11/17/2021 Agreement GJ�COURr4n%
` #00 Kevin Madok, CPA
' * ' Clerk of the Circuit Court&Comptroller—Monroe County, Florida
DATE: December 16, 2021
TO: Judith Clarke, PE, Director
Engineering/Roads&Bridges
ATTN: Nicole Twyman
Executive Assistant
FROM: Pamela G. Hanco �
SUBJECT: December 8th BOCC Meeting
Attached is an electronic copy of the following item for your handling:
E7 Agreement with Pavement Technology, Inc., in the not to exceed amount of
$385,000.00, for application of reclamite asphalt rejuvenation agent on recently resurfaced streets in
Stock Island,Key Haven and Key Largo to extend the life of the asphalt. This contract is being
procured utilizing competitively bid pricing under a joint cooperative bid for City of Margate,
Florida.
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
��:E'y(:F'3,➢VrH7� C'P 9'L�4.YV i4�V4�dY H t4,�,�:C:l„
Standard Form of Agreement
Between Owner and Contractor
Where the basis of'payment is a STIPULATED SUM
AGREEMENT
Made as of the 17th day of November in the year of Two Thousand and Twenty One.
BETWEEN the Owner: Monroe County Board of County Commissioners ("POCC")
1 100 Simonton Street
Key West, Florida 33040 ("Owner")
And the Contractor: Pavement Technology Inc..
24144 Detroit Road
Westlake, Ohio 44145 ("Contractor")
For the following Project Pavement Preservation Project
Various Locations
Monroe County, Florida ("Project")
The Owner and Contractor agree as set forth below.
ARTICLE
The Contract Documents
The Contract Documents consist of this Agreement, County Forms (Ethics Clause; Non-Collusion
Affidavit; Drug-Free Workplace; Public Entity Crime Statement, Vendor Certification Regarding
Scrutinized Companies Lists), Insurance Requirements and Documents, and other documents listed in
this Agreement and Modifications issued after execution of this Agreement. These form the Contract
and are as fully a part of the Contract as if attached to this Agreement or repeated herein. The Contract
represents the entire and integrated agreement between the parties hereto and supersedes prior
negotiations, representations or agreements, either written or oral.
This Agreement is being procured in accordance with Monroe County Code Sec. 2-347(e)(2) utilizing
competitive pricing under a joint cooperative bid for the City of Margate, Miami-Gardens and Plantation
with the City of Margate as the lead agency under Bid No. 2019-009 Asphalt Rejuvenation Project
11/17/21 CONTRACT DOCUMENTS 1
Notice Requirement
All written correspondence to the COUNTY shall be dated and signed by an authorized representative
of the CONTRACTOR. Any notice required or permitted under this agreement shall be in writing and
hand delivered or mailed, postage pre-paid, to the COUNTY by certified mail, return receipt requested,
to the following:
Ms. Judith Clarke, P.E.
Director of Engineering Services
Monroe County
1100 Simonton Street, Room 2-216
Key West, Florida 33040
For the Contractor:
Chris Evers
Pavement Technology Inc.
2144 Detroit Road
Westlake, Ohio 44145
ARTICLE 2
The Work oft is Contract
The Contractor shall execute the Scope of Work as specified and described in Attachment A. The
contract constitutes the entire and exclusive agreement between the Owner and the Contractor with
reference to the Pavement Preservation Project.
ARTICLE 3
Date of Commencement and Substantial Completion
3.1 The date of commencement is the date from which the Contract Time of Paragraph 3.2 is
measured, and shall be the date specified in the Notice to Proceed issued to the Contractor by the Owner.
3.2 The Contractor shall achieve Substantial Completion of the entire Work not later than
120 Days after the Date of Commencement, subject to adjustments of the Contract Time as provided by
the Contract Document.
Uncontrollable Circumstance
3.3 Any delay or failure of either Party to perform its obligations under this Agreement will be
excused to the extent that the delay or failure was caused directly by an event beyond such Party's
control, without such Party's fault or negligence and that by its nature could not have been foreseen by
such Party or, if it could have been foreseen, was unavoidable: (a) acts of God; (b) flood, fire,
earthquake, explosion, tropical storm, hurricane or other declared emergency in the geographic area of
the Project; (c) war, invasion, hostilities (whether war is declared or not), terrorist threats or acts, riot, or
other civil unrest in the geographic area of the Project; (d) government order or law in the geographic
area of the Project; (e) actions, embargoes, or blockades in effect on or after the date of this Agreement;
(f) action by any governmental authority prohibiting work in the geographic area of the Project;(each, a
"Uncontrollable Circumstance"). CONTRACTOR'S financial inability to perform, changes in cost or
11/17/21 CONTRACT DOCUMENTS 2
L,liv,,11 cll 111 110-s;-M,MIiic-D tIMCCI
availability of materials, components, or services, market conditions, or supplier actions or contract
disputes will not excuse performance by Contractor under this Section. Contractor shall give County
written notice within 7 days of any event or circurnstance that is reasonably likely to result ill
an Uncontrollable Circumstance, and the anticipated duration of su .lI Uncontrollable CircUnlstance.
Contractor shall use all diligent efforts to end the Uncontrollable Circumstance, ensure that the effects of
any l.Jncontrollable Circumstance are minimized and resume full performance under this Agreement,
The County will not pay, additional cost as a result of all Uncontrollable Circulnsta.nce, The Contractor
may only seek a no cost Change Order for such reasonable time as the Owners representative may
determine.
ARTICLE
Contract Sum
4.1 The owner shall pay the Contractor in current funds for the Contractor's performance of the
Contract, for the Pavement Preservation[ ro ect at a rate of $0.95 per Square Yard of
asphalt pavement treated, for a total not to exceed amount of Three Hundred and Eighty-
Five Thousand Dollars ($ 85,000) ("Contract Sum") subject to additions and deductions as
provided in the Contract Documents.
