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11/20/2019 Agreement 4V�j COUgTQ�\,1 J4p:,"'7 P,: Kevin Madok, CPA ••.. = Clerk of the Circuit Court&Comptroller—Monroe County, Florida DATE: December 19, 2019 TO: Breanne Erickson, Contract Administrator Project Management FROM: Pamela G. Hanco `I.C. SUBJECT: November 20th BOCC Meeting Attached is an electronic copy of the following item for your handling: F15 Contract for$32,500.00 with McMow Art Glass, Inc. for public art at the new Cudjoe Key Fire Station#11 recommended by the Art in Public Places Committee and the Florida Keys Council of the Arts. Should you have any questions, please feel free to contact me at(305) 292-3550. cc: County Attorney Finance File KEY WEST MARATHON PLANTATION KEY PK/ROTH BUILDING 500 Whitehead Street 3117 Overseas Highway 88820 Overseas Highway 50 High Point Road Key West,Florida 33040 Marathon,Florida 33050 Plantation Key,Florida 33070 Plantation Key,Florida 33070 305-294-4641 305-289-6027 305-852-7145 305-852-7145 Monroe County Art in Public Places Award Agreement This AGREEMENT dated the 20th day of November 2019, is entered into by and between the BOARD OF COUNTY COMMISSIONERS FOR MONROE COUNTY, hereinafter "County"/"BOCC", a political subdivision of the State of Florida, whose address is 1100 Simonton Street, Key West, Florida 33040, and McMOW ART GLASS, INC., a Florida Corporation, whose address is 701 North Dixie Highway, lake Worth, Florida 33460, hereinafter"Artist." WHEREAS,the Monroe County BOCC recognizes the extent of cultural resources available in the county for development, promotion, and enjoyment of the arts. It is the intent of the BOCC to enrich culturally and benefit the citizens of this county through the establishment of Art in Public Places;and WHEREAS, the Art in Public Places Ordinance #022-2001 (AIPP Ordinance), codified at MCC §2-233, authorizes the allocation of one percent (1%) of the County's construction costs for new construction exceeding$500,000.00 and renovations exceeding $100,000.00 to be set aside in a fund and used for acquisition, commission, installation, and maintenance of works of art to be used in,upon,or around the new or renovated County buildings; and WHEREAS, the AIPP Ordinance established an Arts in Public Places Committee (AIPP)to review responses to Requests for Proposals for art to be acquired,commissioned, installed,and maintained in public construction projects and to advise the BOCC regarding the art subject to the AIPP allocation; and WHEREAS, the BOCC desires to acquire public artwork to be installed, placed, and/or located at the Cudjoe Key Fire Station, No. 11, in Cudjoe Key, Monroe County, Florida,to promote understanding and awareness of the visual arts and to enrich the public environment for residents and visitors; and WHEREAS, in conformity with the AIPP Ordinance and MCC §2-233, the Artist was selected by the AIPP Committee to provide public artwork for this location; and 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. 1. AGREEMENT PERIOD: This Agreement is for a period of ninety(90)days after issuance of a notice to proceed to execute and complete the 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 12 and 13 below. All work for which AIPP funds are to be expended must be completed by the stated termination date. 1 Art in Public Places—Cudjoe Key Fire Station No. 11 2. SCOPE OF AGREEMENT: The Artist shall perform all services, and provide and furnish all supplies, materials, and equipment as necessary for transportation, creation, and installation of artwork as follows: A series of three (3) mosaic art glass designs installed on the exterior of the Cudjoe Fire Station, No. 11, in accordance with the approved design elements per the Artist proposal. The designs will be installed at the following locations: Location A: Door surround "Welcome Home."This mural will surround the front entryway on all three(3) sides not to exceed thirty-five (35)square feet. Location B: "Seal of Valor"installed on the eastern facing wall not to exceed forty (40) square feet. Location C: "Heroes of Monroe County" installed on the southern facing wall not to exceed eighty (80) square feet. All glass elements will be installed by the artist team as per engineered specifications. Cost includes design, fabrication, travel, and installation. Signage provided by Monroe County AIPP. Artist shall confer with and coordinate activities with Executive Director, Florida Keys Council of the Arts, Elizabeth Young, in order to insure that there is as much cooperation and cohesiveness in the incorporation of the art in or around the building so that there shall be the least amount of interference between the Artist and the Cudjoe Key Fire Station, No. 11 personnel or any construction staff. 