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Item P4 BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: March 19, 2014 Division: County Administrator Bulk Item: Yes x No _ Staff Contact Person/Phone#: Lisa Tennyson x4444 AGENDA ITEM WORDING: Approval to issue a Request for Proposals for Federal Legislative and Lobbying services. ITEM BACKGROUND: For the past 5 years (since 2009), Monroe County has had a single federal lobbying contract with Cardenas Partners, LLC (formerly Tew Cardenas, LLP). The firm provided good Washington, D.C. representation for Monroe over that period of time. During that time, the County did not go out for an RFP to explore new opportunities for federal representation. The draft Request for Proposals is attached. Should the Board approve the issuance of the RFP, it will be released on March 24, 2014 and proposals will be due back to County May 1,2014. Here is the approximate schedule: • RFP out: March 24 • Responses due back:May 1 • Evaluation Committee Ranking/Recommendation:May/June • BOCC selection/approval of firm: June/July • New Contract to BOCC:July/August • New Contract start date: October 1,2014 PREVIOUS RELEVANT BOCC ACTION: • February 2009 approved agreement with Tew Cardenas LLP • March 2009 approved amendment with Tew Cardenas,LLP • August 2009 approved Consent Assignment to Cardenas Partners,LLC • February 2010 approved Third Amendment with Cardenas Partners,LLC • January 2011 approved Fourth Amendment with Cardenas Partners,LLC • January 2012 approved Agreement with Cardenas Partners,LLC • January 2013 approved Agreement with Cardenas Partners,LLC • January 2014 approved 9-month contract with Cardenas Partners,LLC CONTRACT/AGREEMENT CHANGES: NA STAFF RECOMMENDATIONS: Approval TOTAL COST: cost to advertise INDIRECT COST: BUDGETED: Yes No COST TO COUNTY: SOURCE OF FUNDS: REVENUE PRODUCING:,Yes_ No AMOUNT PER MONTH Year APPROVED BY: County Atty/# OMB/Purchasing Risk Management DOCUMENTATION: Included xx Not Required DISPOSITION: AGENDA ITEM# MONROE COUNTY REQUEST FOR PROPOSALS FOR LEGISLATIVE AND LOBBYING SERVICES FOR MONROE COUNTY'S FEDERAL LEGISLATIVE PROGRAM 18 23 0 o A4 e7 cOUMrr 1N SNE BOARD OF COUNTY COMMISSIONERS Mayor Sylvia Murphy, District 5 Mayor Pro-Tem, Danny L. Kolhage, District 1 Commissioner George Neugent, District 2 Commissioner Heather Carruthers, District 3 Commissioner David Rice, District 4 COUNTY ADMINISTRATOR CLERK OF THE CIRCUIT COURT Roman Gastesi, Jr. Amy Heavilin MARCH 2O14 PREPARED BY: LISA TENNYSON DIRECTOR OF LEGISLATIVE AFFAIRS NOTICE OF REQUEST FOR COMPETITIVE SOLICITATIONS NOTICE IS HEREBY GIVEN that on , 2014 at 3:00 P.M. the Monroe County Purchasing Office will receive and open sealed responses for the following: REQUEST FOR PROPOSALS FOR LEGISLATIVE AND LOBBYING SERVICES FOR MONROE COUNTY'S FEDERAL LEGISLATIVE PROGRAM Requirements for submission and the selection criteria may be requested from DemandStar by Onvia at www.demandstar.com OR www. onroecoun or call toll-free at 1- 800-711-1712. The Public Record is available at the Monroe County Purchasing Office located at The Gato Building, 1100 Simonton Street, Room 2-213, Key West, Florida. All Responses must be sealed and must be submitted to the Monroe County Purchasing Office. I Pi)ge PART 1: Introduction Monroe County is soliciting Proposals from qualified firms to provide federal legislative and lobbying services. The agreement resulting from this solicitation is anticipated to be for a period of three years, commencing on October 1, 2014, and shall continue until September 30, 2017. The services being requested in this Request for Proposals are specifically subject to annual budget appropriation by the Board of County Commissioners for each fiscal year. PART 2: Before Submitting a Proposal A. Each Proposer shall thoroughly examine all the Proposal Documents. B. Ignorance on the part of the Proposer shall in no way relieve him of the obligations and responsibilities assumed under this Proposal. C. The submission of a Proposal will constitute a representation by the Proposer that he has complied with every requirement of the RFP and that the Proposal Documents are sufficient in scope and detail to indicate and convey understanding to him of all terms and conditions for performance of the Work. D. The County reserves the right to reject any and all proposals, or any part of a proposal. The County reserves the right to waive variations from the specifications that do not render the proposal non-conforming. The Owner retains the right to disregard non- conformities, non-responsive proposals or conditional proposals in the best interest of the County. PART 3: General Instructions A. The response to the proposal should be submitted in a sealed addressed envelope to: Monroe County Purchasing Office, I100 Simonton Street, Room 213, Key West, Florida 33040, on or before 3:OOPM EST on May 1, 2014. B. One (1) original and eight (8) copies of the Response must be submitted in a sealed envelope marked on the outside: "Sealed Proposal for LEGISLATIVE AND LOBBYING SERVICES FOR MONROE COUNTY'S FEDERAL LEGISLATIVE PROGRAM" on or before the deadline. Responses will be retained as property of the County. The ORIGINAL of your reply must be clearly marked "Original" on its face and must contain an original, manual signature an authorized representative of the responding firm. All other copies may be photocopies. C. Responses to the Request for Proposals must arrive at the above listed address no later than May 1, 2014 at 3:00 PM EST to be considered. It is the respondent's responsibility to assure that the proposal is delivered at the proper time and location. Responses received after the due date and time, will not be opened. 