Item D1BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date: FEBRUARY 15, 2012 Division: TDC
Bulk Item: Yes X No Department: _
Staff Contact Person/Phone #: Maxine Pacini
296-1552
AGENDA ITEM WORDING:
Approval to advertise a Request for Proposal for FY 2013 Capital Project Funding
ITEM BACKGROUND:
TDC approved same at their meeting of January 31, 2012
PREVIOUS RELEVANT BOCC ACTION:
CONTRACT/AGREEMENT CHANGES:
STAFF RECOMMENDATIONS:
Approval
TOTAL COST: $ BUDGETED: Yes X No
COST TO COUNTY: $ SOURCE OF FUNDS: TDC
REVENUE PRODUCING: Yes X No AMOUNT PER MONTH Year
APPROVED BY: County Atty X OMB/Purchasing N/A Risk Management N/A
DOCUMENTATION: Included X Not Required
DISPOSITION: AGENDA ITEM #
Revised 11 /06
NOTICE OF REQUEST FOR APPLICATIONS -I
This Request for Application is subject to change prior to its issuance should there be a
change in policy by the Board of County Commissioners or the Tourist Development
Council ("TDC").
NOTICE IS HEREBY GIVEN TO PROSPECTIVE APPLICANTS that on May 1, 2012 the
Monroe County Purchasing Office, the Board of County Commissioners of Monroe
County, Florida will receive sealed applications until 5:00 p.m for the following:
BRICKS AND MORTAR/CAPITAL PROJECTS
RFA-TDC--PUR/CV
(Please note that individuals and for -profit organizations are not eligible to apply for
Capital Project funds.)
This application is funded as a fifty percent (50%) reimbursement of funds expended by
the individual organization. The applicant must show that all funds (100%), excluding
TDC funds, are available for the proiect at the time of application so that there is no delay
in the progress of the proiect, and that TDC funding is not used as "matching" funds.
The following is a list of district boundaries in which funds will be allocated:
District I: Key West - (shall encompass the city limits of Key West)
District II: Lower Keys - (city limits of Key West to West end of Seven Mile Bridge)
District III: Marathon — (west end of Seven Mile Bridge to Long Key Bridge)
District IV: Islamorada - (between Long Key Bridge and Mile Marker 90.939)
District V: Key Largo - (from Mile Marker 90.940 to the Dade/Monroe County line and any
portions of mainland Monroe County)
The respective districts wish to solicit applications for consideration within the parameters for
such expenditures as outlined in F.S. 125.0104 -paragraph (5) (a) 1 thru 4 and (b), Tourist
Development Tax.
Requirements for submission and the selection criteria may be requested from DemandStar by
Onvia at www.demandstar.com or call toll -free at 1-800-711-1712. The Request for
Applications and all supporting documentation are public record and may be obtained from the
Monroe County Purchasing Office, located at 1100 Simonton St., Key West, FL 33040.
Technical questions should be directed, via e-mail, to the Administrative Office of the Tourist
Development Council at adminasst(a fla-keys.com. Any addenda to this Request for
Applications (RFA) shall be distributed to vendors on the list of DemandStar distributees for this
RFA.
Monroe County Tourist Development Council FY 2013 Capital Project Application
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Applicant must submit all of the following:
A. One (1) disc OR (1) USB flash drive with complete copy of application as a .pdf (all
attachments must be merged into one document: Please DO NOT include the instruction
pages) and........
B. One (1) signed and marked as ORIGINAL paper copy PLUS......
C. The correct number of paper copies for the district for which you are applying:
District I requires
4
paper copies of application
District II requires
7
paper copies of application
District III requires
6
paper copies of application
District IV requires
4
paper copies of application
District V requires
7
paper copies of application
Place all items together in 1 sealed envelope/box clearly marked on the outside, with the
Proposer's name and "Sealed Application for Bricks and Mortar/Capital Projects Funding"
addressed to:
Monroe County Purchasing Office
1100 Simonton Street, Room 1-213
Key West, FL 33040
Phone: (305) 292-4466
Fax: (305) 292-4465
All Applications must be received by the County Purchasing Office before 5:00 P.M. on
Tuesday, May 1, 2012. Any applications received after this date and time will be automatically
rejected.
