication
- Outboard (forward) impeller shaft lubrication
- Lubrication of all valve control linkages
- Clean or replace air compressor strainer
- Clean engine crankcase breather
- Inspection of generator and service of lubricant system,
full system, and air filter according to its individual
hours of operation (not to exceed 6 months)
Level II: 1000 Hours or one year (which ever comes first)
Full service performed in Level I plus:
- Replacement of coolant hoses, filter and coolant as
needed
- Replacement of all drive belts as needed
- Replacement of pump transmission oil and filter
- Replacement of engine transmission fluid and filter
- Replacement of rear axle lube oil as needed
- Inspection front wheel bearing .
- Replacement and repacking as needed
- Inspection and cleaning of relief valve strainer
- Replacement of secondary fuel filters on both engine and
generator
The number. of vehicles may fluctuate from time to time due to
new purchases or removal of vehicles from inventory. The
inspections shall be preformed at. the respective fire stations.
7.. WORK SCHEDULE Regularly scheduled semi -annual
inspections and preventative maintenance. shall--be conducted at such
intervals as are approved by the DISTRICT.
Page No. 2
8. PUMP TESTS - CONTRACTOR shall perform an annual pump
test at a flat rate cost of $250 each for all' vehicles requiring
such test. In order to facilitate the passing at. the pump test,
minor repairs and adjustments shall be made as 'needed; price
includes clean-up after salt water use.
. .
9. PARTS, FLUIDS AND LUBRICANTS - All parts, fluids, and
lubricants used for maintaining and repairing vehicles shall be
supplied by CONTRACTOR and billed to the DISTRICT at cost plus 25%,
wi th a copy of original parts supplier invoices for all parts
attached to the bill.
10. ENGINE OIL AND FILTER CHANGE and complete drive train
lubrication and any other fluids and/or filter changes, shall be
performed as recommended by the manufacturer.
11. SEMI-ANNUAL INSPECTION SCHEDULE CONTRACTOR shall
perform the following inspection and preventative maintenance twice
per year on all vehicles:
(a) Cooling system, including fan belts, radiator supports,
hoses and clamps, and auxiliary cooler;
(b) Exhaust System, including hanger, clamps, muffler, and
pipes;
(c) Clutch, including freeplay, linkage, and fluid levels;
(d) Manual Transmission, including seals, linkage, and lube
level;
(e) Automatic Transmission, including fluid level, seals,
modulator adjustment, and:linkage;
(f) Drive Train, including U-joints, center support, and
companion flanges;
(g) Rear Axle and Springs, including oil links, spring
hangers, center bolts, and U-bolts
(h) Front End, including steering box, linkage, kingpins
and bushings, spring hangers, and U-bolts;
(i) Mechanical Brakes, including adjustment and fluid
levels;
(j) Air Brakes, including drain, adjustment, wear, and air
leaks;
(k) Tires, including condition and wear;
(I) Electrical System, including running lights, emergency
lights, battery cables, turn lights, 4-way flasher,
headlights, stop lights, and switches;
(m) Fuel System, including hoses and fittings, filters and
brackets, and tank straps;
(n) Booster Tank, including leaks and supports;
Page No. 3
(0)
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(q)
( r)
(s)
Prime Pump, including wires, coupling, switch, and
valve discharge;
Plumbing and Gates, including
valves, control arms and knobs,
Main Pump, including vacuum
packing, clap~ers, and mounting;
Pump Transmission, including fluid levels, seals, shift
motors, and manual override;
Aerial Ladder, including power takeoff, drive shaft and
cOupling, p.t.o. activating device, and outrigger
controls;
Aerial Operation, including engine r.p.m., hydraulic
pressure, operation of all controls, warning devices,
hoses and fittings, rung covers, ladder locks, and ring
gear;
Aerial Platform,
electrical system,
communications, and
leaks, brackets,
and linkage;
test, pressure
bleed
test,
(t)
(u)
including
turntable
water tube.
lubrication,
and platform
leveling,
controls,
The above inspections shall include, at no additional labor
charge, the changing of all applicable filters and fluids
used by the unit being inspected. . Air filt.ers shall be
changed on first inspection and then yearly thereafter.
Fil ters and fluids shall be billed at cost plus 25%, as
previously described in Section 10 of this AGREEMENT.