ARTICLE 5
Progress .Payments
5.1 Based upon Invoices submitted by the Contractor to the Owner, the Owner shall make progress
payments on account of the Contract Sum to the Contractor as provided below and elsewhere in the
Contract Documents. Contractor shall submit to the County invoices with supporting documentation that
are acceptable to the Clerk. Acceptability to the Clerk is based on generally accepted accounting
principles and such laws, rules, and regulations as may govern the Clerk's disbursal of funds.
5.2 The period covered by each Invoice for payment shall be one calendar month ending on the last
day of the month.
5.3 County shall pay pursuant to the Local Government Prompt Payment Act 218.70 Florida
Statutes.
5.4 Each Invoice for Payment shall be based upon the Rate of$0.95 per Square Yard of asphalt
pavement treated in accordance with the Contract Documents, The Invoice shall conform to the Rates
and Contract Sum and be prepared in such form and supported by such data to substantiate its accuracy
as the Owner may require. The list of roads to be treated, unless objected to by the Owner, shall be used
as a basis for reviewing the Contractor's Invoices.
5.5 Invoices for Payment shall indicate the amount of the Work completed as of the end of the
period covered by the Invoice for Payment.
11/17/21 CONTRACT DOCUMENTS 3
Nivement—Preserval.ion Lla�c(j
5.6 Subject to the provisions of the Contract Documents, the amount of each progress payment shall
be computed as follows:
5.6.1 Take that portion of the Contract Sum properly allocable to completed Work as determined by
multiplying the contract rate by the square yards of asphalt treated , less retainage of Five percent (5%).
Pending final determination of cost to the Owner of changes in the Work, amounts not in dispute may be
included in Invoices for Payment. The amount of credit to be allowed by the Contractor to the Owner
for a deletion or change which results in a net decrease in the Contract Sum shall be actual net cost as
confirmed by the Owner. When both additions and credits covering related Work or substitutions are
involved in a change the allowance for overhead and profit shall be figured on the basis of net increase,
if any, with respect to that change.
5.6.2 Subtract the aggregate of previous payments made by the Owner; and
5.6.3 Subtract amounts, if any, for which the Owner has withheld or nullified a Certificate for
Payment.
5.7 The progress payment amount determined in accordance with Paragraph 5.6 shall be further
modified under the following circumstances:
5.7.1 Add, upon Substantial Completion of the Work, a sum sufficient to increase the total payments
to Ninetyjjvc percent (95%) of the Contract Sum, less such amounts as the Owner recommends and
determines for incomplete Work and unsettled claims
ARTICLE 6
Final Payment
Final payment, constituting the entire unpaid balance of the Contract Sum, shall be made by the Owner
to the Contractor when (1) the Contract has been fully performed by the Contractor except for the
Contractor's responsibility to correct nonconforming Work and to satisfy other requirements, if any,
which necessarily survive final payment: and (2) a Final Project Certificate for Payment has been issued
by the Project Manager: such final payment shall be made by the Owner not more than 20 days after the
issuance of the Final Project Certificate for Payment.
ARTICLE 7
Insurance
7.1 Prior to commencement of work the Contractor will provide satisfactory evidence of insurance in
the form of Certificates of Insurance as required in the Insurance Statement.
7.2 The Contractor shall name the Monroe County Board of County Commissioners, its employees
and officials as "Additional Insured" on all policies except for Worker's Compensation.
Insurance Statement
11/17/21 CONTRACT DOCUMENTS 4
i'- c1liK,ni I'rt S s E atraa r�'rta t
The Insurance requirements are as follows:
111surance l cctuire gent Limits
Worker's Compensation Statutory Limits
Employer's Liability WC3 $1,000,000/$1,000,000/$1,000,000
General Liability GI-3 $ 1,000,000 Combined Single Limit
GLXCU *Required Endorsement
Underground, Explosion and Collapse
(XCU)
Vehicle Liability VL3 $500,000 per person; $1,000,000 per occurrence
(Owned, hired and $100,000 Property Damage
Non- owned Vehicles) or
$1,000,000 Combined Limit
All insurers shall have an A.M. Best rating of VI or better and shall be licensed to do business in the
state of Florida.
ARTICLE 8
Miscellaneous Provisions
8.1 Where reference is made in this Agreement to a provision or another Contract Document, the
reference refers to that provision as amended or supplemented by other provisions of the Contract
Documents.
8.2 Payments due and unpaid under the Contract shall bear interest pursuant to the Local
Government Prompt Payment Act 218.735
8.3 Monroe County's performance and obligation to pay under this contract is contingent upon an
annual appropriation by the Board of County Commissioners.
8.4 Public Entities Crimes By signing this Agreement, Contractor represents that the execution of this
Agreement will not violate the Public Entities Crime Act(Section 287.133,Florida Statutes). Violation
of this section shall result in termination of this Agreement and recovery of all monies paid hereto and
may result in debarment from County's competitive procurement activities.
In addition to the foregoing, Contractor further represents that there has been no determination,
based on an audit, that it or any subcontractor has committed an act defined by Section 287.133, Florida
Statutes, as a "public entity crime" and that it has not been formally charged with committing an act
defined as a "public entity crime" regardless of the amount of money involved or whether Contractor
has been placed on the convicted vendor list.
11/17/21 CONTRACT DOCUMENTS 5
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Contractor will promptly notify the County if it or any subcontractor is formally charged with an
act defined as a "public entity crime" or has been placed on the convicted vendor list. 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
contractor, supplier, subcontractor, or consultant under a contract with any public entity, and may not
transact business with any public entity in excess of the threshold amount provided in Section 287.017,
for CATEGORY TWO for a period of 36 months from the date of being placed on the convicted vendor
list.