Dated at Key West this day of , 2012. Monroe County Purchasing Department
Monroe County Tourist Development Council FY 2013 Capital Project Application
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OVERVIEW AND INSTRUCTIONS
INQUIRIES AND CORRESPONDENCE
All questions pertaining to this solicitation should be directed to: Maxine Pacini or Lynda Stuart
at (305) 296-1552 (AdminAsst fla-keys.com,)
All applications submitted in response to this solicitation should be addressed to and
received no later than 5:00 p.m. (close of business day) May 1, 2012
Purchasing Department of Monroe County
1100 Simonton Street, 1 st Floor, Room 1-213
Key West, Florida 33040
Attention: CAPITAL PROJECT FUNDING APPLICATION
CAPITAL PROJECT APPLICATION FUNDING PROCEDURE
The Monroe County Tourist Development Council (TDC) administers the four (4) cent bed tax
collected for the purpose of promoting the Florida Keys as a tourist destination. Each year, the
TDC invites organizations registered to do business in Florida, to apply for funding for Bricks and
Mortar/Capital Improvement projects in the Florida Keys. All applications will be reviewed by the
appropriate District Advisory Committees (DAC's), who shall make recommendations on funding
the project to the TDC. Upon approval of recommended funding allocation by the TDC, the
administrative office will coordinate with the project coordinator to establish a contract for the
project, and will present the proposed contract to the County for final approval.
The following is a list of district boundaries in which funds will be allocated:
District I: Key West - (shall encompass the city limits of Key West)
District II: Lower Keys - (city limits of Key West to West end of Seven Mile Bridge)
District III: Marathon — (west end of Seven Mile Bridge to Long Key Bridge)
District IV: Islamorada - (between Long Key Bridge and Mile Marker 90.939)
District V: Key Largo - (from Mile Marker 90.940 to the Dade/Monroe County line and any
portions of mainland Monroe County)
This application will be funded as a fifty percent (50%) reimbursement of funds expended
by any individual organization. The applicant must show that all funds (100%) are
available for the proiect at the time of application so that there is no delay in the progress
of the proiect, and that TDC funding is not used as "matching" funds.
Monroe County Tourist Development Council FY 2013 Capital Project Application
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APPLICANT RESPONSIBILITIES AND IMPORTANT INFORMATION TO KNOW PRIOR TO
FILLING OUT THE APPLICATION
• Prior to filling out application, please go to www.sunbiz.org to ensure that your
organization is registered to do business in the state of Florida. Only applicants that are
duly registered will be accepted.
• Applicant shall complete, copy, sign (by an authorized officer) and submit the correct
number of copies of the application to the Monroe County Purchasing Department.
(Please DO NOT use three (3) ring HARD binders; soft binders or spiral binding - no
binders are preferred.)
• Applicant shall familiarize itself with referenced online materials noted in this application
(sample contract): http://www.monroecounty-fl.gov/pages/MonroeCoFL TDC/index.
• Cost of preparation and submission of the application is the responsibility of the applicant.
• All information furnished or disclosed as part of the application process is considered
public record by the laws of the State of Florida.
• The applicant shall not lobby, solicit, or act to influence TDC Board and/or advisory
committee members in any way that may have an effect on the outcome of the
competition, discussion, or negotiations leading to the award of a contract. Such action
could lead to an automatic withdrawal of the application from consideration.
• All attachments should be noted as such in the top right hand corner of each sheet —
please do not use tab inserts.
• Be advised that if your organization is awarded funding you will be required to enter into a
contract which delegates you to maintain accurate and complete documentation of the
project. You will be required to obtain a signed amendment to the contract before making
any substantive changes to the project or you may nullify the County's obligation to pay.