12. WEEKLY MAINTENANCE SCHEDULE - CONTRACTOR shall provide
to the DISTRICT a preventative maintenance schedule that .can be
performed weekly by the individual Volunteer Fire Departments'
personnel.
13. MAINTENANCE LOG
inspection and maintenance chart
least the following information:
(a) Date of performance,
(c) service performed,
(e) name of service person(s),
CONTRACTOR shall
on each vehicle
maintain
containing
an
at
b) apparatus serviced,
(d) parts used,'
(f) total downtime of vehicle
A copy of this chart shall be supplied to the Fire Rescue Office
within 30 days of the service. . ..
14. COMMUNICATION - CONTRACTOR shall maintain a telephone
or paging device such that prompt notification of request for
service is possible at all times.
15. RESPONSE TO SERVICE REQUEST - CONTRACTOR shall maintain
i tsel f in a state of readiness such that it can be on the way
within twelve hours of receiving a request.
16. CERTIFICATION CONTRACTOR shall provide evidence
satisfaction to the DISTRICT that its personnel who perform
maintenance work are certified in pump mechanics, general mechanics
and repair.
Page No. 4
17. QUAL~FICATIONS OF" MAINTENANCE PERSONNEL - All personnel
performing maintenance, repairs, adjustments, and related work on
the DISTRICT'S equipment shall be certified or experienced in the
work to be performed. '
18. INDEMNIFICATION - CONTRACTOR shall indemnify and hold
the DISTRICT and Monroe County harmless for any negligence on its
part, or faulty or improper workmanship, for all work performed
under this contract, including all costs of collection, reasonable
attorney fees, claim costs, and as per "Attachment A". All
property or equipment being directly maintained or repaired by
CONTRACTOR shall be considered in its care, custody, and control
while such work is in progress and until physical control of such
property or equipment is restored to the DISTRICT.
19. LOCATION OF WORK This contract covers vehicles
located at the following Fire Stations:
(a) Key Largo (two stations)
20. INSURANCE During the term of this contract, the
Contractor must keep in force and effect the insurance required'by
Attachments Band C. Attachments Band C are attached and
incorporated into this contract.
21. PAYMENTS Payments for semi-annual inspection,
preventative maintenance and pump tests shall be made by the
DISTRICT within 30 days of the completion of the rendered services
on each vehicle and proper invoicing by the CONTRACTOR. All
unscheduled maintenance and repair resulting from equipment failure
or malfunction requiring service shall be billed by the CONTRACTOR
at the applicable rates as specified in Section four and five of
this AGREEMENT. The CONTRACTOR upon notification by the DISTRICT
of an equipment failure or malfunction requiring' unscheduled
maintenance shall, in a timely manner investigate the problem and
provide to the DISTRICT an estimate of the cost for repair and
vehicle downtime. The CONTRACTOR upon receiving authorization to
proceed from the DISTRICT shall effectuate such repair; upon
completion of same the contractor shall notify the DISTRICT of the
out come and actual cost. The DISTRICT shall issue a separate
purchase order for each occurrence of unscheduled maintenance and
repair.
22. This contract takes effect on the date of the last
party to sign.
Page No. 5
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23. Monroe County's performance and obligation to pay
under this contract is contingent upon an annual appropriation by
the B.O.C.C.
IN WITNESS WHEREOF, each party h~reto has caused this contract
to be executed by its duly authorized representative.
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BOARD OF COUNTY COMMISSIONERS
AS THE BOARD OF GOVERNORS,
OF MUNI IPAL SERVICES TAXING
DISTRI S
(SEAL)
Attest: Danny L. Kolhaq., Clerk
INC.
WITNESS:
Page 1\0. 6
A'ITAaiMENr A
APfil20, 1996
MONROE COUNTY, FLORIDA
RISK MANAGEMENT
POLICY AND PROCEDURF~
CONTRACT ADMINI~.RATION
MANUAL
Indemnification and Hold Harmles.
for
Other Contractors aDd Subcontractors
The Cuntmelnr covenants and agrees to indemnify and hold harmless Monroe County Board of
County Commissioners from nny and all claims for bodily injury (including tteath), personal
injury, and property damage (including property owned by Monroe County) and any other losses,
damages, nnd expenses (includingattomey's fees) which arise out of, in connection with, or by
reason of services provided by the Contractor or any of its Suhcontractor(s} in any tier,
occasioncd by the negligence, errors, or other wrongf~l act or omission of The Contractor or its
Subcontmctors in any tier, their empJoyees, or agents.;
In the event the completion Qfthe project (to include the work of others) is delayed or suspended
as n result of the Contractor's failure to purchase or maintain ~he required insurance, the
Cunlraclor shall indemnify the County from any and all increased expenses resulting from such
delay.