21 Pi)ge D. All submissions must remain valid for a period of one hundred and twenty (120) days from the date of the deadline for submission indicated above. The Board will automatically reject the response of any person or affiliate who appears on the convicted vendor list prepared by the Department of General Services, State of Florida, under Sec. 287.133(3)(d), Florida Statute (1997). The Board reserves the right to reject any or all proposals, to waive informalities in the proposals and to re-advertise for proposals. The Board also reserves the right to separately accept or reject any item or items of a proposal and to award and/or negotiate a contract in the best interest of the County. E. The contents of the Proposal of the successful firm will become part of the contractual obligations. F. The County is not responsible for any costs incurred by bidders prior to the issuance of an executed contract and regardless of whether a contract award is made by the County. G. Any questions concerning the Request for Proposal process, required submittals, evaluation criteria, proposal schedule, and selection process shall be in writing, at least ten days prior to the specified due date, and addressed to Lisa Tennyson, Director of Legislative Affairs at term son-lisa&monroecounty-fl.vov. All answers to such questions will be made in writing in the form of an addendum and, if issued, will be furnished to all known prospective Respondents prior to the established Response opening day. Each Respondent shall acknowledge receipt of such addenda in their Response. In case any Respondent fails to acknowledge receipt of such addenda or addendum, his response will nevertheless be construed as though it had been received and acknowledged and the submission of his response will constitute acknowledgment of the receipt of same. All addenda are a part of the contract documents and each Respondent will be bound by such addenda, whether or not received by him. It is the responsibility of each Respondent to verify that he has received all addenda issued before responses are opened. H. Signature of the Respondent: The Respondent must sign the response and other required forms in the space provided for the signature. If the Respondent is an individual, the words "doing business as or "Sole Owner" must appear beneath such signature. In the case of a partnership, the signature of at least one of the partners must follow the firm name and the words "Member of the Firm" should be written beneath such signature. If the Respondent is a corporation, the title of the officer signing the Response on behalf of the corporation must be stated along with the Corporation Seal Stamp and evidence of his authority to sign the Response must be submitted. The Respondent shall state in the response the name and address of each person having an interest in the submitting entity I. Each Respondent shall carefully examine the RFP and other contract documents, and inform him/herself thoroughly regarding any and all conditions and requirements that may in any manner affect cost, progress, or performance of the work to be performed under the contract. Ignorance on the part of the Respondent shall in no way relieve him/her of the obligations and responsibilities assumed under the contract. 31 Pi)ge J. Should a Respondent find discrepancies or ambiguities in, or omissions from, the specifications, or should he be in doubt as to their meaning, he/she shall at once notify the County as required in section G above. K. Responses will be received until the designated time and will be publicly opened and announced at the appointed time and place stated in the Notice of Request for Proposal. Monroe County's representative authorized to open the responses will decide when the specified time has arrived and no responses received thereafter will be considered. No responsibility will be attached to anyone for the premature opening of a response not properly addressed and identified. Respondent, or their authorized agents, are invited to be present. L. All prospective respondents (including but not limited to employee, partner, officer, director, consultant, lobbyist, or any actual or potential sub-contractor or consultant) are hereby instructed not to contact any member of the Board of County Commissioners, County Administrators, Selection Committee members, or Monroe County staff members other than contact person listed above regarding this solicitation or their submittal at any time after the RFP had been advertised and prior to the final evaluation and recommended ranking by County staff for this project. Any such contact shall be cause for rejection of your submittal. M. The County reserves the right to waive any informality in any response, or to re-advertise for all or part of the work contemplated. If responses are found to be acceptable by