You will be required to comply with the following reimbursement procedures outlined in
the sample contract which can be found at http://www.monroecounty-
fl.gov/pages/MonroeCoFL TDC/index.
• Any applicant who intends to utilize volunteer labor or in -kind donations of property (up to
25% of the total project) shall provide in the application a schedule of values for each unit
of in -kind services and/or goods (property). Should funding be allocated, County/TDC
reserves the right to deny the application of certain in -kind services and goods and to
negotiate a revised schedule of values for permissible items. For example, County will
not accept as in -kind the waiver of governmental permit fees.
• The recipient of TDC capital project funding shall designate a project manager if no
licensed architect, engineer, or general contractor is involved in the project. If the project
is performed by County or City personnel, the project manager shall be the Engineer,
Building Official, or Construction Manager of that local government.
• Any part of the project for which the applicant wishes to seek reimbursement from the
County, must NOT commence prior to the date of County approval.
• Maintenance: The applicant shall be responsible for all maintenance and operational
costs of the premises improved or constructed with the use of funding from the
TDC/County. The applicant shall be responsible to the TDC/County for the safekeeping
and proper use of the property entrusted to applicant's care, to include any and all
insurance for the value of the equipment and any maintenance or service contracts
relating to such equipment for its service life. Any disposal of assets procured through
Monroe County Tourist Development Council FY 2013 Capital Project Application
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funding under this contract shall comply with chapter 274, F.S. or chapter 617, F.S.,
dependent upon the type of entity funded under this contract.
• Permits: Applicant shall be responsible for securing all federal, state and local
development approval and permits necessary to complete the project. Award of funds
under this application do not indicate any development approval by the County and
applicant shall be required to comply with all County concurrency requirements under
land use laws of the County and State.
• Taxes: The TDC/County is exempt from Federal, Excise and State of Florida Sales Tax.
• Performance Guarantee: A successful applicant shall warrant, by signing this
application, that applicant has the financial capability of completing the project as planned
without the need to request further funding from TDC/County for same. Applicant shall
warrant by signing this application and confirm in writing (in the form of bank statements;
signed letter from the bank stating that funds are in the bank for the specified project;
documentation provided by a financial institution of a line of credit assigned to the specific
project within the application) that applicant has the funds in place at the time of the
application for grant funds to be able to complete the project prior to seeking
reimbursement of TDC funds. A governmental applicant shall provide a line item budget
for the project in question, and proof that the budget has been adopted by the governing
board of that entity. The applicant by signing the application certifies that: applicant, its
principals, and any previously owned business is/are not and have never been in default
to Monroe County under the terms of any contract. (Default means failure to fulfill
contractual obligations where County had to take legal action to obtain remedy or where a
bonding company had to make good for applicant.)
• In -kind services: In -kind services (donated/free/volunteered labor; materials; goods,
services) up to 25% of the total cost of the project may be considered to meet the 100%
funding of the project. Applicant shall provide a schedule of values for each unit of in -kind
service and/or goods at the time of the application. Should funding be allocated,
County/TDC reserves the right to deny the application of certain in -kind services and
goods and to negotiate a revised schedule of values for permissible items. For example,
county will not accept as in -kind, the waiver of governmental fees.
• Construction and Other Contracts: Applicant, by signing the application, warrants that,
if awarded funds for the project, all contracts, for construction or otherwise, to complete
the project shall be met in compliance with all applicable laws and County purchasing
policy and to comply particularly with F.S. Chapter 255, Chapter 274 and Chapter 287.
Applicant further agrees to provide TDC/County and their designated representatives
with:
a) access to the project premises for inspection of the progress of the project;
b) documentation including copies of all sub-contracts/Request For Bids verifying
compliance with purchase/construction/architectural contract requirements of the County
[Notice to owner, list of sub -contractors, and release of liens must be provided to County];
and
c) access to all records concerning the project. These records must be retained by
applicant for a minimum of four (4) years after the termination date of contract. This
requirement may be for a different time period than that required by other government
agencies. All records must be kept in accordance with Generally Accepted Accounting
Principles.