3. AMOUNT OF AGREEMENT AND PAYMENT: The County shall provide an amount not to exceed Thirty-two Thousand Five Hundred and 00/100 ($32,500.00) Dollars for materials and services used to create and 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 for each of three(3) phases and documentation to satisfy the Clerk that the appropriate phase has been completed, payment shall be made for the following phases at the referenced rates: I) Design Phase: 33.3%of total payment; 2) Materials: 33.3%of total when artist submits receipts for materials and eligible costs equal to or greater than 33.3% of the contract total. Travel expenses are included in this phase and shall be paid in accordance with Florida State Statute 112.061,or as described in 2)a below: 2(a)Travel: All travel expenses shall be reported on a State of Florida Voucher for Reimbursement of Travel Expenses. If Artist has airfare, the original boarding pass, or equivalent, must be attached to the Voucher. If Artist is in a vehicle, mileage must be reported on the Voucher. Mileage is reimbursable at $0.53 cents per mile. Meals 2 Art in Public Places—Cudjoe Key Fire Station No. 11 are to be reported as follows: Breakfast—when travel begins before 6 a.m. and extends beyond 8 a.m. for$10.00; Lunch—when travel begins before 12 noon and extends beyond 2 p.m. for $15.00; and Dinner — when travel begins before 6 p.m. and extends beyond 8 p.m. for$30.00. A State of Florida Voucher for Reimbursement of Travel Expenses is attached and made a part of this contract. 3) Completion: 33.3%final payment due when installation is deemed complete and contractual agreement specifications are verified by the Monroe County Project Management Department or designee. 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, and 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). E. Transportation of the work to the site (see above paragraph 3, item 2). F. Installation to the site. G. Permits and fees necessary for the installation (applicable for exterior projects which may also require HARC review, if applicable). H. Legal costs directly related to the project. I. 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 release of liens if applicable. Final payment request must be submitted no later than sixty (60) days after the completion of the project. 4. OWNERSHIP and RIGHTS: Upon the installation of the artwork and acceptance by the County,the County shall own the artwork and title to the artwork shall pass to the County. This Article 4 and the Artist's signature on this Agreement shall constitute and be construed as the Artist's express waiver of rights as provided in 17 U.S.C. §106A,et al. al.,to the extent that the artwork may be removed,adjusted, replaced, and/or relocated, as deemed necessary by the County without obtaining a waiver or permission from the Artist, and that modification to the artwork resulting from conservation or public presentation involving lighting and placement is not prohibited modification or considered alteration, distortion or mutilation of the artwork. Artist agrees that the County as owner of the building and/or property that includes the artwork may, without the consent or permission of the Artist, make or authorize the making of alterations and/or destruction of such building and/or 3 Art in Public Places—Cudjoe Key Fire Station No. 11 property. Artist agrees that where the artwork may be created or conceived in any fashion by more than one author, the Artist's signature and waiver binds the entire group of authors/artists. 5. RECORDS: The Artist shall keep such records as are necessary to document performance of the agreement and give access to these records at the request of the County, the State of Florida, or authorized agents and representatives of said governmental 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. For Public Records requirements see paragraph 21 below. 6. MODIFICATIONS AND AMENDMENTS: Any and all modifications of the terms of this Agreement shall be only amended in writing and approved by the BOCC. Extensions of time to complete any terms or conditions of this Agreement must be made in writing and may be approved only by the BOCC. 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. HOLD 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. 