'111C first tcn dullars ($ ) 0.00) of remuneration paid to the Contractor is for the indemnification
provided for above.
The ex lent of liabilily is in no way limited to, reduced, or lessened by the insurance requirements
cuntained cls~wherc within this agreement. .
TCS
^"minil'llIlivc Inl'lrul:lion
1147UI} 2
94
ATl'AOIMENr B
April 20. 1996
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 persOlUlel and material), the Contractor shall obtain, at hislher own expense,
insurance as specified in any attached schedules, which are made part of this pontract. 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
obl<..lin insurance consistent with the attached schedules.
The Contractor will not be permitted to commence work governed by this contract (including
pre-staging of personnel and material) until satisfactory evidence of the required insurance has
been furnished to the County as specified below. Delays in the commencement of work,
resulting from the failure of the Contractor to provide satisfactory evidence of the required
insurance, shall not extend deadlines specified in this contract and any penalties and failure to
perform assessments shall be imposed as if the work commenced on the specified date and time,
except for the Contractor's failure to provide satisfactory evidence.
The Contractor shall maintain the required insurance throughout the entire term of this contract
and any extensions specified in the attached schedules, Failure to comply with this provision
may result in the immediate suspension of all work until the required insurance has been
reinstated or replaced. Delays in the completion of work resulting from the failure of the
Contractor to maintain the required insurance shall not extend deadlines specified in this contract
and any penalties and failure to perform assessments shall be imposed as if the work had not
been suspended, except for the Contractor's failure to maintain the required insurance.
TheC,ontractor shall provide, to the County, as satisfactory evidence of the required insurance,
either:
· Certificate of Insurance
or
· A Certified copy of the actual insurance policy.
The County, at its sole option, has the right to request a certified copy of any or all insurance
policies required by this contract.
All insurance policies must specify that they are not subject to cancellation, non-renewal,
material change, or reduction in coverage unless a minimum of thirty (30) days prior notification
is given to the County by the insurer,
The acceptance and/or approval of the Contractor's insurance shall ~rb"e construed as relieving
the Contractor from any liability or obligation assumed under this contract or imposed by law.
Administative [nstruc(ion
#.t7092
14
April 20, 1996
The Monroe County Board of County CommissionersJ its employees and officials wiJI be
included as "Additional Insured" on aU policiesJ 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.
Administalive Instruction
/;47092
15
April 20. 1996
ATI'AClJ.1ENl' C
GARAGE LIABILITY
INSURANCE REQUIREMENTS
FOR
CONTRACT
BETWEEN
MONROE COUNTY, FLORIDA
AND
Recognizing that the work governed by this contract involves the servicing and/or repair of
County-owned vehicles, the Contractor will be required to purchase and maintain a Garage
Policy to include Garage Liability Insurance extending to vehicles, owned or leased by the
Co;,mty, left with the Contractor for servicing, repair, storage, or safekeeping, Coverage should
include, as a minimum:
· Premises and Operations Liability
· Vehicle Liability
· Contractual Liability
· Products and Completed Operations Liability
· Garage Keepers' Legal Liability, to include:
Comprehensive and Collision
The Garage Keepers' Legal Liability shall extend to all County-owned/leased vehicles in the
care, custody, and control of the Contractor.
The Contractor's insurance shall be primary to any coverage maintained by the County,
,
The minimum limits acceptable shall be:
$300,000 Combined Single limit (CSL) for liability
$ 25,000 Garage Keepers' Legal Liability
The Monroe County Board of County Commissioners shall be named as Additional Insured on
all policies issued to satisfy the above requirements.