• Termination for Default/Convenience: The TDC/County reserves the right to terminate
any contract if, in its opinion, there shall be a failure at any time, to properly perform
Monroe County Tourist Development Council FY 2013 Capital Project Application
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faithfully any portion of the project as funded by TDC/County according to the plan
presented with the application, or as modified and accepted in writing by TDC/County.
Further, TDC/County reserves the right to terminate payments under this contract should
the anticipated funding become unavailable for any reason. Should termination occur
under this provision, TDC/County shall give applicant thirty (30) days notice prior to
termination.
• Payments: Applicant shall submit all documentation required by the County Finance
Department in accordance with instructions from said department, prior to payment of any
funds awarded. The TDC Application for Payment forms provided in the TDC
reimbursement package shall be used. Ten percent(10%) of every progress payment
shall be withheld by County until certification of completion of project.
• Contractor and Sub -Contractor Bonding: Applicant shall require all contractors and
sub -contractors to post such performance bonds as are required by such contractors/sub-
contractors entering into contract with the TDC/County.
• Design/Architectural Fees: Design plans and architectural fees will be paid upon
completion of the physical brick and mortar portion of the project outlined within the
contract. Applicant shall submit for reimbursement of design plans and architectural
services within the last segment of their proposed project (Exhibit A). This is to ensure
that TDC dollars are used for completed projects that are open to the public.
• Acknowledgements: Applicant shall be required to display an appropriate public
acknowledgment of the support of the Monroe County Tourist Development Council in a
publicly prominent area of the project.
PERMISSIBLE USES FOR CAPITAL PROJECT FUNDS
All capital projects funded by TDC shall be owned and operated by either a governmental
entity or non-profit organization. Individuals and for -profit organizations are not eligible to
apply for Capital Projects funds. Tourist Development capital project funds may be used in
Monroe County as follows:
1. To acquire, construct, extend, enlarge, remodel, repair, or improve one or more publicly
owned and operated convention centers, sports stadiums, sports arenas, coliseums, or
auditoriums within the boundaries of the taxing district in which the tax is levied.
2. To finance beach improvement, maintenance, re -nourishment, restoration, and erosion
control.
3. To acquire, construct, extend, enlarge,
museums, zoological parks, or nature center
profit organizations and open to the public.
To finance fishing piers.
s
remodel, repair, improve, or promote one or more
which are publicly owned and operated by non -
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APPLICATION FOR CAPITAL PROJECT FUNDING
This application is to request funding from the following District(s):
F-1 District I: Key West - (shall encompass the city limits of Key West)
F-1 District II: Lower Keys - (city limits of Key West to West end of Seven Mile Bridge)
F-1 District III: Marathon — (west end of Seven Mile Bridge to Long Key Bridge)
F-1 District IV: Islamorada - (between Long Key Bridge and Mile Marker 90.939)
F-1 District V: Key Largo - (from Mile Marker 90.940 to the Dade/Monroe County line and any
portions of mainland Monroe County)
Applicant must submit all of the following:
A. One (1) disc OR (1) USB flash drive with complete copy of application as a (all
attachments must be merged into one document: Please DO NOT include the instruction
pages) and........
B. One (1) signed and marked as ORIGINAL paper copy PLUS..
C. The correct number of paper copies for the district for which you are applying:
District I requires
4
paper copies of application
District II requires
7
paper copies of application
District III requires
6
paper copies of application
District IV requires
4
paper copies of application
District V requires
7
paper copies of application
APPLICANT ORGANIZATION:
(Registered business name exactly as it appears on www.sunbiz.orq).