the COUNTY, written notice will be given to the selected respondent of the award of the contract. N. If the award of a contract is annulled, the County may award the contract to another Respondent, or the work may be re-advertised or may be performed by other qualified personnel as the County decides. O. A contract will be awarded to the Respondent deemed to provide the services which are in the best interest of the County. P. The County may conduct such investigations, as it deems necessary to assist in the evaluation of any Proposal and to establish the responsibility, qualifications, and financial ability of the Proposers, proposed subcontractors, and other persons or organizations to do the Work in accordance with the requirements of the County and to the County's satisfaction within the prescribed time. Q. The County reserves the right to reject the Proposal of any Proposer who does not pass any such evaluation to its satisfaction. R. If the Contract is awarded, it will be awarded to the lowest, conforming responsible Proposer. S. The contract shall be put in final form by the County and given to the Proposer for signature. The Proposer shall sign and deliver all four originals of the Contract 4 1 P ) g e Agreement to the contract manager, Lisa Tennyson, within ten days after receipt of a contract from the County. All other Contract Documents such as Insurance Certificates are to be provided to Lisa Tennyson within fourteen days after approval of the contract by the Board of County Commissioners. T. Disqualification of Respondents 1. PUBLIC ENTITY CRIME STATEMENT: A person or affiliate who has been placed on the convicted vendor list following a conviction for a public entity crime may not submit a proposal on a contract to provide any goods or services to a public entity, may not submit a proposal on a contract with a public entity for the construction or repair of a public building or public work, may not submit Proposals on leases or perform work as a contractor, supplier, subcontractor, or 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, for CATEGORY TWO for a period of 36 months from the date of being placed on the convicted vendor list. Category Two: $25,000.00. 2. Failure to complete these forms (in addition to those listed in Tab F) and submit them with your Response may result in immediate disqualification of your Response: a. NON-COLLUSION AFFIDAVIT: Any person submitting a proposal in response to this invitation must execute the enclosed NON-COLLUSION AFFIDAVIT. If it is discovered that collusion exists among the Respondents, the proposals of all participants in such collusion shall be rejected, and no participants in such collusion will be considered in future bids for the same work. b. DRUG-FREE WORKPLACE FORM: Any person submitting a bid or proposal in response to this invitation must execute the enclosed DRUG-FREE WORKPLACE FORM and submit it with his/her bid or proposal. Failure to complete this form in every detail and submit it with your bid or proposal may result in immediate disqualification of your bid or proposal. c. LOBBYING AND CONFLICT OF INTEREST CLAUSE: Any person submitting a bid or proposal in response to this invitation must execute the enclosed LOBBYING AND CONFLICT OF INTEREST CLAUSE and submit it with his/her bid or proposal. Failure to complete this form in every detail and submit it with the bid or proposal may result in immediate disqualification of the bid or proposal. PART 4: Selection Process A. The County Administrator shall appoint a Selection Committee that will review all timely submitted proposals. B. The Selection Committee will review proposals, rank the firms in order of preference and present its ranking and recommendation to the Board of County Commissioners (BOCC). 51 Pi)ge C. Should the BOCC decide to go forward with the procurement of Federal Lobbying Services, the BOCC shall direct staff to negotiate an agreement with the selected Firm for the proposed services. D. Should the BOCC be unable to negotiate a satisfactory agreement with the selected firm, the County may then undertake negotiations with the second most qualified firm. E. No binding contract is created between any Respondent and the County until a contract is approved by the Board of County Commissioners. PART 5: Evaluation Criteria Proposals will be evaluated and ranked on the basis of the following considerations: • Qualifications of Firm, Staff Assigned and Sub-contractors: 25 points • Past Performance: 35 points • Approach: 30 points • References: 5 points • Rates: 5 points PART 6: Schedule The following schedule is proposed: A. Release of RFP: March 24, 2014 B. Deadline for Receipt of Proposals: May 1, 2014 at 3:OOPM EST C. Selection Committee Review and Recommended Ranking of Proposals: May 2014 D. BOCC Approval of Ranking and Selection of Top Ranked Firm: June/July 2014 E. Contract Negotiations: July/August 2014 F. BOCC Approval of Contract: August/September 2014 G. Contract Start Date: October 1, 2014 PART 7: Scope of Services The successful firm will provide legislative and lobbying services at the federal level to assist Monroe County in developing and implementing a Federal Legislative Program; will have a keen understanding of Monroe County's priorities, policy objectives, and