4 Art in Public Places—Cudjoe Key Fire Station No. 11 10. NONDISCRIMINATION. Artist and County agree 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. Artist or County 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 VII 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. 3601 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. 12101 Note), as may be amended from time to time,relating to nondiscrimination on the basis of disability; 10) Monroe County Code Chapter 14,Article II,which prohibits discrimination on the basis of race, color, sex, religion, national origin, ancestry, sexual orientation, gender identity or expression, familial status or age; 11) Any other nondiscrimination provisions in any Federal or state statutes which may apply to the parties to, or the subject matter of,this Agreement. 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. 12. TERMINATION: This Agreement shall terminate pursuant to Paragraph 1. 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 5 Art in Public Places—Cudjoe Key Fire Station No. 11 • terminate this Agreement without cause upon giving ninety(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/she has not employed, retained or otherwise had act on his/her 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 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 thirty-six (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 is authorized to contract Artist's services. 6 Art in Public Places—Cudjoe Key Fire Station No. 11 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 (1) 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 effect. 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. 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 Insured" 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 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: $300,000 Combined Single Limit(CSL) 7 Art in Public Places—Cudjoe Key Fire Station No. 11 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. 21. PUBLIC RECORDS COMPLIANCE: Contractor must comply with Florida public records laws, including but not limited to Chapter 119, Florida Statutes and Section 24 of Article I of the Constitution of Florida. The County and Contractor shall allow and permit reasonable access to, and inspection of, all documents, records,papers, letters or other"public record"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 contract and related to contract performance. The County shall have the right to unilaterally cancel this contract upon violation of this provision by the Contractor. Failure of the Contractor to abide by the terms of this provision shall be deemed a material breach of this contract and the County may enforce the terms of this provision in the form of a court proceeding and shall, as a prevailing party, be entitled to reimbursement of all attorney's fees and costs associated with that proceeding. This provision shall survive any termination or expiration of the contract. The Contractor is encouraged to consult with its advisors about Florida Public Records Law in order to comply with this provision. Pursuant to Ha. Stat., Sec. 119.0701 and the terms and conditions of this contract, the Contractor is required to: (I) Keep and maintain public records that would be required by the County to perform the service. (2) Upon receipt from the County's custodian of records, provide the County with a copy of the requested records or allow the records to be inspected or copied within a reasonable time at a cost that does not exceed the cost provided in this chapter or as otherwise provided by law. (3) Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law for the duration of the contract term and following completion of the contract if the contractor does not transfer the records to the County. (4) Upon completion of the contract, transfer, at no cost, to the County all public records in possession of the Contractor or keep and maintain public records that would be required by the County to perform the service. If the Contractor transfers all public records to the County upon completion of the contract, the Contractor shall destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. If the Contractor keeps and maintains public records upon completion of the contract,the Contractor shall meet all applicable requirements for retaining public records. All records stored electronically must be provided to the County, upon request from the County's custodian of records, in a format that is compatible with the information technology systems of the County. 