DESIGNATED PROJECT CONTACT PERSON
(Please note that the TDC Administrative Office conducts most of its correspondence,
including contract and reimbursement material by e-mail, so the person listed below
should be able to accept responsibility for receipt of this information)
Name & Title:
Telephone/mobile no:
E-mail:
Address:
Monroe County Tourist Development Council FY 2013 Capital Project Application
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TYPE OF APPLICANT: F-1 Non -Profit FIGovernmental Entity
PROJECT TITLE:
LOCATION OR ADDRESS OF PROJECT: Provide physical (postal service) address, RE# and
legal description (lot, block, subdivision) and attach map.
WHICH OF THE FOLLOWING APPLIES TO YOUR PROJECT?
F]Publicly owned and operated E]Owned and operated by anon -profit organization
F]Publicly owned and operated by anon -profit organization
WHICH OF THE FOLLOWING BEST DESCRIBES YOUR PROJECT?
FIConvention Center E]Sports Stadium F]Sports Arena [:]Coliseum
FIFishing Pier F]Museum FIZoological Park [:]Nature Center
FlAuditorium F_1*Beach or Beach Park Facility
Which of the following applies to your project?
F-]Acq u i re FIConstruct [:]Extend F]Enlarge [:]Remodel
F-]Repair F-1 I m p rove
*If you checked the box for Beach or Beach Park Facility, which of the following applies?
FlImprovement FIRe-nourishment FIRestoration FlErosion control
F]Maintenance FIConstruct FIRepair
If the TDC/County requires a Conservation Easement Deed or mortgage note requiring
repayment of TDC monies in the event of transfer of ownership or change in use of the
premises, would you be agreeable to executing same?
F]Yes F-1 N o
Application is for
% of total funds to be obtained from all sources.
Monroe County Tourist Development Council FY 2013 Capital Project Application
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Has applicant received previous TDC assistance: ❑Yes ❑No
If yes, please specify year, amount, and nature of project.
List any previous grant-in-aid assistance received by the applicant or for the property from any
government agency. Indicate year of award, amount, division which awarded the grant, and a
brief description of the project assisted by each.
For purposes of this application no more than twenty-five (2591o) percent of total project cost shall
be of in -kind services and materials. TDC requires confirmation in writing that project funds are
in place at the time of this application for grant funds (see Performance Guarantee on page 5).
Payment is a 50% reimbursement of the total cost of each segment of the project, subject to the
cap on expenditures for that segment as set forth in the contract. Applicant must be prepared to
pay the entire cost of segment in advance of seeking the 50% reimbursement. (The project may
be broken down into 2 or 3 segments. When one segment is completed, reimbursement of 50%
of that cost can be applied for through the TDC.)
Monroe County Tourist Development Council FY 2013 Capital Project Application
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a) TDC funds Confirmed/Available
requested: Hard -Dollar funds
Confirmed Total Project
In -kind Funds Cost
(Up to a maximum of
25% of project)
b) State source of resources for the project specified in this application:
(i) Hard -dollar:
(ii) In -kind:
Projected in -kind services and _goods shall be allocated the following values, subject to
negotiation with TDC/County. List here all such anticipated values:
n the space below, write a brief description of the overall project:
Monroe County Tourist Development Council FY 2013 Capital Project Application
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In the space below write a list of specific items/services, and the dollar amount for each of those
items/services that your requested TDC funds will be spent on.
PROJECT DESCRIPTION
1. Use:
a) Original use of structure and date of construction:
b) Modifications to the present date including date &description:
c) Present use:
d) Any other uses between original and present:
e) Proposed use:
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f) Insert or attach photograph of existing site:
g) Historic designation: Indicate whether the property has been listed in the
National Register, is located in a National Register district, is a locally designated historic
landmark or is located in a locally designated historic district. If located within a historic district,
provide the official name of the district. This information is available from the planning agency
having jurisdiction over the property.