project funding needs; shall pro-actively identify and seek legislative and administrative remedies and/or appropriations to advance the County's priorities, policy objective and project funding needs. The successful firm will be expected to handle a range of activities including, but not limited to: A. Meet with County staff (County Administrator, County Attorney, Legislative Director, and other relevant staff as needed) and the Board of County Commission to develop a detailed Federal Legislative Program. Work closely with County staff to identify the County's goals, priorities and specific projects, and which of these can be addressed at 6 1 P ) g e the federal level, and assist in developing written material on each priority and project in the County's Federal Legislative Program to provide to congressional staff and federal agency staff. B. Monitor current federal legislation, federal budget process, federal agency actions legislative committee meetings, executive branch activity, agency hearings and meetings prior to and during the regular session, and pro-actively report to the County, both verbally and in writing, any new information or legislative events that may directly or indirectly impact the County; and in the event that action is needs, advise the County. C. Propose and implement lobbying strategies to help support the County's federal agenda. D. Develop and evaluate strategy for the support, opposition, or amendment of pending legislation that enhances the County's federal legislative program. E. Identify key Congressional and federal agency contacts relating to specific County issues; draft appropriate correspondence; and schedule briefings and meetings between County officials and Congressional leaders, executive branch representatives, and agency representatives. F. Coordinate with County's Congressional delegation in gaining support for the County's federal agenda. G. Advocate with Congressional members, congressional committees, executive branch, and federal agencies in support of the County's goals, priorities, and projects. H. Represent the County and the Board before Congress and federal agencies. I. Work closely with County staff in researching current issues and providing background information. J. Provide technical assistance and guidance to staff on correspondence and reports. K. Review the legislative policy statements adopted by the Florida Association of Counties and the National Association of Counties and other local governments and lobbying groups for the purpose of identifying issues which may either positively or negatively affect the County. L. Provide written monthly activity reports and periodic updates on advocacy activity, pending legislation, briefings/meetings, and on issues of interest or concern to the County. Reports must contain, when possible, specific legislation, names of contacts made, and the County's legislative priority it relates to, as well as any foreseeable legislation or rulings that may affect the County. M. Provide a written report that summarizes the status of the County's federal legislative program within one week of the closing of the session, and a more detailed final written report on specific legislation and new requirements affecting the County within 30 days from close of session. 71 Pi)ge N. Secure funding for programs and projects which have been identified by the County as priorities; research and provide information on existing and new appropriations activities, availability of funding, distribution of funding, year-end rollover funding, techniques to be used by County to capitalize on opportunities, and examples of successful local government applications; identify agencies or local governments which may be competing for specific grants or appropriations, and help align support for the County's position. O. Be available for regular calls, meetings with County staff in Washington, DC as needed, and an annual presentation to the Board in Monroe County, Florida. P. Provide office space for County staff to use when they are in Washington, DC. PART 8: Required Submittal Submit I original and 8 copies of the proposal in a sealed envelope bearing the name and address of the respondent. Monroe County requires comprehensive responses to every section within this RFP. The response shall by typed on 8-1/2 by 11" white paper and bound; shall be clear and concise. Proposals submitted without the required information will not be considered. Proposals shall be organized and sections tabbed. Statements submitted without the required information will not be considered. Responses shall be organized as indicated below. The Respondent should not withhold any information from the written response in anticipation of presenting the information orally or in a demonstration, since oral presentations or demonstrations may not be solicited. Each Respondent must submit adequate documentation to certify the Respondent's compliance with the County's requirements. Respondents should focus specifically on the information requested. Additional information, unless specifically relevant, may distract rather than add to the Respondent's overall evaluation. Financial information, as described below under TAB G, may be submitted in a separate envelope marked "Confidential". To facilitate review of the responses, Firms shall follow the described proposal format: TAB A: Cover Page Provide a cover page that reads "Proposal for LEGISLATIVE AND LOBBYING SERVICES FOR MONROE COUNTY'S FEDERAL LEGISLATIVE PROGRAM." The cover page should contain the Respondent's name, address, telephone number and the name of the Respondent's contact person. 