GKl
Administalive Instruction
1147092
47
IDRKERS I ~IOO
April 20, 1996
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:
Contract for:
Address of Contractor:
Phone:
Scope of Work:
Reason for Waiver:
Policies Waiver
will apply to:
Signature of Contractor:
Approved
Not Approved
Risk Management
Date
County Administrator appeal:
Approved:
Not Approved:
Date:
Board of County Commissioners appeal:
Approved:
Not Approved:
Meeting Date:
Administative Instruction
#4709.2
99
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warrants that he/it has not employ~k retained
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or otherwise h".d act on his/its behalf any former:County officer or employee in violation of
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SWORN STATEMENT UNDER. ORDINANCE NO, 10-1990
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MONROE COUNTY, FLORIDA
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ETHICS CLAUSE
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Section 2 of Ordinance no. 10-1990 or any Courlty officer or employee in violation of
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Section 3 of Ordinance No, 10-1990. For breac~ ~r violation of this 'tovision the County
may, in its discretion, terminate this contract v4t~~~t liability and may ~so, in its discretion,
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deduct from the contract or purchase price" or otherwise recover, the full amount of any fce,
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conunis:;ion, percentage, gift, or consideration 'paid to 'ibe former County officer or employee.
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PERSONALL Y APPEARED BEFORE ME, t~I'~dersisned authority,
xf!J~ A). ,Mv ~ ..(). 0 who~~~ lirreing sworn by me, affixed hislhcr
signature (name of individual signing) in the spac~ ~rovii above on this /6: "'day of
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My commissioCf~~/IIIIIIIIIIIIIII~IIII.'III1I11IIN...... ( , ,.: ':: 1 I'
)' -..~~-,;-;-J. Rose Mane Hunter, l ' . I I
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.~: ~ ; Con1lllil:'~n No. C:C 42?Mt ,', i ! ' 'I
'. ~O''f\.f:j. MyCollUDllllOOExptrcs 12111191 ',' 'I: .
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~. DRUG-FREE WORKP~CE 'pRM
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The undersigned vendor in accordance with Florida ~talute 2J7.087 hereby certifies ttat:
roU: - T r!.CH (<.6.fJ;j I fL- ~ i.IUI\(,~ ~aX,.., I
(Name of Business)
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), Publish a statement notifying employees that the unlawful manufacture, distribution, d;:;pcns..
ing, possession, or use of a controlled substance is prohibited in the workplace and specif}'ing the
actions that will be taken against employees for viola~~nsof sucb prohibition. I
2. I nfono employees about the dangers of drug abtUe. in the ""ivlace, the business' s Policy of
maintaining a drug-free workplace, any available dru~ counseling, rehabilitation, and employee
assistance programs, and the penalties that may be imposed uPon employees for drug abuse
violations. I
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3, Give each employee engaged in providing the commodities or contractual services that are
under bid a copy of the statement specified in subsection (I). .. I
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4. I n the statement specified in subsection (1), notify the employees that. as a cbndition of working
on t he commodities or contractual services that are undff bid, the employee will abide by the: tenns
of the statement and will notify the employer of any conviction of, or plea of guilty or nob
contendere to, any violation of Chapter 893 (Florida S~~tutes) 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. .
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5. Impose a sanction on, or require the satisfactory participation in a drug abuse assistance' or
rehaQilitation program ifsuch is available in t~e employee's community, or any employee who is
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so convlcte . , " , ,
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6. Make a good faith effort to continue to maintain a drug-free workplace through implementation
of t his section. t I :
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As the person authorized to sign the stat
1 equirements.