8.5 The following items are part of this contract:
a) Maintenance 4 Records: Contractor shall maintain all books, records, and documents
directly pertinent to performance under this Agreement in accordance with generally
accepted accounting principles consistently applied. Each party to this Agreement or
their authorized representatives, shall have reasonable and timely access to such records
of each other party to this Agreement for public records purposes during the term of the
Agreement and for four years following the termination of this Agreement. If an auditor
employed by the County or Clerk determines that monies paid to Contractor pursuant to
this Agreement were spent for purposes not authorized by this Agreement, the Contractor
shall repay the monies together with interest calculated pursuant to Sec. 55.03; FS,
running from the date the monies were paid to Contractor.
b) Right to Audit: Availability qJ'Records. The records of the parties to this Agreement
relating to the Project, which shall include but not be limited to accounting records (hard
copy, as well as computer readable data if it can be made available; subcontract files
(including proposals of successful and unsuccessful bidders, bid recaps, bidding
instructions, bidders list, etc.); original estimates; estimating work sheets;
correspondence; change order files (including documentation covering negotiated
settlements); backcharge logs and supporting documentation; general ledger entries
detailing cash and trade discounts earned, insurance rebates and dividends; any other
supporting evidence deemed necessary by Owner to substantiate charges related to this
agreement, and all other agreements, sources of information and matters that may in
Owner's reasonable judgment have any bearing on or pertain to any matters, rights,
duties or obligations under or covered by any contract document (all foregoing
hereinafter referred to as "Records") shall be open to inspection and subject to audit
and/or reproduction by Owner's representative and/or agents of Owner. Owner may
also conduct verifications such as, but not limited to, counting employees at the job site,
witnessing the distribution of payroll, verifying payroll computations, overhead
computations, observing vendor and supplier payments, miscellaneous allocations,
special charges, verifying information and amounts through interviews and written
confirmations with employees, Subcontractors, suppliers, and contractors'
representatives. All records shall be kept for seven (7) years after Final Completion.
11/17/21 CONTRACT DOCUMENTS 6
I I-ave In(MLLI UL
C) Governing Law, Venue, Interpretation, Costs, and Fees: This Agreement shall be
governed by and construed in accordance with the laws of the State of Florida applicable
to contracts made and to be performed entirely in the State.
In the event that any cause of action or administrative proceeding is instituted for the
enforcement or interpretation of this Agreement, the County and Contractor agree that
venue shall lie in the appropriate court or before the appropriate administrative body in
Monroe County, Florida. This Agreement shall not be subject to arbitration.
d) Severability: If any term, covenant, condition or provision of this Agreement (or the
application thereof to any circumstance or person) shall be declared invalid or
unenforceable to any extent by a court of competent jurisdiction, the remaining terms,
covenants, conditions and provisions of this Agreement, shall not be affected thereby;
and each remaining term, covenant, condition and provision of this Agreement shall be
valid and shall be enforceable to the fullest extent permitted by law unless the
enforcement of the remaining terms, covenants, conditions and provisions of this
Agreement would prevent the accomplishment of the original intent of this Agreement.
The County and Contractor agree to reform the Agreement to replace any stricken
provision with a valid provision that comes as close as possible to the intent of the
stricken provision.
e) Attorney's Fees and Costs: The County and Contractor agree that in the event any
cause of action or administrative proceeding is initiated or defended by any party relative
to the enforcement or interpretation of this Agreement, the prevailing party shall be
entitled to reasonable attorney's fees and court costs, as an award against the non-
prevailing party, and shall include attorney's fees and courts costs in appellate
proceedings. Mediation proceedings initiated and conducted pursuant to this Agreement
shall be in accordance with the Florida Rules of Civil Procedure and usual and customary
procedures required by the circuit court of Monroe County.
f) Binding Effect: The terms, covenants, conditions, and provisions of this Agreement
shall bind and inure to the benefit of the County and Contractor and their respective legal
representatives, successors, and assigns.
g) Authority: Each party represents and warrants to the other that the execution, delivery
and performance of this Agreement have been duly authorized by all necessary County
and corporate action, as required by law.
h) Claims for Federal or State Aid: Contractor and County agree that each shall be, and
is, empowered to apply for, seek, and obtain federal and state funds to further the purpose
of this Agreement. Any conditions imposed as a result of funding that effect the Project
will be provided to each party.
i) Nondiscrimination: County and Contractor 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
11/17/21 CONTRACT DOCUMENTS 7
court order. County or Contractor agree to comply with all Federal and Florida statutes,
and all local ordinances, as applicable, relating to nondiscrimination. These include but
are not limited to: 1) Title VI of the Civil Rights Act of 1964 (PL 88-352) which
prohibits discrimination on the basis of race, color or national origin; 2) Title IX of the
Education Amendment of 1972, as amended (20 USC ss. 1681-1683, and 1685-1686),
which prohibits discrimination on the basis of sex; 3) Section 504 of the Rehabilitation
Act of 1973, as amended (20 USC s, 794), which prohibits discrimination on the basis of
handicaps; 4) The Age Discrimination Act of 1975, as amended (42 USC ss. 6101-6107)
which prohibits discrimination on the basis of age; 5) The Drug Abuse Office and
Treatment Act of 1972 (PL 92-255), as amended, relating to nondiscrimination on the
basis of drug abuse; 6) The Comprehensive Alcohol Abuse and Alcoholism Prevention,
Treatment and Rehabilitation Act of 1970 (PL 91-616), as amended, relating to
nondiscrimination on the basis of alcohol abuse or alcoholism; 7) The Public Health
Service Act of 1912, ss. 523 and 527 (42 USC ss. 690dd-3 and 290ce-3), as amended,
relating to confidentiality of alcohol and drug abuse patient records; 8) Title Vill 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 1910 (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 11, 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.
j) Covenant of No Interest: County and Contractor covenant that neither presently has
any interest, and shall not acquire any interest, which would conflict in any manner or
degree with its performance under this Agreement, and that only interest of each is to
perform and receive benefits as recited in this Agreement,
k) Code of Ethics: County agrees that officers and employees of the County recognize and
will be required to comply with the standards of conduct for public officers and
employees as delineated in Section 112,313, Florida Statutes, regarding, but not limited
to, solicitation or acceptance of gifts; doing business with one's agency; unauthorized
compensation; misuse of public position, conflicting employment or contractual
relationship; and disclosure or use of certain information.
1) No Solicitation/Payment: The County and Contractor warrant that, in respect to itself, it
has neither employed nor retained any company or person, other than a bona fide
employee working solely for it, to solicit or secure this Agreement and that it has not paid
or agreed to pay any person, company, corporation, individual, or firm, other than a bona
fide employee working solely for it, any fee, commission, percentage, gift, or other
consideration contingent upon or resulting from the award or making of this Agreement.