8 Art in Public Places—Cudjoe Key Fire Station No. 11 (5) A request to inspect or copy public records relating to a County contract must be made directly to the County, but if the County does not possess the requested records,the County shall immediately notify the Contractor of the request, and the Contractor must provide the records to the County or,allow the records to be inspected or copied within a reasonable time. If the Contractor does not comply with the County's request for records,the County shall enforce the public records contract provisions in accordance with the contract, notwithstanding the County's option and right to unilaterally cancel this contract upon violation of this provision by the Contractor. A Contractor who fails to provide the public records to the County or pursuant to a valid public records request within a reasonable time may be subject to penalties under Section 119.10, Florida Statutes. The Contractor shall not transfer custody, release, alter, destroy or otherwise dispose of any public records unless or otherwise provided in this provision or as otherwise provided by law. IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS, BRIAN BRADLEY AT PHONE# 305-292-3470 BRADLEY- BRIAN( MONROECOUNTY-FL.GOV, MONROE COUNTY ATTORNEY'S OFFICE, 1111 12."."" Street, SUITE 408, KEY WEST, FL 33040. 22. RISK OF LOSS. Risk of loss or damage to the artwork shall be borne by the Artist until acceptance of the artwork by the County as indicated after the final payment has been made. The Artist shall carry insurance sufficient to cover the purchase • price of the artwork to cover risk of loss or damage to the artwork until final acceptance by the County. 23. WARRANTIES OF QUALITY AND CONDITION.Artist represents and warrants that the artwork, as fabricated and installed, will be free from defects in material and workmanship which cause or accelerate deterioration of the artwork and that reasonable maintenance of the artwork will not require procedures substantially in excess of those described in the Artist's maintenance recommendations or proposal. The warranties described in this Article shall survive for a period of five (5) years after final acceptance of the artwork, with periodic required maintenance by the County, according to instructions provided by the Artist. The County shall give written notice to the Artist of any breach of this warranty during the five (5) year period. The Artist shall, at no cost to the County, cure reasonably and promptly the 9 Art in Public Places—Cudjoe Key Fire Station No. 11 breach of warranty by means of repair, restoration, refurbishing, re-creation, or replacing the artwork. 24. REPAIRS AND RESTORATION. The County reserves the right to determine when and if repairs and restorations to the artwork will be made after final acceptance. Repairs and restorations to the artwork occurring five (5) years after the County's final acceptance of the artwork will be the responsibility and at the expense of the County. 25. NOTICE. Any notice required or permitted to be given to either party under this Agreement shall be in writing and hand delivered or sent by United States Mail, postage prepaid, to the other party by certified mail, return receipt requested,or by courier with proof of delivery. The place for giving Notice shall remain the same as set forth herein until changed in writing in the manner provided in this paragraph. Notice shall be sent as follows: For Artist For County: Sharon Materio Florida Keys Council of the Arts McMow Art Glass, Inc. 1100 Simonton Street 701 North Dixie Highway Key West, FL 33040 Lake Worth, FL. 33460 and County Attorney P.O. Box 1026 Key West, FL 33041-1026 (REMAINDER OF PAGE INTENTIONNALLY LEFT BLANK) 10 Art in Public Places—Cudjoe Key Fire Station No. 11 IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed the day and year first above written. Execution by the Artist must be by a person with authority to bind the entity. Signature <;F hp'�`� c son executing the document must be notarized and witnessed by another �, Tftc$r�o�;� a entity, or by two (2) other witnesses. , 1 � f[ BOARD OF COUNTY COMMISSIONERS ` inr ti Xir t= w VIN MADOK, CLERK OF MONROE C'. T FLORIDA s s \ &3A .a' l 3'` By: OP,AV I 4 ''. : °�"",;:-\V Deputy Clerk Mayor/C ai r 4 WITNESSES: ARTIST: McMOW ART GLASS, INC. 1 S' nature Signature ee C. \c\ .