8 1 P ) g e TAB B: Qualifications, Experience To the extent possible, highlight qualifications and experience in areas and on issues relevant to Monroe County's federal priorities, policy objectives and project funding needs. 1. Briefly introduce your firm, providing a summary of the administration, organization and staffing of your firm, including multiple offices, if applicable. Include the age of the firm; brief history; average number of employees over the past five years; present size of firm and nature of services provided. 2. Provide a list of current clients, with a brief description for each that includes the following: a. Client name; b. Contract dollar value; c. Dates covering the term of the contract; d. The number of years the client has contracted with the firm; e. Description of work performed; f. Results of the services/project performed; g. Name of primary contact and phone number. 3. List the names, titles, and describe the qualifications and other vital information of all key personnel that will be assigned to work on Monroe County matters. Key personnel include all partners, manager, and other professional employees that will perform work or services for Monroe County. Provide a brief resume of these key person(s) to be assigned to this project, including but not limited to: a. Name and Title; b. Role that the individual will assume in fulfilling the contract; c. Education; d. Experience: 1. Type of federal issues, dollar value of funding/appropriations, success of efforts; 2. Experience relative to Monroe County's issues and priorities; 3. Number of years lobbying for this firm and number of years lobbying for other firms; 4. Current work assignments for other clients and percent of time spent on those assignments; 5. Membership and participation in professional associations and whether registered as a lobbyist; 6. Other relevant experience and qualifications. 91 Pi)ge If the firm intends to use any subcontractors to perform services identified in the Scope of Services, then identify the specific services to subcontracted, the person or firm that will be providing such services and describe in detail lobbying experience, qualifications, and it specific engagement role in this project. 4. Specify what unique characteristics set the firm apart from others who perform the same or similar functions, and any qualifications you consider to be significant, innovative, or otherwise relevant to the County's consideration of your firm. TAB B: Past Performance To the extent possible, highlight past performance and success in areas and on issues relevant to Monroe County's federal priorities,policy objectives and project funding needs. 5. Describe the firm's success in representing county/local government issues at the federal level. List examples (no more than 10) of legislative/lobbying work product (bill drafting and gaining support for proposed legislation; proven success in protecting and/or advocating clients' position on proposed legislation) which best illustrate the approach and success of the firm and current staff which is being assigned to this contract. For each issue please provide the following: a. Name of the client b. Nature of the issue c. Outcome of the lobbying efforts on the issue d. Key professionals involved, including the roles of each. The same information must be provided for any subcontractor. 6. Describe firm's success at the federal level related to specific areas/issues of relevance to Monroe, such as: a. Environment and Natural Resources b. Water Quality c. Transportation d. Health and Human Services e. Federal Agencies such as FEMA, Army Corp of Engineers, and EPA. 7. Describe the firm's success, particularly within the past 5 years, in obtaining funding (grants, appropriations, etc.) for county/local government clients. Highlight the key professionals within the Firm that were responsible. 101 Pi)ge TAB C: Approach to Implementation of Monroe County's Federal Legislative Program 8. Describe the firm's plan for accomplishing the work and services to be provided to Monroe County. The firm should indicate a clear understanding of Monroe County's federal issue's and of the scope of work, including a detailed project plan for this project, outlining major tasks and responsibilities, time frames, and staff assigned. 9. Identify the process and tools that will be used to monitor critical issues. Identify progress reports that will be made during process and key decision points. Clearly distinguish the Firm's duties and responsibilities and those of the County's. (Absence of this distinction shall mean the Firm is assuming full responsibility for all tasks.) 10. Show the organizational chart as it relates to service identifying key personnel who will be responsible for the provision of this service. (It should be understood that it is the intent of Monroe County to insist that those indicated as the consultant team in this RFP response actually execute the program.) 