For the breach or violation of the provision, the Contractor agrees that the County shall
have the right to terminate this Agreement without liability and, at its discretion, to offset
from monies owed, or otherwise recover, the full amount of such fee, commission,
percentage, gift, or consideration.
11/17/21 CONTRACT DOCUMENTS 8
1"'a vc IT e 111 P re+.+�l v ill[I A Lo hn[Lr(IL
m) 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 F.S. 119.0701 and the terms and conditions of this contract, the Contractor is required to:
(1) 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.
(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.
11/17/21 CONTRACT DOCUMENTS 9
IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION
OF CHAPTER I ACT"RAC' OR'S DUTY
TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT,
CONTACT THE CUSTODIAN OF PUBLIC RECORDS,BRI AN BRADLEY AT
PHONE# 305-292-3470 BRADLEY-BRIANaMONROECOUNTY-FL.GOV1
MONROE COUNTY ATTORNEY'S OFFICE 1111 12"'H Street, SUI 4[T.f T4,.08K.EY
WEST, FI, 3.3040.
n) Non-Waiver of Immunity: Notwithstanding the provisions of Sec. 768.28, Florida
Statutes, the participation of the County and the Contractor in this Agreement and the acquisition of any
commercial liability insurance coverage, self-insurance coverage, or local government liability insurance
pool coverage shall not be deemed a waiver of immunity to the extent of liability coverage, nor shall any
contract entered into by the County be required to contain any provision for waiver.
0) Privileges and Immunities: All of the privileges and immunities from liability,
exemptions from laws, ordinances, and rules, pensions and relief, disability, workers' compensation, and
other benefits which apply to the activity of officers, agents, or employees of any public agents or
employees of the County, when performing their respective functions under this Agreement within the
territorial limits of the County shall apply to the same degree and extent to the performance of such
functions and duties of such officers, agents, volunteers, or employees outside the territorial limits of the
County.
P) Legal Obligations and Responsibilities: Non-Delegation of Constitutional or Statutory
Duties. This Agreement is not intended to, nor shall it be construed as, relieving any participating entity
from any obligation or responsibility imposed upon the entity by law except to the extent of actual and
timely performance thereof by any participating entity, in which case the performance may be offered in
satisfaction of the obligation or responsibility. Further, this Agreement is not intended to, nor shall it be
construed as, authorizing the delegation of the constitutional or statutory duties of the County, except to
the extent permitted by the Florida constitution, state statute, and case law.
q) Non-Reliance by Non-Parties: No person or entity shall be entitled to rely upon the
terms, or any of them, of this Agreement to enforce or attempt to enforce any third-party claim or
entitlement to or benefit of any service or program contemplated hereunder, and the County and the
Contractor agree that neither the County nor the Contractor or any agent, officer, or employee of either
shall have the authority to inform, counsel, or otherwise indicate that any particular individual or group
of individuals, entity or entities, have entitlements or benefits under this Agreement separate and apart,
inferior to, or superior to the community in general or for the purposes contemplated in this Agreement.
r) Attestations: Contractor agrees to execute such documents as the County may
reasonably require, including a Public Entity Crime Statement, an Ethics Statement, and a Drug-Free
Workplace Statement.
S) No Personal Liability: No covenant or agreement contained herein shall be deemed to
be a covenant or agreement of any member, officer, agent or employee of Monroe County in his or her
11/17/21 CONTRACT DOCUMENTS 10
L'tstva;atts w I's(';e �t<tlit—nULoaj�—,,Lt
individual capacity, and no member, officer, agent or employee of Monroe County shall be liable
personally on this Agreement or be subject to any personal liability or accountability by reason of the
execution of this Agreement.
t) Execution in Counterparts: This Agreement may be executed in any number of
counterparts, each of which shall be regarded as an original, all of which taken together shall constitute
one and the same instrument and any of the parties hereto may execute this Agreement by signing any
such counterpart.
u) SectionHeadings: Section headings have been inserted in this Agreement as a matter of
convenience of reference only, and it is agreed that such section headings are not a part of this
Agreement and will not be used in the interpretation of any provision of this Agreement.
v) Special Conditions: Any special conditions are detailed in Article I0.
w) Hold Harmless and Indemnification: Notwithstanding any minimum insurance
requirements prescribed elsewhere in this agreement, the Contractor covenants and agrees that he shall
defend, indemnify and hold the COUNTY and the COUNTY's elected and appointed officers and
employees, and harmless from and against (i) claims, actions or causes of action, (ii) litigation,
administrative proceedings, appellate proceedings, or other proceedings relating to any type of injury
(including death), loss, damage, fine, penalty or business interruption, and (iii) costs or expenses that
may be asserted against, initiated with respect to, or sustained by the County and the COUNTY's elected
and appointed officers and employees from liabilities damages, losses and costs, including but not
limited to, reasonable attorney's fees, to the extent caused by the negligence, recklessness, or intentional
wrongful misconduct of the Contractor and persons employed or utilized by the indemnifying party in
the performance of the construction contract. The monetary limitation of liability under this contract
shall be not less than 1 million per occurrence pursuant to F. S. 725.06. Insofar as the claims, actions,
causes of action, litigation, proceedings, costs or expenses relate to events or circumstances that occur
during the term of this Agreement, this section will survive the expiration of the term of this Agreement
or any earlier termination of this Agreement.
In the event the completion of the project (including the work of others) is delayed or suspended as a
result of the Contractor's failure to purchase or maintain the required insurance, the Contractor shall
indemnify the County from any and all increased expenses resulting from such delay.
The first ten dollars ($10.00) of remuneration paid to the Contractor is for the indemnification provided
for above.