All Capital projects funded by TDC shall be owned and operated by a governmental entity or
non-profit organization. Applicant shall provide proof of property ownership or long-term lease
for consideration of funding.
2. Ownership or other interest in property by applicant:
a) Official records reference for ownership documentation
b) If not owned by applicant, provide long-term lease of property and provide notarized
consent letter from owner for use of property as outlined in this application
3. If proposed project calls for transfer of title of real property to County, two (2) current real
estate appraisals and one (1) environmental assessment shall be provided. The TDC/County
shall ascertain, prior to acceptance of any donation or prior to purchase, that the property will
pose no environmental hazard or liability for same, to County. The TDC/County must also
ascertain permissible governmental interest in the transfer of title. Indicate any such proposed
title transfers here.
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4. *This paragraph applies only to an acquisition funding request, but you will still need to
complete items 5 through 13, whether this is new construction or renovations, additions, or
exhibits. The purchase amount shall not exceed the value of the property as determined by the
average of two appraisals, or the average of the closest two appraisals if more than two are
obtained. NOTE: The maximum grant amount from tourist development revenue for an
acquisition project shall not exceed 50% of the purchase amount. Indicate the area of the
property to be acquired in acres:
In evaluating applications for acquisition funding, an important consideration is the
appropriateness of the size of the site to be acquired. Determinations of the appropriateness of
site size will be made on a case -by -case basis and will depend on the characteristics for which
the property is considered to be significant. Sufficient property should be acquired to assure that
the historic relationship of a structure or archaeological site to its surrounding environment is
preserved. However, it is important that no more property than is necessary to achieve
established preservation objectives be included in the acquisition project application. As this
factor is crucial to favorable consideration of your grant application and will have substantial
impact on the cost of the required application documentation, we encourage prospective
applicants to consult with the staff of the TDC Administrative Office prior to initiating the required
documentation.
5. Protection of property: Indicate any type of state or federal protection currently
afforded the property. It may be that more than one type may be applicable. Provide citations
for applicable local protective ordinances. Include copies of property -specific restrictive legal
instruments in an attachment. By signing and submitting this application, the proposer warrants
that all restrictions are disclosed. Failure to include every restriction on the property may result
in immediate termination of any contract and demand for return of any monies paid thereunder.
6. Is the property threatened by imminent destruction, deterioration or other loss which may
include demolition, vacancy, severe deterioration, loss of structural integrity, encroaching
development, adverse environmental conditions, vandalism, etc.? Be specific regarding the
nature of immediacy of the threat. If so, describe in detail:
7. a) Are there any building restrictions on the site? If so, describe. Attach copies of all
recorded easement and restrictive covenants. By signing and submitting this application, the
Monroe County Tourist Development Council FY 2013 Capital Project Application
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proposer warrants that all restrictions are disclosed. Failure to include every restriction on the
property may result in immediate termination of any contract and demand for return of any
monies paid thereunder.
b) Is the proposed project compatible with the County's Concurrency
Requirements under the existing and proposed Land Use Comprehensive Plan? How have you
ascertained such compatibility? (Note: If your description does not provide information about
existing permits and/or review by the County Planning Department, your application shall be
rejected.)
c) Does the site contain endangered or threatened species of flora or fauna?
F]Yes F-1 N o Describe/Explain:
d) Are there facilities existing or planned to accommodate the physically disabled?
F]Yes F-1 N o Describe/Explain:
e) Monroe County thinks that recycling is important. Does your entity recycle?
F]Yes F-1 N o Describe/Explain:
Monroe County Tourist Development Council FY 2013 Capital Project Application
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f) Public accessibility and use: Indicate the extent to which the property is
currently or will be scheduled to be open to the public each year (hours per day, days per week
and weeks per year) upon project completion. Indicate whether or not the property will be
accessible to the handicapped per Chapter 553, Part V, Florida Statutes and the Americans with
Disabilities Act, Public Law 1012-336. If not, provide a brief explanation. Estimate the number
of persons who will use or visit the completed facility annually. For archaeological projects, if the
site will not be accessible to the public, estimate the number of persons annually who will be
exposed to the interpretive materials and reports resulting from the project. How was this
estimate derived?