11. Describe the method the firm uses to communicate with a client on its projects and issues, and provide an example of such communication with a comparable local government client on an issue before Congress, Executive Branch, and/or federal agency. 12. Describe how the firm plans to establish, maintain, and enhance working relationships between County officials and staff and key members of Congress, committee staff, Executive Branch, and federal agencies. 13. Describe how the firm will enhance the County's financial position with respect to obtaining congressional appropriations, federal grants, incentives, etc. and avoiding federal unfunded mandates that may impact the County. Provide specific examples of successful appropriations, grants, etc. obtained for comparable local government clients. 14. Provide an example of legislation (e.g, bill, amendment, report language, etc.) the firm prepared/drafted on behalf of a comparable local government client for introduction in Congress. 111 Pi)ge 15. Provide an example of written documentation prepared for a presentation before a legislative committee and/or federal agency. TAB D: References Provide reference for similarly successful projects from five current comparable clients, including the name of the client, contact name, telephone, and email address. TAB E: Rate Firms may submit proposals based on an annual lump sum basis payable monthly over the course of the year. All proposals must include a maximum not-to-exceed amount. Firms shall incur no travel or related expenses chargeable to the County. TAB F: Required Forms These forms are attached. 1. Response Form 2. Lobbying and Conflict of Interest Clause 3. Drug Free Workplace Certification 4. Non-Collusion Statement Form 5. Insurance and Indemnification Statement TAB G: Required Financial Information and Litigation. Financial information, as described below, may be submitted in a separate envelope marked "Confidential". Pursuant to Monroe County Code Section 2-347(h), Respondents shall provide the following information: 1. A list of the person's or entity's shareholders with five percent or more of the stock or, if a general partnership, a list of the general partners; or, if a limited liability company, a list of its members; or, if a solely owned proprietorship, names(s) of owner(s); 2. A list of the officers and directors of the entity; 121 Pi)ge 3. The number of years the person or entity has been operating and, if different, the number of years it has been providing the services, goods, or construction services called for in the bid specifications (include a list of similar projects); 4. The number of years the person or entity has operated under its present name and any prior names; 5. A print out of the "Detail by Entity Name" screen from the Respondent's listing in www.sunbiz.orb; 6. A copy of the Respondent's Annual Report that is submitted to the Florida Secretary of State; 7. Answers to the following questions regarding claims and suits: a. Has the person, principals, entity, or any entity previously owned, operated or directed by any of its officers, major shareholders or directors, ever failed to complete work or provide the goods for which it has contracted? If yes, provide details; b. Are there any judgments, claims, arbitration proceeding or suits pending or outstanding against the person, principal of the entity, or entity, or any entity previously owned, operated or directed by any of its officers, directors, or general partners? If yes, provide details; C. Has the person, principal of the entity, entity, or any entity previously owned, operated or directed by any of its officers, major shareholders or directors, within the last five years, been a parry to any lawsuit, arbitration, or mediation with regard to a contract for services, goods or construction services similar to those requested in the specifications with private or public entities? If yes, provide details; d. Has the person, principal of the entity, or any entity previously owned, operated or directed by any of its officers, owners, partners, major shareholders or directors, ever initiated litigation against the county or been sued by the county in connection with a contract to provide services, goods or construction services? If yes,provide details; e. Whether, within the last five years, the owner, an officer, general partner, principal, controlling shareholder or major creditor of the person or entity was an officer, director, general partner, principal, controlling shareholder or major creditor of any other entity that failed to perform services or furnish goods similar to those sought in the request for competitive solicitation; 8. Customer references (minimum of three), including name, current address and current telephone number; 131 Pi)ge 9. Credit references (minimum of three), including name, current address and current telephone number; 10. Financial statements for the prior three years for the responding entity or for any entity that is a subsidiary to the responding entity; and 11. Any financial information requested by the county department involved in the competitive solicitation, related to the financial qualifications, technical competence, the ability to satisfactorily perform within the contract time constraints, or other information the department deems necessary to enable the department and Board of County Commissioners to determine if the firm/person responding is responsible. 