The extent of liability is in no way limited to, reduced, or lessened by the insurance requirements
contained herein. In the event any claims are brought, or actions are filed against the County with
respect to the indemnity contained herein, the Contractor agrees to defend against any such claims or
actions regardless of whether such claims or actions are rightfully or wrongfully brought or filed. The
Contractor agrees that the County may select the attorneys to appear and defend such claims or actions
on behalf of the County. The Contractor further agrees to pay at the Contractor's expense the attorneys'
fees and costs incurred by those attorneys selected by the County to appear and defend such actions or
claims on behalf of the County at both the trial and appellate levels. The County at its sole option, shall
11/17/21 CONTRACT DOCUMENTS 11
have the sole authority for the direction of the defense, and shall be the sole judge of the acceptability of
any compromise or settlement of any claims or actions against the County,
X) Adjudication of Disputes or Disagreements: COUNTY and CONTRACTOR agree
that all disputes and disagreements shall be attempted to be resolved by meet and confer sessions
between representatives of each of the parties. 'The CONTRACTOR and COUNTY Representative shall
try to resolve the claim or dispute with meet and confer sessions. If the issue or issues are still not
resolved to the satisfaction of the parties, then any party shall have the right to seek such relief or
remedy as may be provided by this Agreement or by Florida law. This Agreement is not subject to
arbitration. This provision does not negate or waive the provisions of paragraph y or Article 9
concerning termination or cancellation.
y) Cancellation: In the event that the Contractor shall be found to be negligent in any aspect
of installation, stocking, maintenance, repair, or service,the County shall have the right to terminate this
agreement after five days written notification to the Contractor.
Z) Cooperation: In the event any administrative or legal proceeding is instituted against
either party relating to the formation, execution, performance, or breach of this Agreement, County and
Contractor agree to participate, to the extent required by the other party, in all proceedings, hearings,
processes, meetings, and other activities related to the substance of this Agreement or provision of the
services under this Agreement. County and Contractor specifically agree that no party to this
Agreement shall be required to enter into any arbitration proceedings related to this Agreement.
8.6 Successors and Assigns: The Contractor shall not assign or subcontract its obligations under this
agreement, except in writing and with the prior written approval of the Board of County Commissioners
for Monroe County, which approval shall be subject to such conditions and provisions as the Board may
deem necessary. This paragraph shall be incorporated by reference into any assignment or subcontract
and any assignee or subcontractor shall comply with all of the provisions of this Agreement. Subject to
the provisions of the immediately preceding sentence, each party hereto binds itself, its successors,
assigns and legal representatives to the other and to the successors, assigns and legal representatives of
such other party.
8.7 No third Party Beneficiaries: Nothing contained herein shall create any relationship,
contractual or otherwise, with or any rights in favor of, any third party. it is specifically agreed between
the parties executing this Agreement that it is not intended by any of the provisions of any part of the
Agreement to create in the public or any member thereof, a third party beneficiary under this Agreement, or
to authorize anyone not a party to this Agreement to maintain a suit for personal injuries or property damage
pursuant to the terms or provisions of this Agreement. The Recipient guaranties the payment of all just
claims for materials, supplies, tools, or labor and other just claims against the Recipient or any subcontractor,
in connection with this Agreement. Additionally, the Recipient agrees to include the following
indemnification in all contracts with contractors/subcontractors, or consultants/sub consultants who perform
work in connection with this Agreement.
8.8 The Recipient will not discriminate against any employee employed in the performance of this
Agreement, or against any applicant for employment because of age, ethnicity, race, religious belief,
disability, national origin, or sex. The Recipient shall provide a harassment-free workplace, with any
allegation of harassment given priority attention and action by management, The Recipient shall insert
11/17/21 CONTRACT DOCUMENTS 12
1!1_amenq Lll_Ptcss_(�ml Lia LIPE6L
similar provisions in all contracts and subcontracts for services by this Agreement. The Recipient affirms
that it is aware of the provisions of Section 287.134(2)(a), Florida Statutes. An entity or affiliate who has
been placed on the discriminatory vendor list 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 a public entity;
may not be awarded or perform work as a contractor, supplier, subcontractor, or consultant under a contract
with any public entity; and may not transact business with any public Recipient. The Recipient further agrees
that it shall not violate Section 287.134(2)(a), Florida Statutes, and acknowledges and agrees that placement
on the list during the term of this Agreement may result in the termination of this Agreement.
83 E-Verify System - Beginning January 1, 2021, in accordance with F.S. 448.095, the Contractor
and any subcontractor shall register with and shall utilize the U.S. Department of Homeland Security's
E-Verify system to verify the work authorization status of all new employees hired by the Contractor
during the term of the Contract and shall expressly require any subcontractors performing work or
providing services pursuant to the Contract to likewise utilize the U.S. Department of Homeland
Security's E-Verify system to verify the work authorization status of all new employees hired by the
subcontractor during the Contract term. Any subcontractor shall provide an affidavit stating that the
subcontractor does note ploy, contract with, or subcontract with an unauthorized alien. The Conti-actor
shall comply with and be subject to the provisions of F.S. 448.095
ARTICLE 9
9.1 Termination for Cause
9.1.1 Contractor or Owner, may terminate this agreement, for cause, after providing Written Notice of
the default and if said default is not cured within 15 days,the agreement may be terminated upon five
(5) additional days' Written Notice.
9.2 Termination for Convenience and suspension by Owner
9.2.1 Contractor or Owner may terminate this agreement, without cause, upon providing 30 days
Written Notice.
9,2.2 The Owner may,without cause, order the Contractor in writing to suspend, delay or interrupt the
Work in whole or in part for such period of time as the Owner may determine.
9.3 Scrutinized Companies
If the County determines that the Contractor has been placed on the Scrutinized Companies that Boycott
Israel List, or is engaged in a boycott of Israel, the County shall have the option of(1) terminating the
Agreement after it has given the Contractor written notice and an opportunity to demonstrate the
agency's determination of false certification was in error pursuant to Section 287.135(5)(a), Florida
Statutes, or (2) maintaining the Agreement if the conditions of Section 287.135(4), Florida Statutes, are
met.