ent I certify that this firm complies fully with the above
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Bidder's Signature
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NON.COlLlJSION AFFIDAVIT
t<iJ8'~~ n. ~L..i;{''-12-
of the
city of k t):.~ L ~(l..6o , ,
under penalty of perj ry, depose and say that;
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accor Ing to aw on my oath, Grid
1) lam 1>,.u:~, 0)::' F/f2E, --r~c.}J 1f?A/7J1R...SLtzJI,cL. ~,thl)biddermakil1fJ
the Proposal for the project described as follows: i
2) The prices in this bid have been arrived at "ndependently without collusion,
consultation, communication or agreementforthe puq)ose of restricting compe.ition, as
to any matter relating to such prices with any other bidder or with any competitor;
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3; Unless otherwise required by law, the prices which have'been quot~d in this
bid have not been knowingly disclosed by the bid~er 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 i
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4) No attempt has been made or will be made bl( the b~dder to induce! any other
person, partnership or corporation to submit, or not to submit, a bid for the purpo!;(; (If
restricting competition; , 'I
5) The statements contained in this affidavit are true and correct, and made with
full knowledge that Monroe County relies upon the truth of th statements cdntained in
thiz affidavit in awarding contracts for said pro
STATE o~d.r::L-1~' ~ /-e)
(Signature of Bidder)
COUNTYOF '~-/..IA~ /~h
/ / DATE
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PE SONAlL Y APPEARED BEFORE ME, the undersigned authority,
. J1A who.aft.r !lrst being sworn by me, (name of
individual signing) affixed his/her signature In the space provided above on this
J
;"19 717
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My commission expires:
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MCP #)
'1IIIIIIIIIIIIIIIIIIlIIIII/. ,...I/".....lINIIIIIIIIIIII,I<
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.>: ~~"y ~lJ. Ros~ M:me unler, (
'. ~ ~ NoWy Public. S~te of Florida ~
~. ~ 4 Commisaioo Nr,. CC 0427069 (
>; .'>01,,-0'" MyCommiuioll E,~r.jn:s 12/18198 ~
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. t.aoo.).N()TAlI.Y. FI&. NOf~ s,,,,;... ''!: Oonclia. Co, (
'~\'I'I'W~\'I'I'I'I'I'I'I'IW\'I'I'I'I'I\'IW;.)W;" ,Y,W."'I'\"'\W.. .
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SWORN STATEMENT PURSUANT TO SECTION 287.133(3)(a),
!LORIDA STATUTES, ON PUBLIC ENTITY CRIMES
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THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRE ENCE OF A NOTARY PUBLIC on
OTHER OFFICIAL AUTHORIZED TO ADMINISTER OATUS. .,. .worn statemeDt i. submitted
to /YJ~,JR.tJL-. ~L/.~
(print nam,J of the public entityl
by ~6f./<r j). &J....,l.R flUS .
(print individual" nama and title)
for
f m.L ~ ,6, tN
#
,,"'bose busiDess addreu i.
f'. fJ . B...... IJ~ D ' " I
Iu.'j J..>>ll.6.o h. ~*7, '
and (;r appUcablc) il, Federal Employer Idcntifi..;... N.~bcr (FEIN) II 50{ -/10 . 0 :).r"/ <t1 ~ lif:1
(If the entity bas no FEIN, include the Social Security Number oithe ~ndi"iduaJ "pID.thi. .wo.:o I
5tatement~
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I undemand tbat a "public entity crime" u dellaed 'D pa~lrapla 18~.lJ3(l)(d, Flortd~ Statutes. means a
"10lation of any .tate or federal law by a persoD wlda rapect to aDd directly related to tbe transaction of busitlcn
,,"'itb allY public entity or with an agency orpolitical..bdlvislon ohny otlaer state or of the United States, iOduding,
but not limited to, any bid or contract for goods or lerncei to be provided to any public entity or an a~cnl:y or
floli t ica.! 5U bdh ision of ally other state or of the United State. and Involvingantitrust, fraud, then, blibclY, coll.l!.i 011,
racketeering, conspiracy, or material misrepresentatioD.,' , I
I
J. understand tbat "convicted" or "conviction" al deftaed I~ Paralrapb 187.1J3(1)(b), Florida Stat~, means it
finding o( guilt or a conviction of a public entity crime, witla ~r without an adjudicatton of guilt, in any f~dend or
~t<lte trial COurt of record relating to charges brougltt by In~lctlDent or Information fter July 1, J9li9, <Ill a n:!.ult
of a jIJry \'erdict, nonjury trial, or entry of a plea 0( pllty 01' nolo contendere. I '
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I understand that an "affiliate" as defined in Parauapb 187.133(1)(a), Florida StIItutas, means::
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1. A p~decessor or SUCCeSlOr of a perIOD convicted of a ,..'Iic eDtity crl.e; or
2. An cntity un:ler the control of any aatul'al pc..... wbof.jactive ia the manale_ent of the entity and who has
been con\'icted of a public entity crime. The term" affiliate" include. those officers, directors, executives, p<lrt ltC rs,
shareholders, employees, members, and agents who are active in the mADagement 0( an affiliate. The OWIU.'..~hip
by one person of shares constituting a controlling interelt In another person, or pooling of equipm~nt ,01' illWI11C
among perSOlls when not for (air ma.ket value under an al1ft'llength agreement, man be a prima facie ca.;c that
one person \:ont:'ols another person. A persou who IJ,nowinglyenten into ajoiut venture with a persoll who t.a~ IH.'~'n
cuO\icted of a lJublic entity crime in Florida during the preCeding 36 mOllths shall be considered an affiliak.