- s y.0 L 4 Print Name Title Print Name DATE: /� • 5—-/ 7 DATE: 2 'gnatup t � 4A-,, , ',`, 4 MONROECOUNTY ATTORNEY'SOFFICE Print Name Title A P ROVED AS �,T F R DATE: a - `/f �'LE PATRICIA FABLES ASSISTANT COUNTY ATTORNEY STATE OF � ;c�A.. DATE; l o r l 7 - 1 COUNTY OF ( o` . a.- On this__5-' - day of De.c.e.m\r4d, , 2019, before me, the undersigned notary public, personally appeared S „ cl\o,er;v , known to me v be the Q person whose name is subscribed above or who produced .. as . —F, identification,and acknowledged that he/she is the person who executed the abovtract r93 W with Monroe County for the artwork at the Cudjoe Key Fire Station, No. IT Tor the C ..,.. purposes therein contained. c r-.,. to 2 :_-. 22. rn Notary Public My Commission Expires: .7....-:c o 9 iiii:19. k �/ / mot'.PP,; L� HOLLY MELBA ADLER * (_� * Commission#GG132803 N9,_'11i11__,,,T Expires August 25,2021 FOF FI.o BondedlTW Budget NotarySantaa 1I Art in Public Places—Cudjoe Key Fire Station No. II ATTACHMENT STATE OF FLORIDA TRAVELER AGENCY VOUCHER FOR REIMBURSEMENT SOCIAL SECURITY NO. HEADQUARTERS OF TRAVEL EXPENSES CHECK ONE: OFFICER/EMPLOYEE NONEMPLOYEE IND.CONTRACTOR OPS RESIDENCE(CITY) Travel Performed Hour of Meals for I Per Diem Class Map Vicinity DATE From Point of Origin Purpose or Reason Departure Class or Actual C Mileage Mileage Other Expenses To Destination (Name of Conference) And Hour of A&B Lodging Meals Claimed Claimed Return Travel Expenses Amount Type Statement of Benefits to the State:(Conference or Convention) Column Column Column 0 Mi. Column Summary Total Total Total Total Total 44.5¢Mi. $ - $ - $ - $ - $ - $ - Revolving Fund: Advance: LESS ADVANCE RECEIVED Check No. Warrant No. LESS CLASS C MEALS(Officers/Employees Only) $ - Check Date Warrant Date LESS NON-REIMBURSABLE ITEMS INCLUDED ON PURCHASING CARD Agency Voucher No. Statewide Doc.No. NET AMOUNT DUE TRAVELER $ 0.00 Agency Voucher No. NET AMOUNT DUE THE STATE . $ 0.00 I hereby certify or affirm and declare that this claim for reimbursement is true and correct in every material matter,that the travel expenses were actually Pursuant to Section 112.061(3)(a),Florida Statutes,I hereby certify or affirm that to the best of my knowledge incurred by me as necessary in the performance of official duties:that per diem claimed has been appropriately reduced by any meals or lodging included the travel was on official business of the State of Florida and was for the purpose(s)stated above. in the convention or conference registration fees claimed by me,and that this voucher conforms in every respect with the requirements of Section 112.061,Florida Statutes SUPERVISOR'S SIGNATURE: TRAVELER'S SIGNATURE: SUPERVISOR'S TITLE: SIGNATURE DATE: TITLE: SIGNATURE DATE: FOR AGENCY USE: Form DFS-AA-15(Rev.07/06) • TRAVEL PERFORMED BY COMMON CARRIER OR STATE VEHICLE THIS SECTION REQUIRED TO BE COMPLETED ONLY WHEN COMMON CARRIER IS BILLED DIRECTLY TO THE STATE AGENCY Date Ticket Number or From To Amount Name of Common Carrier or State Vehicle Number State Agency Owning Vehicle STATE OF FLORIDA PURCHASING CARD CHARGES THIS SECTION REQUIRED TO BE COMPLETED ONLY WHEN TRAVEL RELATED EXPENSES ARE PAID BY USING THE STATE OF FLORIDA PURCHASING CARD Date MerchanWendor Description of Item Acquired Amount of Charge • THIS SECTION REQUIRED TO BE COMPLETED ONLY WHEN NON-REIMBURSEABLE ITEMS WERE PURCHASED USING THE STATE OF FLORIDA PURCHASING CARD Date MerchanWendor Description of Item Acquired Amount of Charge Total(This amount must appear on the line"Less Non-Reimbursable Items Included on Purchasing Card"on the reverse side of this form.) $ - GENERAL INSTRUCTIONS Class A travel--Continuous travel of 24 hours or more away from official headquarters. Breakfast---when travel begins before 8 a.m.and extends beyond 8 a.m. Class B travel--Continuous travel of less than 24 hours which involves overnight absence from official headquarters. Lunch-----when travel begins before 12 Noon and extends beyond 2 p.m. Class C travel--Travel for short or day trips where the traveler is not away from his official headquarters overnight. Dinner when travel begins before 6 p.m.and extends beyond 8 p.m.or when travel occurs during night-time hours due to special assignment. • NOTE: No allowance shall be made for meals when travel is confined to the city or town of official headquarters or immediate vicinity except assignments of official business outside the traveler's regular place of employment if travel expenses are approved and such special approval is noted on the travel voucher. Rate of Per Diem and Meals shall be those prescribed by Section 112.061,Florida Statutes. Non-reimbursable items may not be charged