ARTICLE 10
Special Conditions
11/17/21 CONTRACT DOCUMENTS 13
B�,ra1c:srar rat 1'a��c r�a�Eaa���_."r�a`c�t�
10.1 Cleaning Up
10.1.1 The Contractor shall keep the premises and surrounding area free from accumulation of waste
materials or rubbish caused by operations under the Contract. At completion of the Work, the
Contractor shall remove from and about the project waste materials rubbish, the Contractor's tools,
equipment, machinery and surplus materials. Clean up shall be performed to the satisfaction of the
Owner.
10.2 Access to Work
10.2.1 The Contractor shall provide the Owner's Representative and the Owner access to the Work: in
preparation and progress wherever located.
10.3 Care of Trees, Shrubs and Grass
10.3.1 The Contractor shall be fully responsible for maintaining in good condition all vegetation inside
the County right-of-way. Contractor will conduct work in a manner that minimizes the amount of
vegetation that is impacted by the Work. Where vegetation must be removed or destroyed incident to the
Work, the Contractor, after completion of the work, must replace or restore to the original condition all
destroyed or damaged shrubbery, grass areas or pea rock areas.
10.4 Maintenance of Traffic
10.4.1 The Contractor shall be responsible for the proper maintenance control and detour of traffic in
the area of Work, during the course of Work. All traffic control and maintenance procedures shall be in
accordance with the requirements of the Florida D.C.T.
10.4.2 All traffic control signs and devices, barricades, flashers, flambeaus and similar devices shall be
furnished and maintained by the Contractor.
10.4.3 Work shall be conducted in such a manner to cause the least possible interruption to traffic.
Necessary access to and from adjacent properties shall be provided at all times.
10.5 Barricades and Protection of Work
10.5.1 The Contractor shall protect his work throughout its length by the erection of suitable barricades,
where required. He shall further indicate his work at night by the maintenance of suitable lights or
flares. He shall comply with all laws or ordinances covering the protection of such work and the safety
measures to be employed therein. "The Contractor shall carry out his work so as not to deny access to
private property. All utility access manholes, valves, fire hydrants, and letter boxes shall be kept
accessible at all tunes.
10.5.2 In the event or threat of a hurricane the Contractor shall remove all equipment and material from
the roadway. He shall make the area safe to traffic and pedestrian. No object from the site should pose a
threat to anyone caused by wind or water.
10.6 Permits, Fees and Notices
l 1/17/21 CONTRACT DOCUMENTS 14
10,6.1 The Contractor shall secure and pay for all permits, impact fees, governmental fees, licenses,
inspections and surveys required by Federal, State, or Municipal bodies having jurisdiction over the
project for the proper execution and completion of the Work which are customarily secured after
execution of the Contract.
10.6.2 The Contractor shall comply with and give notices required by laws, ordinances, rules,
regulations and lawful orders of public authorities bearing on performance of the Work.
10.6.3 If the Contractor performs Work knowing it to be contrary to laws, statutes, ordinances, building
codes, and rules and regulations without such notice to the Owner, the Contractor shall assume full
responsibility for such Work and shall bear the attributable costs.
ARTICLE 1.1
PROTECTION OF PERSONS AND PROPERTY
11.1 Safety Precautions and Programs
11.1.1 The Contractor shall be responsible for initiating, maintaining and supervising all safety
precautions and programs in connection with the performance of the Contract.
11.2 Safety of Persons and Property
11.2.1 The Contractor shall take reasonable precautions for safety of, and shall provide reasonable
protection to prevent damage, injury or loss to:
1. employees on the Work and other persons who may be affected thereby;
2. the Work and materials and equipment to be incorporated therein, whether in storage on or off
the site, under care, custody or control of the Contractor or the Contractor's Subcontractors or Sub-
subcontractors;
3. other property at the site or adjacent thereto, such as trees, shrubs, lawns, walks,pavements,
roadways, structures and utilities not designated for removal, relocation or replacement in the
course of Work; and
4. Work or operations by the Owner or other Contractors.
11.2.2 The Contractor shall promptly remedy damage and loss to property caused in whole or in part by
the Contractor, a Subcontractor, a S ub-subcontractor,
11.3 Emergencies
11.3.1 In an emergency affecting safety of persons or property, the Contractor shall act, at the
Contractor's discretion, to prevent threatened damage, injury or loss. Additional compensation or
extension of time claimed by the Contractor on account of an emergency shall be determined by the
Owner.
Article 12
Change Orders
11/17/21 CONTRACT DOCUMENTS 15
Pavemetit Preservation Project
12.1 Description:A Change Order is a written instrument prepared by the Owner and signed by the
Owner and Contractor stating their agreement upon all of the following: 1. A change in the work 2.
The amount of the adjustment in the contract Sum, if any; and 3. The extent of the adjustment in the
Contract Time, if any.
12.1.1 Changes in the Work may be accomplished after execution of the contract, and
without invalidating the Contract, by Change Order.The Contractor may only seek a no cost
Change Order for such reasonable time as the Owner may determine.
12.2 Procedure:: Should the Owner contemplate making a change in the Work or a
change in the Contract Time of Completion, the Director of Engineering Services will provide
the Contractor a description of the contemplated change. The Contractor will either: 1. Make the
described change in the Work at no change in the Contract Sum and no change in the Contract
Time of Completion;
2. After analyzing the described change, promptly advise the County Director of
Engineering Services as to credit or cost proposed for the described change and time
adjustment, if any; or
3. Meet with the County Director of Engineering Services as required to explain costs and
time adjustments when appropriate and determine other acceptable ways to achieve the
desired objective.
ESS WHEREOF the parties hereto have executed this Agreement on the day and date first
Qttte ag;we in counterparts,each of which shall, without proof or accounting for the other
to• be deemed an original contract.
BOARD OF COUNTY COMMISSIONERS
N MADOK, Clerk OF MONROE COUNTY,FLORIDA
hQAry'toE-c U0 A!,f
• y: By l'a%)14%
As Deputy Clerk Mayor
Date 12'/a I2 .4 r x. 1-71
-,
(SEW ) ` ' Pa ement Technology Inc ; ;
B.y. .