I
I understand that a "person" as defined in Paragraph 217.lJ3(1)(e). Florida Statute_, mean. any natural plrson
or entity orgauiz.ed under the lawl o( any Itate or ,of die (}aieC.. State. wlab tbe lelal flOwer to enter in eo a binding
cont. ;.&ct and which bid. or applies to bid on contracta for.... Provision of IVOtH or lervice.lct by a publi.:: cnliey,
or w hirb otherwise tran,ace. or appJiclto tran.act bu"... wltb a publk entity. The te..... "person Of includes t hOJe
officers, directors, exccutives, partners, shllrebolftn, employees, memben. and acentl who are 2rtive iu
maD<igemcnt of all cotity.J.2.J.4.S.
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/lmd 0.. illfo""atioll '"d beli,f. .10. ..al.m.n. wbi.b I bave n,arked ""low I, tme ill relatioll tlllh. '"1;',
~l,hmittjnl; this !ih'urn st.ltt'/HIlI. I'ndic:atc which llt.atemcut aplllics.J ..
-~ N.i'h,,- II.. .nl;ly ,ubmillh.g lbi, '.ora "at.men'. nor any of 'I.< om...... direeto". ."'00'1,-,-",
p.dllcr:;, :,halThol.ki-s, {'lIIp[OlCt':i, mcmbcn;, oC' az~ents who al'e au:tive in It...: manaZ:emcut of the cntitv, "'~I
"" .11, h... of 'b. .'"it, h., 10,." tbar"d .it 10 m,d ,o"vk..d of a Ilublle ,-"ti. yeri... ".b,,,,,...,,t ,,; I" I I
I,I'J(i'J. I
. --- 1'1... .n".y '"b.n'"i,," fl.i, "'ora ""emellt. nor ony of it, om...... '''r.eto.... ."elltiv", loao-,,,..,,,.
,loa re 1001 d..... '''''ploy",. ""110 be", or ag."t, ". 100 ore activ. ill .be manag.mell' of .be ell'i.y. nu,- an omli."
Lf Ihc ellfity l.as bcen t'haq::\'d wiih add cOlwictcd of a IIUhUe entity crime Mlblle/lucat to July I, 19119.
--- The enlily sl:bmiUing this SWllm statcment, or OIIC or Dlore of ib officers, directors. elccuthcs,
p:-:rlncrs, sllal'choldcrs, clllllloyccs, members, or :-Igcnts who al'e active in tile m:anagcment of the cntity, or
~n affijidlt; ()I' (I,( entity ha:; becn chal'ged ~...ith aDd convicted of a public entity erime subsequcnt tn July I,
I 'Jri'J. lIol'c\c'-, Iherc bots bC~I.1 a subscqucnt IlrOCeeding before a lIearing Ot'licer of ihc State of Norma,
viI isiuu of Atllll;lJistralh'eHearin~s alld the Filial Order entercd by the If~aring Offi('cr dctcauinetJ lj,;.t
i: 1\ a.~ IJlIt i.1 tl'l' {lllblic inlcn'st to Jllace Ihe clltity submitting this swum statemcnt on the l',Ulvirtcd \'t'/lIlclI'
Ii~r. /Allal'h.. u.py of th(; finalllnki,'J
0. IllN DEHST AND 11lA l'l'UE SUBMISSION OF THIS FORM TO TilE CONTRACTING OFFlClm
h)J< THE PlIlJlIC ENTITY WENTIFIEJJ ON PARAGRAPIf 1 (1NE) ABOVE IS }'OR TIIAT P(JlH.I(~
;-:!'i'i'llY UNL \' AND, TIIA-rTIllS It'ORMIS VALID TUROUGH ~:CEM8ERJl OFTHECAI.END.\U
fEAR IN WHICH IT IS .f'lLED. I ALSO UNDERSTAND THAT AM REQlJIRED TO INFOUM TilE
pcnuc ENTITY PRIOR TO ENTERING INTO A CONTRAcr!1N EXC..:SS 01<' TilE TIIRl<:SIIOl.n
AMOUNT PHOVJDEO IN S[('TlON 287.(H7,fI.OIUDASTATIJTF.~F'ORCAT"~G()UY TWO OF A/",n:
CHANCE IN THE INFORMATION CONTAINED IN THIS F'OnM.