on the State of Florida Purchasing Card. Inadvertent non-reimbursable charges are to be deducted from the travel reimbursement claimed on the reverse side of this form on the line"Less Non-reimbursable Items Included on Purchasing Card"and the above"Non-reimbursable Items"section of"State of Florida Purchasing Card Charges"section above must be completed. Per diem shall be completed at one-fourth of authorized rate for each quarter or fraction thereof. Travel over a period of 24 hours or more will be calculated on the basis of 6-hour cycles, beginning at midnight;less than 24-hours travel will be calculated on the basis of 6-hour cycles,beginning at the hour of departure from official headquarters. Hour of depature and hour of return should be shown for all travel. When claiming per diem,the meal allowance columns should not be used. Claims for actual lodging at single occupancy rate plus meal allowances should be put in the"Per Diem or Actual Lodging Expenses"column and include the appropriate meal allowances in the"Meals for Class A&B Travel"column. Claims for meals allowance involving travel that did not require the traveler to be away from headquarters overnight should be included in the"Class C Meals"column. Vicinity travel must appear in the separate column. When travel is by common carrier and billed directly to the traveler,the amount and description should be included in the"Other Expenses"column.A copy of the ticket or invoice should be attached to this form. If travel is by common carrier and billed directly to the State agency,then the"Travel Performed by Common Carrier or State Vehicle"section above should be completed. If travel is by common carrier and the carrier is paid by the use of the State of Florida Purchasing Card,then the"State of Florida Purchasing Card Charges"section above should be completed. The name of the common carrier should be inserted in the"Map Mileage Claimed"column in these instances.Justification must be provided for use of a noncontract airline(or one offering equal or lesser rates than the contract airline)or rental car(or one having lower net rate)when contract carriers are available. Additionally,justification must be provided for use of a - rental car larger than a Class"B"car. If travel is performed by the use of a State-owned vehicle,the word"State"should be inserted in the"Map Mileage Claimed"column on the reverse side of this form,and the above section designated as"Travel Performed by Common Carrier or State Vehicle"should be completed. If lodging is paid by the use of the State of Florida Purchasing Card,the words"Purchasing Card"should - be inserted in the"Per Diem or Actual Lodging Expenses"column on the reverse side of this form,and the above section designated as"State of Florida Purchasing Card Charges"should be completed. Incidental travel expenses which may be reimbursed include:(a)reasonable taxi fare;(b)ferry fares and bridge,road,and tunnel tolls;(c)storage and parking fees;(d)telephone and telegraph expenses;(e)convention or conference registration fee. If meals are included in the registration fee,per diem should be reduced accordingly. Receipts should be obtained when required. The official Department of Transportation map should be used in computing mileage from point of origin to destination whenever possible. When any State employee is stationed in any city or town for over 30 days continuous work days,such city or town shall be deemed to be his official headquarters and he shall not be allowed per diem or subsistence after the period of 30 continuous work days has elapsed,unless extended by the approval of the agency head. If travel is to a conference or convention,the"Statement of Benefits to the State"section must be completed or a copy of the Authorization to Incur Travel Expense,Form DFS-AA-13,must be attached. Additionally,a copy of a agenda and and registration receipt must be attached.Any fraudulent claim for mileage,per diem or other travel expense is subject to prosecution as a misdemeanor. NON-COLLUSION AFFIDAVIT I, ,.d ")7-0'l (/( of the city 6/adde (/(4WW ?d 2Fj4 i / Fe according to law on my qath, and nder penalty of perjury, depose and say that: 1. I am ,A,Atteie/n*.