. By. Oa
Title: . Title: IMO
11/17/21 CONTRACT DOCUMENTS 16
MONROE COUNTY ATTORNEY
L wt:0 0 r'A-' i i`.iiirYl M
CHRISTINE LIMBERT•BARROW S
ASSISTANT COUNTY ATTORNEY
DATE 12/16/21
I'w-e.mium L`r-cAe -k)—,i,_I"rWmi
Affachment
Scope of Work
11/17/21 CONTRACT DOCUMENTS 17
N�r mn�Pll
Scope Of Work
Scope of services includes all labor and materials necessary for the application of Reclamite
Asphalt Rejuvenation Agent to Monroe County roads specified below. Price per square yards is
inclusive of labor and materials, mobilization, maintenance of traffic, notification to residents, and clean
up.
11/17/21 CONTRACT DOCUMENTS 18
Key Haven Square
Street From To Wards Amount
Allamanda Ave Key Haven Rd Allamanda Ter 6,544 $6,216,80
Allamanda Ter Allamanda Ave Dead End 3,200 $1040.00
Amaryllis Dr Allamanda Ave Dead End 3,236 $3,074.20
Arbutus Dr Allamanda Ave Dead End
3,236 $3,074.20
Aster Ter Allamanda Ave Dead End 3,236 $3,074.20
Azalea Dr Allamanda Ave Dead End 3,236 $3,074.20
Bamboo'ier Bougainvillea Ave Dead end 2,611 $2,480.45
Bamboo Ter Bougainvillea Ave Dead End 2,944 $2,796.80
Beechwood Dr Bougainvillea Ave Bamboo Ter 1,667 $1,583.65
Birchwood Dr Bougainvillea Ave Bamboo Ter 1,473 $1,399.35
Bougainvillea Ave Key Haven Rd Bougainvillea Ter 2,222 $2,110,90
Cactus Dr Cypress Ave Dead End 1,209 $1,148.55
Coconut Dr Cypress Ave Dead End 758 $720.10
Cypress Ave Key Haven Rd Cypress Ter 4,122 $3,915.90
Cypress Ter Cypress Ave Dead End 1,333 $1,266.35
Driftwood Dr Key I Iaven Rd Dead End 3,369 $3,200.55
Driftwood Ter Key haven Rd Driftwood Dr 667 $633.65
Evergreen Ave Key Haven Rd Dead End 2,718 $2,582.10_
Evergreen Ct Evergreen Ave Dead End 200 $190.00
Evergreen Ln Evergreen Ave Dead End 362 $343.90
Evergreen Ter Evergreen Ave Dead End 251 $238.45
........
Floral Ave Key Haven Rd Dead End 3,073 $2,919.35
Key Haven Blvd U.S. 1 Dead End 2,778 $2,639.10
Key Haven Rd U.S. 1 Dead End 15,970 $15,171.50
Key Haven Ter Key Haven Blvd Dead End 1,953 $1,855.35
West Cypress Ter Cypress Ter Dead End 1,333 $1,266.35
Total 73,701 $70,01 .95
Stock Island Square
Street From To Wards Amount
5th Ave West End of Rd Robyn Ln 8,560 $8,132.00
5th St U.S. 1 5th Ave 5,769 $5,480.55
7th Ave Cross St Sth St
2,267 $2,153.65
Cross St U.S. 1 5th Ave 4,684 $4,449.80
MacDonald Ave U.S. I Maloney Ave 6,640 $6,308.00
Maloney Ave MacDonald Ave Peninsular Ave 19,511 $18,535.45
Miriam St 12th Ave 6th Ave 2,680 $2,546.00
11/17/21 CONTRACT DOCUMENTS 19
fla c^rwof
Peninsular Ave Maloney Ave Dead End 1,922 $1825.90
Roberta St 12th Ave 6th Ave 2,684 $2,549.80
Robyn Ln 5th St 5th Ave 1,629 $1,547.55
Shrimp Rd 5th Ave End of County Part 3,044 $2,891.80
Suncrest Rd West End of Rd East End 2,244 $2,131.80
Total 61,634 $58, 52.3
Key Largo Square
Street From To Yards Amount
Bonito 1_,n U.S. 1 Dead End 2,364 $2,245.80
Cuda Ln U.S. 1 Dead.End 1,931 $1,834.45
Dove Rd U.S. 1 Dead End 2,378 $2,259,10
Heron Rd U.S. 1 Dead End 2,378 $2,259.10
Lobster Ln U.S. 1 Dead End 2,896 $2,751.20
Mockingbird Rd U.S. 1 Dead End 2,367 $2,248.65
North Bay Harbor Dr U.S. 1 South Bay Harbor Dr 3,113 $2,957.35
Red Bird Rd Dove Rd Mockingbird Rd 1,511 $1,435.45
Snapper Ln U.S. 1 Dead End 2,444 $2,321.80
South Bay Harbor Dr U.S. 1 North Bay Harbor Dr 3,607 $3,426.65
Sunset Ct Sunset Rd Sunset Ted 1,067 $1,013.65
Sunset Rd U.S. 1 North Bay Harbor Dr 5,467 $5,193.65
Unnamed Ln Snapper Ln Lobster Ln 516 $490.20
Unnamed alley South Bay Harbor Dr Sunset Rd 1,198 $1,138.10
Bay View Ave U.S. 1 North Dr 2,358 $2.240.10
- _ ..