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(sij;natureJ
~---._.-._-- -._--
Sl\om to and suhsc.:ribcd bcfore me this..L?-~ day of
~'
~~ 1~'C}7
T'<-<-<.M ~1-' ;L -
Pcr~nAlly known~
( :: t-"rud'II"':'I/ i<f('li:iJk;";r;
.. . .-.... ..-.... ..--.... . .-......
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· Not~~'"J'f;uhlic .' St~fp. o~~l:~~<~'~( )
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(T) pe of identification)
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.My - It mh.:llt!u npi(cs________ ____,
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(Prillt~ae~ or~:un.pc /;I ~~,-IP ~
t:>S ~omrilKsfuiTetfn~.ne_or otary pubht:)
".lIINIINNI/IINIIIIIINIII"/1111. '1lllllllll1llll.j<
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.,' :\~'" ~tJ. Rose Mllfiq Hunter <
) ~ ... Notary Public, S~le of Florida ~
.>, ~ ~ Commission No: CC 427069 (
l ..."" 0, f\.O~ My Commission Expires 12118/98 ~
,- ,~: I-IQO.).NOTAAY. FIt. NcWy S<mo<. Ilood",. W. (
1~..,~\\\\\,\, \\ ,\\\ ',W,\ W" '"'''' W",.."" ,\...., \ (
Fonn PUR 706~ (Rev. 06/11/92)
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MONROE COUNTY FIRE RESCUE
VEHICLE LIST - DISTRICT 6
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KEY LARGO
OC269391 1438-511 R-65 SAULS. RESCUE/PUMPER 1994 1250 750
IFDNFOK3DV A27941 1438-95 R-71 FORD RESCUE/ PUMPER 1983 500 500
CKY244F382580 1438-59 R-72 CHEVY RESCUE 1974 0 0
CE12-6238 1438-9 E-67 LFRNC. PUMPER 1978 1500 1000
CE12-6239 1438-10 E-68 LFRNC. PUMPER 1978 1500 1000
1 FVXFSEBOPP419863 1438-330 T-69 BRDMN. TANKERI PUMPER 1993 1250 3000
1F9DBAA8XK1037630 1438-231 L-70 E-1 LADDER 1988 1500 1000
E= ENGINE T= TANKER
R= RESCUE U= UTILITY
L= LADDER H= HOSE TRUCK
A IT ACHMENT 1
Jan-04-00 09:29A Risk Management
305 295 4364
P.Ol
Smith, Mack & Associates, Inc.
Warner-Harrison House
3384 Post Road, suite 1
warwick RI 02886-7133
(401) 732-2800 ()
Fire Tech Repair Service,
P.O. Box 1570
Inc.
COMPANY
. . A Hartford
~M;ANY _
COMPNlV
C
Inl?~E~~ce Company
'It'URED
Key Largo
(305) ,451-4230
FL 33037-
CCMPNlV
D
.c.OY.EAAGU;:~i~:;~:::i:f;i;:i~;t~.: ;E:~~:n~;o~3~:.i~:,i:::~~'.::'~D::~~Lb~~:~:~ ~ :,;:;::5~:~.::;\;~~;~+~~:.:~~ta:~f;2~:.::;: ;,~:.~: ;;~E:~ ;::<y~;~;:,:::;:;:':;i' ::::: ::~:~~;;;'d;~i;;~'::.':,::::;:i:i::::';; . .