8. Describe present physical condition of site: (attach legal description per property tax
records). Indicate the present condition of the property by checking the appropriate term below:
FlExcellent: The property is habitable and occupied; no repairs are needed. All physical
evidence indicates that the property is under continuous maintenance. Application is for
expansion and enhancement.
F]Good: The property is habitable and occupied; only cosmetic repairs are needed
(e.g., peeling paint, missing ornamental features, some deteriorated mortar, etc.) Property is
maintained but in need of minor repair.
F]Fair: The property is habitable but may be vacant. Both the structural integrity
(foundation, framing, etc.) and weather tight integrity of the property (siding, walls, roofing, etc.)
are in jeopardy because of prolonged neglect.
F]Poor: The property is uninhabitable and vacant. Major structural repairs are
needed. Weather tight integrity has been lost. The property is derelict, abandoned and not
habitable without major rehabilitation work.
Monroe County Tourist Development Council FY 2013 Capital Project Application
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Also, list any specific factors or problems which contribute to the present condition of the
property.
9. List and describe all major work items included in the proposed project.
10. Status of Project Planning:
❑ Not yet initiated ❑
❑ Schematics complete ❑
❑ Documents complete ❑
Initiated
Design development
Construction documents completed
11. Name and Address of Project Consultant (architect, engineer, contractor, etc.).
Enclose planning or architectural documents completed to date (1 set).
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12. Has a contract for architectural services or construction services been executed?
❑Yes F-1 N o
If so, indicate the scope of services to be provided under this contract and whether these
services were obtained through competitive negotiations, requests for applications or other
process.
13. Please check one of the following boxes regarding architectural services for this project:
❑ a signed, sealed bid process was utilized for acquiring architectural services
or
❑ project does not require architectural services
14. Describe the means by which the structure(s) affected by this project will be maintained
subsequent to restoration/rehabilitation. Include sources and estimated amounts of funding for
such maintenance. It is the County's policy not to fund operations and maintenance costs of
organizations notwithstanding any tourism promotional value of a project.
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PROJECT BUDGET AND TIMETABLE - ALL PROJECTS
1. Cost Estimates: List all major work items and the estimated costs of each. If the project
is phased, segregate clearly those costs for the phase to be assisted by the TDC funds
requested. All phases and total estimated cost of the entire project must be listed here.
Total cost of phase/project for which funds are requested:
a)Phase $
b)Project $
Amount of TDC funds requested: (Funds requested from TDC not to exceed 50% of the
total project cost)
a)Phase $
b)Project $
Total confirmed In -kind funds: $
2. Outline of expansion opportunity for acquiring further grants.
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3. Tentative timetable. Indicate all major project activities and the anticipated time required
to complete each stage of the project on the graph below.
Project Timetable (in months)
Project Activity 1 2 3 4 5 6 7 8 9 10 11 12
a).
b).
c).
d).
e).
f).
J)-
Please indicate any critical dates and explain why they are critical.
4. What is the total project cost: $
5. Length of time for project completion in months and year(s):
PROJECT BENEFITS - ALL PROJECTS
1. Is the primary purpose of the project to promote tourism in Monroe County?
F]Yes F-1No
2. How will the project promote tourism in Monroe County?
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ADDITIONAL INFORMATION - ALL PROJECTS:
1. District in which the project is located.
2. Population of city/district where project activity will take place.
3. Federal Employer's Identification Number of applicant's organization.
4. Permitting: List all permits required to complete this project.
5. Outline of proposed program in which this project will promote tourism in Monroe County.
6. Applicant must demonstrate the ability to complete the project as proposed and to
maintain and operate the project as a viable and long-term tourist attraction that is open to the
public.