141 Pi)ge TAB F: Required Form RESPONSE FORM RESPOND TO: MONROE COUNTY BOARD OF COUNTY COMMISSIONERS c/o Lisa Tennyson, Director of Legislative Affairs GATO BUILDING, ROOM 2-213 1100 SIMONTON STREET KEY WEST, FLORIDA 33040 1 acknowledge receipt of Addenda No.(s) I have included: o The Submission Response Form o Lobbying and Conflict of Interest Clause o Non-Collusion Affidavit o Drug Free Workplace Form o Respondent's Insurance and Indemnification Statement o Insurance Agent's Statement In addition, I have included a current copy of the following professional and occupational licenses: (Check mark items above, as a reminder that they are included.) Mailing Address: Telephone: Fax: Date: Signed: Witness: (Seal) (Name) (Title) 151 Page^ TAB F: Required Form LOBBYING AND CONFLICT OF INTEREST CLAUSE SWORN STATEMENT UNDER ORDINANCE NO. 010-1990 MONROE COUNTY, FLORIDA ETHICS CLAUSE (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 Agreement without liability and may also, in its discretion, deduct from the Agreement or purchase price, or otherwise recover, the full amount of any fee, commission, percentage, gift, or consideration paid to the former County officer or employee". (Signature) Date: STATE OF: COUNTY OF: Subscribed and sworn to(or affirmed) before me on (date) by (name of affiant). He/She is personally known to me or has produced as identification. (type of identification) NOTARY PUBLIC My commission expires: 161 Pi)ge TAB F: Required Form NON-COLLUSION AFFIDAVIT I, of the city of according to law on my oath, and under penalty of perjury, depose and say that: 1. 1 am of the firm of the bidder making the Proposal for the project described in the Request for Qualifications for: and that I executed the said proposal with full authority to do so: 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 b 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 upon the truth of the statements contained in this affidavit in awarding contracts for said project. (Signature of Respondent) (Date) STATE OF: COUNTY OF: PERSONALLY APPEARED BEFORE ME, the undersigned authority, who, after first being sworn by me, (name of individual signing) affixed his/her signature in the space provided above on this day of 20 NOTARY PUBLIC My Commission Expires: 171 Page^ TAB F: Required Form DRUG-FREE WORKPLACE FORM The undersigned vendor in accordance with Florida Statute 287.087 hereby certifies that: (Name of Business) 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. Respondent's Signature Date NOTARY PUBLIC My Commission Expires: 181 Page^ TAB F: Required Form RESPONDENT'S INSURANCE AND INDEMNIFICATION STATEMENT Insurance Requirement Required Limits Worker's Compensation Statutory Limits Employer's Liability $100,000/$5000,000/$1,000,000 General Liability $300,000 per Person, $500,000 per Occurrence, $200,000 Property Damage or $500,000 Combined Single Limit Vehicle Liability $200,000 per Person, $300,000 Per occurrence, $200,000 Property Damage or$300,000 Combined Single Limit Professional Liability $500,000 per occurrence $1,000,000 aggregate IDEMNIFICATION AND HOLD HARMLESS FOR CONSULTANTS AND SUBCONSULTANTS The CONSULTANT covenants and agrees to indemnify and hold harmless COUNTY/Monroe County and Monroe County Board of County Commissioners, its officers and employees from liabilities, damages, losses and costs, including but not limited to, reasonable attorneys' fees, to the extent caused by the negligence, recklessness, or intentional wrongful conduct of the CONSULTANT, subcontractor(s) and other persons employed or utilized by the CONSULTANT in the performance of the contract. In the event that the completion of the project (to include the work of others) is delayed or suspended as a result of the CONSULTANT' failure to purchase or maintain the required insurance, the CONSULTANT shall indemnify the County from any and all increased expenses resulting from such delay. Should any claims be asserted against the COUNTY by virtue of any deficiency or ambiguity in the plans and specifications provided by the CONSULTANT, the CONSULTANT agrees and warrants that CONSULTANT shall hold the County harmless and shall indemnify it from all losses occurring thereby and shall further defend any claim or action on the County's behalf. The first ten dollars ($10.00) of remuneration paid to the CONSULTANT is consideration for the indemnification provided for above. The extent of liability is in no way limited to, reduced, or lessened by the insurance requirements contained elsewhere within this agreement. 191 Page^ This indemnification shall survive the expiration or earlier termination of the Agreement. RESPONDENT'S STATEMENT I understand the insurance that will be mandatory if awarded the contract and will comply in full with all the requirements. Respondent Signature INSURANCE AGENT'S STATEMENT I have reviewed the above requirements with the bidder named below. The following deductibles apply to the corresponding policy. POLICY DEDUCTIBLES Liability policies are Occurrence Claims Made Insurance Agency Signature Print Name: 201 Page^