THIS 'is TO CERTiFY THAfTHE POUCles 'OFINSuRANC'ELisTED BELOW HAVEBEEN IsSUED TO THE' INSuReD NAMEO'ABOVE YFOATHE POUCYPeJillOO
INDICATED. NOlWITHSTANDING ANY REQUIREMENT. TERM OR CONomON OF ANY CONTAACT OR OTHER DOCUMEN1 WITH RESPECT TO WHICH ~IS
CERTIFICATE MAY Be ISSUED OR MAY PeAT~N, THE INSURANCE AFFORDED BY THE POUCIES OESCRIBED HEREIN IS SUBJECT iO ALL THE TERMS.
exCLUSIONS AND CONomONS OF SUCH POUCIES, UMITS SHOWN MAY HAve BEEN REDUC~O BY PAID ClAIMS,
co I . TVPI 0' IN,UAANCE I - pOUC:Y MUMe!A r~OlK:Y E'''c:ma 11'ClK:Y EXPI..AnoNI - WilIT1
LTA I I I - OATIIMIIIODI'tVl I IIATE ""M/DD/YYI
I GENERAL IJA8lUn GENeJ\ALAtlQAEGATe ,
~~GCNEAAl~81U"" / / / / PAOOUCTS.COMPIOP~ I
_.,+- ClAIMS MACE 0 OCCuFl ~NAl..' NJV tNJUAV I
_ _" OWNER9l CONTAACTOR'S PROT' \ EIoO'lOCCURRENCE I
__ . FIRfOAMAOE ~ one"..) S
~ ~~~~~~ ,
AUfOMO..Lf LIA8IU'TY
ANY AUTO
ALL. OWNED AUTOS
SCHEDUL&O AUTOS
HIRED AUTOS
NONONNEO AUTOS
7
/
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COMlIINED SiNaL! LIMIT
s
\\'~:"r~:
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8001LY INJUAY
(Per IMf'O"I
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90CILY INJURY
(p., ..,clOenQ
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PAOPE'fllY ONtIAOE ,
AUTO 0Nl V . EUCClOENT S 3 0 0 0 0 0
OlJolER'THAN AUTO ONLY:
EACH 1\CCl0000T .
AGGREGATE S
EACH OCC\JRflENC! S
AGGREGATe ·
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A
o.2UECBU'4172
04/01/99 04/01/00
~~Eaa w.8lun
H UMlIABJA FORM
, O'!lofEP.'T!"....":\:M9AEW. ~ORM
WORI(IM CO.I'IIISAT10fl AND
EMI'LOYERe' W.IIUn
lHE pRlJII'AETORI INC\. ,
PAR'T1'l~CUT1VE \
orflCEM ARe: exCL
A o"nieAl'hysical Dam, 02UECBU4172
A Physical Dam. 02UECBU4172
A Garagekeepers 02UECBU4~72
/ /
/ /
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EL EA01 ACCICENT I
E\. DISEASE. POUC'J' LIMIT ·
a. OISEASe . EA EMPLOYEE I
comprehens i ve $ 5 0 0 ded .!
Collision $500 ded. I
Liability - Direct
Prima Covera e
04/01/99 04/01/00
04/01/99 04/01/00
04/0~/99 04/0~/00
D"CPIP'TIOM O. oI'!MT10NS/lOCAT10NINBlJCLESlSI'ECIAL lTOll
Certificate holder is addicional insured with respect to these
coverages.
'~~t,-r~f:~~~~91;~r:I:ti:::..;:::;~~.;;:.,::;~;.:~;~:::;;::;:':::;{iE::f;;E:L:::;:~E:<:.': ....'....:
&HOULIJ ....'1 Of mE .uJ0Vf OUc:A1810 ,ouao U CAltClU.tlJ eEIOAE TltE
OPlflATlON OATE THEREOf. TMI ISSUING COIIIIf'AMY .".lJ. EIlOfAVOR TO ..All.
Monroe Councy _ Monroe County Boar-d. .J.Q.... OAYS WlIITnN MOTlC!' TO TME CEATlflCAfW HOUlIA ItAIiIID TO mE lOT,
of County Commissioners ~ BUT 'AlLUR. "/0 MAIL Suc:M 'OTICE aHAlJ.lllroeE"O 011.101\11011 0" "",..un
C 11 R d I) n 0' ANY KIN aft.M....aS~ IltNPr 0" .......n'..TATIYES,
~;~ 0 we~t ~~e))~: 0 ..':::' . _~ .", .~,::_........,.nCr.1<L. ,.11ilO,,'OilOil"..
.....nRo2S.S,l1195F " ,.....I.f.\:C,. -~, "M" ..,.."" .... ~
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:::..:::::(~Er:~~N~,~~tl~~~;:;;;~::;0':~:~.:'~r:i:~.~~~~:.:~t~:~:::Jni::E;~~::~:~:~;j~<':E~):::;ii:::;:~.;..'