Included in this demonstration should be a summary of the applicant's past grant
experience, past two (2) year's financial statements, proposed operational budget and
description of administrative resources available to applicant and committed to the project.
Attach financial statements, budgetary and other documents.
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NON -COLLUSION AFFIDAVIT and VERIFICATION
I, , of the city of according to
law on my oath, and under penalty of perjury, depose and say that:
1) I am
application for the project described as follows:
the applicant making the
2) The prices in this application 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 applicant or with any competitor;
3) Unless otherwise required by law, the prices which have been quoted in this
application have not been knowingly disclosed by the applicant and will not knowingly be
disclosed by the applicant prior to application opening, directly or indirectly, to any other
applicant or to any competitor; and
4) No attempt has been made or will be made by the applicant to induce any other
person, partnership or corporation to submit, or not to submit, an application 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.
VERIFICATION
HEREBY CERTIFY that I have read the forgoing application and that the facts stated herein
are true and correct to the best of my knowledge and belief.
President's/Mayor's Name Typed President's/Mayor's Signature
Sworn to and subscribed before me this Day of 20
personally appeared , , and
known to be the person named in and who executed the foregoing document.
My commission expires: Notary Public State of
Monroe County Tourist Development Council FY 2013 Capital Project Application
21
DRUG FREE WORKPLACE FORM
The undersigned vendor in accordance with Florida Statute 287.087 hereby certifies that:
(Name of Business)
1. Publishes a statement notifying employees that the unlawful manufacture, distribution,
dispensing, possession, or use of a controlled substance is prohibited in the workplace and
specifying the actions that will be taken against employees for violations of such prohibition.
2. Informs employees about the dangers of drug abuse in the workplace, the business's
policy of maintaining a drug -free workplace, any available drug counseling, rehabilitation, and
employee assistance programs, and the penalties that may be imposed upon employees for
drug abuse violations.
3. Gives each employee engaged in providing the commodities or contractual services that
are under application a copy of the statement specified in subsection (1).
4. In the statement specified in subsection (1), notifies the employees that, as a condition of
working on the commodities or contractual services that are under application, the employee will
abide by the terms of the statement and will notify the employer of any conviction of, or plea of
guilty or nolo contendere to, any violation of Chapter 893 (Florida Statutes) or of any controlled
substance law of the United States or any state, for a violation occurring in the workplace no
later than five (5) days after such conviction.
5. Imposes a sanction on, or require the satisfactory participation in a drug abuse assistance
or rehabilitation program if such is available in the employee's community, or any employee who
is so convicted.
6. Makes a good faith effort to continue to maintain a drug -free workplace through
implementation of this section.
As the person authorized to sign the statement, I certify that this firm complies fully with the
above requirements.
Applicant's Signature:
Date:
Monroe County Tourist Development Council FY 2013 Capital Project Application
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k)
ATTACHMENTS AND CERTIFICATIONS -ALL PROJECTS
The following supporting documents are attached.
F-I Proof of ownership/consent of owner for use of property as outlined in this
application:
(i) F-I Official record reference for ownership documentation; or
(ii) F-I Consent letter from owner for use of property as outlined in this application
F-I Citations to applicable protective ordinance if applicable
F-I Copy of letter designating project supervisor
F-I Map showing location and boundaries of project area (for all types of
projects involving specific site or area which cannot be identified by a street
address)
F-I Photographs of existing conditions of project site(s) or area -one set of
originals and 7 photocopies
F-I Documentation of confirmed project funds
F-I Annual operating budget upon completion
F-I Plans and specifications, if completed (development projects only —one set)
F-I All restrictive documents governing use of the property
F-I Non -Collusion Affidavit and Verification Form (notarized)
F-I Drug Free Workplace Form
certify that the information contained in this application is true and correct to the best of my
knowledge, and that I am the duly authorized representative of the applicant.
Signature:
Title:
Date:
Monroe County Tourist Development Council FY 2013 Capital Project Application
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