- of the firm of /Al/t(J),d ,,�=[J, ,iae ,_ 4 the proposer making the Proposal for the project described in fhe notice for calling for proposals for:A-Z-PP —i� 6 w n "� and that I executed the said proposal w' full thority to do so; 2. The prices in this proposal 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 proposer or with any competitor; and 3. Unless otherwise required by law, the prices which have been quoted in this proposal have not been knowingly disclosed by the proposer and will not knowingly be disclosed by the proposer prior to proposal opening, directly or indirectly, to any other proposer or to any competitor; and 4. No attempt has been made or will be made by the proposer to induce any other person, partnership or corporation to submit, or not to submit, a proposal for the purpose of restricting competition; and 5. The statements contained in this affidavit are true and correct, and made with full knowledge of said proje(je _ ,— OC- ?.1 /C) ; 01-// (Signature of Proposer) (Date) STATE OF: �� (k c:__ COUNTY OF: Pox`yt, Q6et_ PERSONALLY APPEARED BEFORE ME, the undersigned authority,SA-4-k.,(J who, after first being sworn by me, (name of individual signing) affixed his/her signature in the space provided above. r on this F`/ day of QC,�-D),,, , 20i 9 . G A Aell/L--- NOT PPU%IC My commission expires: i�f R /O -) c�OZ tYP(� HOLLY MELBA Ap1EER / '' ' ' c Commission 0 GG 132803 `` au+ 'of ExiresAugust 25,2021 1jF0F ittr- Bonded Dry Budp¢rtbtay$BMOCs LOBBYING AND CONFLICT OF INTEREST CLAUSE SWORN STATEMENT UNDER ORDINANCE NO. 010-1990 MONROE COUNTY, FLORIDA ETHICS CLAUSE in-. 'l°AU L1-f4T` G-64-5 (Company) "... 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 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 former County officer or employee". (Signature) Date: /0Z. • ✓- ` /9 STATE OF: �r• d.GL COUNTY OF: Pcx‘r1N, Subscribed and sworn to (or affirmed) before me on 12, zc \'2.014 (date) By (\cir+ a :v (name of affiant). He/She is personally known to me or has produced as identification. (Type of identification) NOT PUB IC olts+Y P�s HOLLY MELBA ADLER My commission expires: I Zl�12-0 [q 2 Commission#GG132803 ( �'ic4i.' Expires August 25,2021 9 of f1,01= Bedded MN Budget NotarySYvbeo DRUG-FREE WORKPLACE FORM The undersigned vendor in accordance with Florida Statute 287.087 hereby certifies that: • (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 available drug counseling, rehabilitation, and employee assistance programs, and the penalties that may be imposed upon employees for drug abuse violations. 3. Gives each employee engaged in providing the commodities or contractual services that are under proposal a copy of the statement specified in subsection (1). 4. In the statement specified in subsection (1), notifies the employees that, as a condition of working on the commodities or contractual services that are under proposal,the employee will abide by the terms of the statement and will notify the employer of any conviction of, or plea of guilty or nolo contendere to, any violation of Chapter 893 (Florida Statutes) or of any controlled substance law of the United States or any state, for a violation occurring in the workplace no later than five (5) days after such conviction. 5. Imposes a sanction on, or 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. Makes 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. Proposer's Signature faZ 1/9 Date 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 a contract to provide any goods or services to a public entity, may not submit a bid on a contract 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,subcontractor, or CONTRACTOR 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, Florida Statutes, for CATEGORY TWO for a period of 36 months from the date of being placed on the convic d vendor list." I have read the above and state that neither 'j/?a4„G; % (Proposer's name) nor any Affiliate has been placed on the convicted vendor list within the last thirty-six (36) months. (Signature) l Date: /� o2p -/9 STATE OF: Word COUNTY OF: PaA\ Naj, Subscribed and sworn to (or affirmed) before me on the V day of OC -o\nos . 20 9 by \C(,(\t;,--\ nali2-.f-';0 (name of affiant). He/She i- personal) IdCown came or has produced pe of identification) as identification. My Co missio"ran//Exxppires: q aZ 2 c/ _ 20-‘14(Y Poe HOLLY MELBAR • NO/T✓A(/R►✓I[VY PUBLIC =s_.e. * c°" ss'°" GG 1321303 T., .4LI_..• c Expires August25,2021 (SEALTeop .(14s aondednwsuayac► swvtres VENDOR CERTIFICATION REGARDING SCRUTINIZED COMPANIES LISTS Project Description(s): C. a c' 1 A i��A � ,{�21y1/ Respondent Vendor Name: o� OV (2/ t i CLb tau J4' Vendor FEIN: ��-- CO Cs &S . / Vendor's Authorized7 Representative Name and Title: 57 r' �i�'/ Le0/, /),Q/1 !Address: O/ At j City:� hiatee/...(k State: FCC Zip: 93 Tt O Phone Number57/;.5 —b!/ Email Add ress5/1/iitIC g. )22. /taik . 