Central Ave U.S. 1 South Dr 1,964 $1,865.80
Coconut Dr U.S. 1 Seaside Ave 1,178 $1,119.10
Dove Ave U.S. 1 Dead End 2,244 $2,131.80
Gumbo Limbo Ave U.S. 1 Meridian Ave 1,464 $1,390.80
Lime St U.S. 1 Seaside Ave 1,096 $1,041.20
Lycaloma Ave U.S. 1 Meridian Ave 1,004 $953.80
Mahogany Ave U.S. 1 North Dr
g Y 1,753 $1,665.35
Mangrove Ave U.S. I North Dr 1.753 $1,665.35
Meridian Ave U.S. 1 South Dr 3,058 $2,905.10
North Dr East Ave Central Ave 1,978 $1,879.10
Ocean View Blvd U.S. 1 Dead End 3,596 _ $3,416.20
Palm Dr U.S. 1 Seaside Ave
816 $775.20
Peace Ave U.S. 1 Dead End 2,558 $2,430.10
Pine Ave U.S. 1 Meridian Ave 511 $485.45
Seaside Ave West End Coconut Dr 3,400 $3,230.00
South D►° Meridian Ave Dead End 378 $359.10
Total 64,346 $61,1 8.7
11/17/21 CONTRACT DOCUMENTS 20
Key. Largo Smarr
Street From 1`ca Vards Amount
C-905 L1.S. I Card SOLIntl Rd 172,444 ` 16:3, 21. 0
Total 172,444 $163,821.80
yt cs1 ... � �. Saaarr
Str act Proms TO 'arrd Ararount
Duw l St _.. "1°va.aiaaara AveEaton St 7,650 ; 7,267.5t3
Total 7,650 $7,267.50
C"r•and Totai 379,775 $360,786.25
1 1/17/2I CONTRACT DOCUMENTS 21
County Foy
I I/1'7121 CONTRA _T D�.C� JMENT C
Pavement Pre'-;Mation Proigo
SWORN STATEMENT UNDER ORDINANCE NO. 010-1990
MONROE COUNTY, FLORIDA
ETHICS CLAUSE
onpany)
"...warrants that he/it has note loyed, retained or otherwise had act on his/her 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. 0 10-1990. 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 Agreem t or�purchase price, or,(e r, 1purcrhase price,' 0 pri or
otherwise recover, the full amount of any fee, commission, percen age), gl or consideration
paid to the former County officer or employee,"
Si re)
Date:
STATE OF: OA-/ 0
COUNTY OF: C V
U
Subscribed and sworn to (or affirmed) before me, by means of physical presence or 0
online notarization, on �-7
(date) by O ice, (name of affiant). He he
ersonally known to me or has produced (type of
identification) as identification.
44
NbTARY PUBLIC
My Commission Expires:
No,wy puUJO,State of Ohio
11/17/21 CONTRACT DOCUMENTS W OWWjojon Exoma-Feboq 27,20Z
Pavement Preservation Pros ct
NON-COLLUSION AFFIDAVIT
I, _ S �' .� " 7, of the city of // according to law on
my oath, and under penalty of perjury, depose and say that
a. I a �c,� Cr " /���5'v���' of the firm of
the bidder making the
Proposal for the project des6ribed in the Request for Proposals/Bid for_City of
Margate's Sid No. 01 -00>Asphalt Reitivenation Prroiect and that I executed the
said proposal with full authority to do so;
b. 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;
C. 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
d. no attempt has been made or will be made by the bidder to induce any other
person, partnership or corporation to submit, or not to submit, a bid for the purpose
of restricting competition;
e. the statements contained in this a id e true and correct, d"Made with full
knowledge that Monroe County reli upo the truth of the s teme is contained in
this affidavit in awarding contracts r said project.
(ft
Date. /
t `
STATE OF;
COUNTY OFa �r�► +�
Subscribed and sworn to (or affirmed) before me, by means of J4 physical presen o, '
online notarization, on ocjy �- .'�7W "Zo l (date) by �
.w —n to me,
c+. .-1 r' A (name of affiant). N e is personally know or
has produced ype of
identification) as identification. m
NOTARY PUBLIC -
My Commission Expires: NOWN pddia.stau cf ONO
-
11/17/21 CONTRACT DOCUMENTS 3
.2�
h
DRUG-FREE WORKPLACE FORM
The und,-rsianed 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'
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 w _' lace through
w
implementation of this section.
As the person authorized to sign the staterne t, I c rtify that this firm c drug-free
ully with the
above requirements.
(Sig�at re)
STATE OF:
COUNTY OF:
Subscribed and sworn to (or affirmed) before me, by means of C4 1 physics 'pig error or ,
,
online notarization, on 1 try
,
d. �
(name of iffiant). _The-_. onj�ly 'In * 1r
r has produced (type of identific' e0ni )
as identification.
NOTARY PUBLIC 17
My Commission Expires: --lbabeth Mialc „y
11/17/21 CONTRACT DOCUMENTS �Notatypt 4 State of Ohio
W Owm*iaimn 44�6:Febn"27,202>
Pavement Preservation 1!11�
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,
for CATEGORY TWO for a period of 36 months from the date of being placed on the convicted
vendor list."
I have read the above and state that neither (Respondent's name)
nor any Affiliate has been placed on the convicted vendor list within the last 3-6-moDths.
Si re)
Date:
STATE OF.
5.
COUNTY OF: vyGiD -
��1
Subscribed and sworn to (or affirmed) before me, by means of 9 physical pres`0ind'0' 6'r 0
online notarization, on (date) by
(name of affiant). e'is personally known o m or has produced (type of identification) as
identification.
NOTARY PUBLIC
E Mi
My Commission Expires: 2,1--fizeWheleugAy
W COZZMAD,Mft of Ohio
E*M:Nbmq 27,20jr
11/17/21 CONTRACT DOCUMENTS 5
Pa,urncxnt 1'resery ition Pr(�cct
VENDOR CERTIFICATION REGARDING SCRUTINIZED COMPANIES LISTS
Project Descriptions). c 4'i ca C s a„s
Respondent Vendor Name: Verr ,_r
Vendor FEIN: '
Vendor's Authorized Representative Name and Title: �� t t'Gt� i'. S C
Address: 2(-(/Vq
City: 1Le State: zip:
Phone Number: q yb - 9'Vd -/9`�f-
Email Address: dVI-a" ( e a, ,
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: , who is
authorized to sign o e alf of the above refer nee compan _ ....._
Authorized Signatu e.
Print Name: ( t
Tittle: S�' ...
Note: The List are available at the following Department of Management Services Site:
http-//www.dms.nivflorida.com/business operations/state urchasinp-/vendor information/convicted su
spended discriminatory cot )taints vendor lists
11/17/21 CONTRACT DOCUMENTS 6