67t1 x/ .Section 287.135, Florida Statutes prohibits a company from bidding on, submitting a proposal for, or entering into or renewing a contract for goods or services of any amount if, at the time of contracting or renewal,the company is on the Scrutinized Companies that Boycott Israel List,created pursuant to Section 215.4725, Florida Statutes, or is engaged in a Boycott of Israel. Section 287.135, Florida Statutes, also prohibits a company from bidding on, submitting a proposal for, or entering into or renewing a contract for goods or services of$1,000,000 or more, that are on either the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector Lists which were created pursuant to s. 215.473, Florida Statutes, or is engaged in business operations in Cuba or Syria. As the person authorized to sign on behalf of Respondent, I hereby certify that the company identified above in the Section entitled "Respondent Vendor Name" is not listed on the Scrutinized Companies that Boycott Israel List or engaged in a boycott of Israel and for Projects of$1,000,000 or more is not listed on either the Scrutinized Companies with Activities in Sudan List,the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List, or engaged in business operations in Cuba or Syria. I understand that pursuant to Section 287.135, Florida Statutes, the submission of a false certification may • subject company to civil penalties, attorney's fees, and/or costs. I further understand that any contract with the County may be terminated, at the option of the County, if the company is found to have submitted a false certification or has been placed on the Scrutinized Companies that Boycott Israel List or engaged in a boycott of Israel or placed on the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List or been engaged in business operations in Cuba or Syria. Certified By: / /�Ll `'�� /61Qf; /J , S �i�'Gt/J��ll4 f� i!aus' "thorized to sign on behalf of the above referenced company. i��� /1'V}yl 3e(. Authorized Signature: , Print Name: j9--Ala . 11;4-r- O Title: /11 1 Note: The List are available at the following Department of Management Services Site: http://www.dms.myflorida.com/business operations/state purchasing/vendor information/convicted susp ended discriminatory complaints vendor lists A>coRD CERTIFICATE OF LIABILITY INSURANCE 10/2 E 9MIDD"'"Y) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the pollcy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). _ PRODUCER CONTACT CAROL BAKER Town&Country Insurance Agency PHO ` 1525 Herbert St.Ste 106 ISJC►PHONE.Exti 386-767-0147 C,No);386-767-5075 Port Orange FL 32129 Miss, carol@townco1.com INSURERIS)AFFORDING COVERAGE NAIC 0 INSURER A:WESTERN WORLD. INSURED McMow Art Glass Inc and Creative Etching Inc INSURERS:ASCENDANT COMMERCIAL INSURANCE INC 701 N Dixie Highway INSURER C:BRIDGEFIELD EMPLOYERS Lake Worth FL 33460 INSURER0: INSURER E: - INSURER F: COVERAGES . CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR TYPE ADDL SUER POUCYEFF^ POLICY EXP LTR INS° 4WD POUCYNUMBER IMMIDDIYYYY) IMMIDDIYYYYI I LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE Q OCCUR PRAMAES(EnENo curr nc) 5 100,000 MED EXP(Any are person) $ 10.000 A • X NPP8486460 01-13.2019 01-13-2020 PERSONAL&ADV INJURY 5 1,000,000 GEM.AGGREGATE LIMIT APPLIES PER, GENERAL AGGREGATE S 2,000,000 X POLICY 0 PROT 0 LOC PRODUCTS•COMP'OP AGG 5 2,000,000 JEC OTHER: S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S 500,000 IEe occidenIl iii ANY AUTO BODILY INJURY(Per person) 5 B ■ OWNED SCHEDULED AUTOS ONLY X AUTOS BODILY INJURY(Per accident) 5 El AUTOS .NON-OWNED CA-45j027-0 08-20-2019 08-20-2020 PROPERTYDAMAGE S AUTOS ONLY .AUTOS ONLY Mar Rcodentl S UMBRELLA UAB OCCUR EACH OCCURRENCE 5 EXCESS UAB H CLAIMS-MADE AGGREGATE S DED RETENTIONS $ WORKERS COMPENSATION PER OTH AND EMPLOYERS'U Y IN ABIUTY STATUTE I ER CANYPROPRIETORIPARTNERIEXECUTIVE EL.EACH ACCIDENT $ 1,000,000 OUnd RIMuryMBE EXCLUDED? NIA 0830-28990 04-01-2019 04-01-2020 E.L.DISEASE-EA EMPLOYEES 1,000,000 D C PToIOibe uOnFd OP ERATIONSbelow EL:DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule.may be attached I(more apace is squired) Board of Monroe County Commissioners is named as ad itional insured 1 MEElj`19T WAIVE / CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County Board of County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Commisioners 1100 Simonton Street#2-216 AUTHORIZED REPRESENTATIVE Key West, Fl 33040 ���� _`-° ` -J 1 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD