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Item C13 C.13 County f � .�� ",�, 1 BOARD OF COUNTY COMMISSIONERS Mayor Craig Cates,District 1 Mayor Pro Tem Holly Merrill Raschein,District 5 The Florida Keys Michelle Lincoln,District 2 James K.Scholl,District 3 David Rice,District 4 County Commission Meeting December 7, 2022 Agenda Item Number: C.13 Agenda Item Summary #11482 BULK ITEM: Yes DEPARTMENT: Emergency Management TIME APPROXIMATE: STAFF CONTACT: Jeff Manning (305)289-6325 NA AGENDA ITEM WORDING: Approval to amend contract with Deliver Lean Services, LLC, to reflect change of ownership and name; NationsMarket, LLC. All other terms and conditions of contract approved at the September 21st, 2022 BOCC meeting remain in effect. ITEM BACKGROUND: Monroe County approved renewal of the contract with Lean Culinary Services, LLC. d.b.a.Deliver Lean, at the September 21 st, 2022 BOCC meeting to provide emergency feeding services during disaster or other emergency incidents. NationsMarket, LLC acquired Lean Culinary Services September 21st, 2022. NationsMarket LLC agrees to continue under terms and conditions of the approved agreement. PREVIOUS RELEVANT BOCC ACTION: Monroe County BOCC approved the initial agreement with Lean Culinary Services at the October 21 st, 2020 meeting, and approved renewal of the agreement at the September 21 st, 2022 meeting. CONTRACT/AGREEMENT CHANGES: First amendment to contract for emergency feeding serivices to reflect change of ownership and name STAFF RECOMMENDATION: Approve DOCUMENTATION: AMENDMENT TO DELIVER LEAN CONTRACT Nations Market Final Agenda DeliverLean Renewal Executed 2022 10 COI NationsMarket signed exp 12 20 2022 W-9 NationsMarket FINANCIAL IMPACT: Packet Pg.468 C.13 Effective Date: December 7', 2022 Expiration Date: October 18', 2023 Total Dollar Value of Contract: TBD Total Cost to County: TBD Current Year Portion: Budgeted: Source of Funds: CPI: Indirect Costs: Estimated Ongoing Costs Not Included in above dollar amounts: Revenue Producing: If yes, amount: Grant: County Match: Insurance Required: YES Additional Details: 12/07/22 001-13500 - EMERGENCY MANAGEMENT $0.00 TBD REVIEWED BY: Shannon Weiner Completed 11/20/2022 10:24 AM James Molenaar Completed 11/21/2022 12:11 PM Purchasing Completed 11/21/2022 12:25 PM Budget and Finance Completed 11/21/2022 12:28 PM Brian Bradley Completed 11/21/2022 2:15 PM Lindsey Ballard Completed 11/21/2022 2:37 PM Board of County Commissioners Pending 12/07/2022 9:00 AM Packet Pg.469 DocuSign Envelope ID:91 B907AA-FC54-488D-B677-4896760F77CA C.13.a FIRST AMENDMENT TO THE CONTRACT FOR STANDBY EMERGENCY FEEDING SERVICES This First Amendment made and entered into 71h day of December 2022,by and between Monroe County, a political subdivision of the State of Florida, whose address is 1100 Simonton Street, Key West Florida 33040, its successors and assigns, hereinafter referred to as "County," through the Monroe County Board of County Commissioners ("BOCC") 0 AND c- 0 NationsMarket, LLC,whose principal address is 1801 NW 661h Avenue, Suite 100, 0 Plantation, FL 33313, its successors and assigns, hereinafter referred to as "Contractor". WITNESSETH: WHEREAS, in the event of an emergency or major disaster, including but not limited to storms, natural and man-made disasters, acts of terrorism or other declared State of � Emergency, the County will need to provide feeding services for its emergency workers, U_ including Monroe County employees and other authorized personnel when in the County 0 performing essential work in order to be able to provide County services and to support response and recovery efforts; and U) WHEREAS, these emergency workers will be working throughout Monroe County and in or near the County Emergency Operations Center in Marathon, Florida, and therefore feeding services are expected to be required throughout Monroe County in order to restore and provide U County services and provide the necessary response and recovery services; and 9 z WHEREAS, Contractor is located in Plantation, Florida and is willing and able to U provide feeding services during future emergencies or major disasters, should the County need z feeding services for its emergency workers in the event of an emergency or major disaster; and W WHEREAS, County and Lean Culinary Services, LLC d.b.a Deliver Lean, entered into > an agreement for the provision of emergency feeding services for a period of two years which W expired October 20, 2022; and a 0 WHEREAS, Lean Culinary Services was acquired by NationsMarket, LLC; and WHEREAS, County and NationsMarket, LLC, agreed to renew said agreement on October 19th 2022; and WHEREAS, County and NationsMarket, LLC desire to continue under terms and conditions of the existing agreement; and �E c� WHEREAS, it is in the mutual best interests of the County and Contractor to amend the Agreement to reflect this corporate name change. Packet Pg.470 DocuSign Envelope ID:91 B907AA-FC54-488D-B677-4896760F77CA C.13.a NOW THEREFORE, in consideration of the mutual promises, covenants and agreements stated herein and in the original and renewed Agreements; and for other good and valuable consideration, the sufficiency of which is hereby acknowledged, the parties agree as follows: E 1. Effective December 7th, 2022, County and Contractor agree to amend the Contract for Standby Emergency Feeding Services to reflect the change in ownership of Contractor. 2. County and Contractor will continue to perform all of their duties,responsibilities, and ti obligations tinder the Agreement. 0 3. Where the corporate name, Lean Culinary Services, LLC., or Deliver Lean appears in the original Agreement and Renewal Agreement, the name shall hereinafter be amended to read "NationsMarket„ LLC" 4. The remaining provisions of the Renewed Agreement dated October 19th 2022, as amended, not inconsistent herewith, remain in ftull force and effect. IN WITNESS WHEREOF, the parties have caused this Agreement to be executed the date set forth below. Seal: BOARD OF COUNTY COMMISSIONERS KEVIN MADOK, Clerk OF MONROE COUNTY, FLORIDA z U By: By: As Deputy Clerk Mayor U z (Seal) CONTRACTOR Attest: By: By: CEO Title: Title: qp E c5 James D. Digitally signed by James D. Molenaar Molenaar Date:2022.11.2112:11:17 -05'00' Approved as to Form and Legal Sufficiency James D. Molenaar Asst. County Attorney MONROE COUNTY ATTORNEY'S OFFICE Packet Pg.471 io- Kevin Madok, cpA Clerk of the Circuit Court& Comptroller—Monroe County, Florida DATE: ()(-tol)cr 14, 2022 TO: Jell'NImining, Sr. Plminer Emergency N11miagerrient FROM: Pmucla G I Imico4i—C. SUBJECT: September 21" B()CC Nlcctliig E Attaclicd is mi electronic copy oftlic following 11cm for your liandfing: E C 13 1 st Renc%val of'Staridby Agreement for Imiergency Feeding Services willi 1kari Culinan- Services 1,11C (1/b/a Deliver 1,cmi, I*or one year. 0 U 4- 0 Sliould you liavc miN-questions please feel free to contact nie at (305) 292-3550. 0 CL CL x W E CC: Comity Attonicy F111MICe File KEY WEST MARATHON PLANTATION KEY 500 Whitehead Street 3117 Overseas Highway 88770 Overseas Highway Key West, Florida 33040 Marathon, Florida 33050 Plantation Key, Florida 33070 1 Packet Pg. 472 C.13.b MONROE COUNTY FIRST RENEWAL OF CONTRACT FOR STANDBY EMERGENCY FEEDING SERVICES FIRST RENEWAL OF STANDBY AGREEMENT FOR EMERGENCY FOOD SERVICES THIS FIRST RENEWAL AGREEMENT ("Agreement"), is made and entered into as of this 19t"day of October, 2022 ("Effective Date") by and between Lean Culinary Services LLC d/b/a DeliverLean, 2050 McKinley Street, Bay 2, Hollywood, FL 33020 (hereinafter referred to as "Contractor") and Monroe County Board of County Commissioners (BOCC), hereinafter referred to as "County" (collectively, "Parties") in accordance with the terms and conditions of the original agreement executed October 20, 2020, and set to expire October 20, 2022. 0 U WHEREAS, in the event of an emergency or major disaster, including but not limited to storms, natural and man-made disasters, acts of terrorism or other declared State of Emergency, the County will need to provide feeding services for its emergency workers, including Monroe County employees and other authorized personnel when in the County performing essential work in order to be able to provide County services and to support response and recovery efforts, and WHEREAS, these emergency workers will be working throughout Monroe County and in or near the County Emergency Operations Center in Marathon, Florida, and therefore feeding services are expected to be required throughout Monroe County in order to restore and provide County services and provide the necessary response and recovery services; and WHEREAS, Contractor is located in Hollywood, Florida and is willing and ableto provide feeding services during future emergencies or major disasters, should the County need feeding services for its emergency workers in the event of an emergency or major disaster; WHEREAS, Contractor and County entered into an agreement for the provision of emergency feeding services for a period of two years which expires October 20, 2022; NOW THEREFORE, in consideration of the mutual promises and covenants contained herein, the Parties hereby agree as follows: 1 Packet Pg.473 C.13.b 1.0 Description ofGoods/Services. This Agreement consists of this document, including all exhibits and attachments. The intent of this Agreement is to enter into a non-exclusive contract with a vendor who will provide sufficient food for responders after a hurricane or other disaster. The term "Responders" will include both people working in the County's Emergency Operations Center (EOC), wherever the EOC may be located, as well as other Responders working in the field in locations away from the EOC. The services of the Contractor will be activated only after issuance of (a) a local declaration of emergency by the Mayor, Mayor Pro Tern or Sheriff of Monroe County, pursuant to Section 11-1 of the Monroe County Code, and (b) a Task Order signed by one of the following: Monroe County Emergency Management Director or Monroe County Budget Director. If activated, the Contractor will be notified via a telephone call to the contact person listed below, followed by a text message ore•mail to confirm the activation. The County will make every attempt to notify the Vendor that the Task Order is being issued, at least thirty- U six (36) hours in advance of issuance of the Task Order. The Contractor shall report to and be supervised by the Food Unit Leader within the Monroe County Logistics Section operating within the Monroe County Emergency Operations Center. In the event of activation, the Contractor shall be provided with name and contact information for the Food Unit Leader at the time of activation. In the event that services are required, the services provided shall be as follows: X The Contractor will provide feeding services for County employees and for authorized County contractors/personnel in two groups/phases. The first group will consist of County emergency workers designated to remain in-County during an incident. The second group will consist of County employees called back to work in the County to perform essential work in order to provide County services, including response and recovery services post-incident. n Feeding services can reasonably be expected to begin one week before an incident (e.g., up to one week before expected landfall of a hurricane) and will continue for an indeterminate period of time as needed to perform and provide County Services. c� Depending upon the disaster circumstances, the Contractor may be required to stage equipment at multiple locations. It is expected that meals will be provided at the County's Emergency Management Operation Center in Marathon, Florida (currently located within the Marathon Government Center, 2798 Overseas Highway, Marathon Florida). In addition, additional locations for meal service may be necessary at different locations in the Keys. Currently, the County envisions that meals would be staged out of at least two (2) additional locations in the Upper Keys (e.g., Murray Nelson Building in Key Largo and a fire station in Tavernier) and two (2) additional locations in the Lower Keys (e.g., fire station 13 on Big Pine Key and fire station 8 on Stock Island) ("Additional Locations"). All of the Additional Locations have at least minimal kitchens. If the Additional Locations are activated, the Proposer will be 2 Packet Pg.474 C.13.b responsible for ensuring proper and necessary set-up, relocation, maintenance, protection and/or removal of such equipment including periodic and final clean-up of the staging site(s) upon request by the County. The County will provide the Additional Locations at no charge to the Contractor. 1.1 Each Task Order issued shallspecify: a) Which meals (breakfast, lunch, dinner and/or midnight snack) the Contractor will provide (depending on the capability of the Contractor, the County may split the meals and/or locations amongst multiple contractors); b) Locations; and c) Quantities, per meal and per location. 1.2 The Contractor, as tasked, shall provide appetizing, nutritional, andwell balanced hot and cold meals for up to four (4) designated times a day throughout a 24-hour period, as follows: 0 U 4- Breakfast Approx. 8 am each day Lunch Approx. 11 am — 1 pm each day 0 Dinner Approx. 5 pm — 7 pm each day Midnight Snack Approx. 11 pm — 1 am each day The Contractor may be tasked to serve up to four (4) meals per day, per employee, seven days a week or for a specific day of the week as tasked, per the hours of operation until such disaster is deemed concluded by the Mayor or his designee or the service becomes no longer necessary. All provided meals shall include but are not limited to o Condiments relevant to the mealprovided o Serving items such as disposable plates, utensils, and napkins o Selection of beverages that are iced down if required and cups if necessary E The County would prefer that box ("grab and go") lunches be used for the lunch meal. Box lunches may also be used for the Midnight Snack, at the Contractor's preference. The Contractor shall be responsible for all ingredient purchases, receipts, storage, issue, handling, processing, packaging, preparation, staging, and clean up before and after each meal. 1.3 Quantities. The Task Order shall notify the Contractor of the numbers of meals to be served. As a rough estimate, the County currently anticipates the following quantities- 3 Packet Pg.475 C.13.b Meal Location Number Breakfast Monroe County EOC - pre- storm 75 Breakfast Monroe County EOC - post- storm Up to 400 Breakfast Additional Locations - post- storm Up to 40 per location (4 locations Lunch Monroe County EOC - pre- storm 75 Lunch Monroe County EOC - post- storm Up to 400 Lunch Additional Locations Up to 40 per location (4 post-storm locations Dinner Monroe County EOC - pre- storm 75 c� Dinner Monroe County EOC - post- storm Up to 400 0 U 41 Dinner Additional Locations Up to 40 per location (4 0 post-storm locations Midni ht snack Monroe County EOC 140 CL CL 1.4 Personnel/Hygiene: Contractor shall comply with all applicable state and county health and safety codes related to food preparation. All areas that the Contractor operates shall be cleaned and sanitized on a regular basis per standard operating procedures. Contractor shall provide staff to supervise the daily cleaning and sanitation of the assigned areas and oversee maintenance of kitchen equipment. All employees of the Contractor shall be instructed on proper hygiene and appropriate dress while catering/serving the County. Proposer shall provide trained and competent culinary experts to manage and supervise the preparation of all meals. All employees of Contractor that are involved with food preparation will have food handler's training and certificate. E 1.5 Certifications Required: All contractors must provide proof that the business entity or individual is authorized to do business in the State of Florida and Monroe County and must have paid all necessary business taxes. At time of execution, and again upon activation if requested, the contractor must provide a copy of a current license from the State of Florida Department of Business and Professional Regulation, or other state equivalent. 2.0 Designated Point of Contact: The Contractor and the County will each provide a Designated Point of Contact and shall provide each other with all communication methods. The County Point of Contact will liaise with the Designated Point of Contact for the Contractor, to 4 Packet Pg.476 C.13.b provide a list of feeding needs. Both Designated Points of Contact will work with each other to resolve any issues thatarise. 3.0 Term. This Agreement is effective from October 19, 2022 through October 18, 2023("Initial Term"). At the end of the Initial Term this Agreement may be renewed in writing for additional periods ("Renewal Terms") of one (1) year each, subject to the mutual agreement of the parties. Monroe County's performance and obligation to pay under this contract is contingent upon an annual appropriation by the BOCC. 4.0 Fees, Invoices. a) All meals will be billed at the following rates: $12.00 per person (Boxed Breakfast) $14.00 per person (Boxed Lunch) $10.00 per person (Green Salad with Protein - steak or salmon option $2) $17.00 per person (Pre-packaged ready to heat and eat entrees) $8.00 per person (midnight snack) 0 U b) All Meal Charges will be paid for by the County upon presentation of an invoice, in accordance with the Florida Local Government Prompt 0 Payment Act. The invoices may be delivered by mail to: Monroe County, Office of Management & Budget 1100 Simonton St., Suite 2-213 Key West, FL 33040 Attn: Purchasing OR e-mailed to- OMB-Purchasing@MonroeCounty-fl.gov Subject line to read: EOC Invoice for Procurement Unit The Contractor shall submit to County invoices with supporting documentation 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. Each invoice must list the number of meals covered in the invoice, broken down by type of meal (breakfast, lunch, dinner Midnight Snack), head count per meal, and dates of service. c) The County is exempt from sales and use taxes. A copy of the tax exemption certificate will be provided upon request. d) Both parties understand that during a storm, the usual services and amenities available to the Contractor may not be available, including power and water. The Contractor will use its best efforts to provide the feeding services and prepare meals that do not require the use of power when such utility is not available or to prepare for alternative power 5 Packet Pg.477 C.13.b supply. 5.0 Insurance The Contractor shall provide certificates of insurance showing the following insurances prior to execution of this Agreement or shall submit and have approved a request for a waiver of the insurance. The coverages required are: workers' compensation, in statutory amounts; employer's liability insurance in the amount of $500,000 per accident/$500,000 bodily injury or bodily injury by disease, per employee; general liability, in a minimum amount of $500,000 combined single limit; and vehicle liability, in a minimum amount of $300,000 per person, $300,000 per occurrence, $300,000 property damage or $300,000 combined single limit. (At a minimum, vehicle liability must extend to owned, non-owned, and hired vehicles.) Monroe County or Monroe County Board of County Commissioners must be named as an additional insured on the general liability and vehicle liability policies, only. U 6.0 Miscellaneous. 0 6.1 Assignment. Neither party may assign (voluntarily, by operation of law, or otherwise) this Agreement (or any rights or obligations contained herein) without the prior written consent of the other party, whose consent shall not be unreasonably withheld. Any permitted assignee shall assume all obligations of its assignor under this Agreement. Any purported assignment or transfer in violation of this section shall be void. Should there be a change in ownership or management; the contract shall be canceled unless a mutual agreement is reached with the new owner or manager to continue the contract with its present provisions and pricing.. 6.2 Entire Agreement. This Agreement is the entire agreement between the parties. This Agreement supersedes all prior or contemporaneous oral or written communications, proposals, and representations with respect to ; the subject matter covered by this Agreement. The terms and conditions of this Agreement can only be modified via a written agreement signed by all parties. 6.3 Counterparts. This Agreement may be executed by the parties in separate counterparts each of which when so, executed and delivered shall be an original, but all such counterparts together shall constitute but one and the same instrument. 6 Packet Pg.478 C.13.b M6001 6ANo ces Any notice, cornrnuniration or paymerd required under Ws Age shall be addrasoed astollows: County: Codraclor. Mon oe counh 80CC Lean Culinary,Services.LLC 1100 S rnonton Street &a Dew Key West, FL 33040 Attn: Scott Harris Athr Ronan Gasbsk Coady Arbni*sfralor E .5 Federal and State Required,Public Records, and Scrutinized Business Co lied Clauses Do clauses included in Appendix B are hereby mcn�cra�d in this Aommed WHEREOF,the parties have ceased this AOreement to be ex xided the U ` below. 4 ,6 e BOARD OF COUNTY COMMISSIONERS � MADOK Cleric OF MOB COUKTY, FLORIDA wll l c5 AS Deputy Cleric MayaoWAsirrna n Date: 40 LV114fA.,_ e � ®a (Seal) CONSULTANT Adest Title: James D. y ftbft owl AS3L c01A�� ... .... . .,.. Packet Pg.479 C.13.b APPENDIX A SCOPE OF SERVICES 1. Scope of Services 1.1 General The County recognizes the vulnerability of its citizens to damage, injury and loss of life and property resulting from disasters. Such disasters require 24/7 responses from the County's emergency responders, County employees, various elected officials and appointed officials. Providing meals to these individuals is necessary in order for them to carry out their duties to the public effectively. E 1.2 Catering Requirements c� Contractor must mobilize, stage, and provide the required services within twenty- four (24) hours of notice to activate by the County. Where possible, and in c0 accordance with the County's emergency operation plan for such events, the 1 County will provide up to thirty-six (36) hours advance notice to the provider. Depending upon the disaster circumstances, the provider may be required to stage equipment at a pre- determined location. If so, the provider is solely responsible for ensuring proper and necessary set-up, relocation, maintenance, protection and/or removal of such equipment including periodic and final clean-up of the staging site(s) upon request by the County. Use of County facilities will be at no charge to the Contractor. However, if any damages occur at any staging areas directly resulting from such stating activities of the provider, Contractor will be responsible for the repair of such damage to its pre-damaged condition. Proposer shall provide hot and cold meals at four (4) designated times a day throughout a 24-hour period; approximately as follows: Breakfast Approx. 8 am each day Lunch Approx. 11 am - 1 Pm each Dinner Approx. 5 Pm - 7 Pm each Midni ht Snack Approx. 11 Pm - 1 am each to include breakfast, lunch, dinner, and a midnight meal. This service shall continue to serve four (4) meals per day, per employee, seven days a week, per the hours of operation until such disaster is deemed concluded by the Mayor or his or her designee. Meals will include but are not limited to all condiments, beverages, utensils, disposable plates, cups and staging of equipment and clean-up. Approximate personnel to be fed are between 25 and 400 depending on the size and duration of the incident. Proposer shall provide procurement, handling and storage of all food service-related items and products for up to 400 authorized persons. Proposer shall also provide kitchen equipment, staff, and management sufficient to cater up to 400 meals per mealtime and oversee all related activities. The Contractor may be tasked to serve up to four (4) meals per day, per employee, 8 Packet Pg.480 C.13.b seven days a week or for a specific day of the week as tasked, per the hours of operation until such disaster is deemed concluded by the Mayor or his designee or the service becomes no longer necessary. All provided meals shall include but are not limited to o Condiments relevant to the meal provided o Serving items such as disposable plates, utensils, and napkins o Selection of beverages that are iced down if required and cups if necessary The County would prefer that box ("grab and go") lunches be used for the lunch meal. Box lunches may also be used for the Midnight Snack, at the Contractor's preference. E The Contractor shall be responsible for all ingredient purchases, receipts, storage, issue, handling, processing, packaging, preparation, staging, and clean up before and after each meal. 0 U All hot meals and box lunches must conform to USDA USFS 14-day rotation meal plans regarding nutrition, food types, calorie counts, and means of service. The successful Proposer may be asked to provide a certain percentage of meals (approximately 20%) that are vegan or vegetarian. As a rule, Kosher meals will not < be required. If Kosher meals are required it is acknowledged that additional special arrangements will be made which may result in additional costs. c� X 1.3 Quantities. 76 The Task Order shall notify the Contractor of the numbers of meals to be served. As a rough estimate, the County currently anticipates the following quantities: Meal Location Number Breakfast Monroe County EOC - pre-storm 75 Breakfast Monroe County EOC - post-storm Up to 400 Breakfast Additional Locations - post-storm Up to 40 per location (4 locations) Lunch Monroe County EOC - pre-storm 75 Lunch Monroe County EOC - post-storm Up to 400 Lunch Additional Locations - post-storm Up to 40 per location (4 locations) Dinner Monroe County EOC - pre-storm 75 Dinner Monroe County EOC - post-storm Up to 400 Dinner Additional Locations - post-storm Up to 40 per location (4 locations) Midnight Monroe County EOC 40 9 Packet Pg.481 C.13.b 1.4 Personnel/Hygiene Contractor shall comply with all applicable state and county health and safety codes related to food preparation. All areas that the proposer operates shall be cleaned and sanitized on a regular basis per standard operating procedures. Contractor shall provide staff to supervise the daily cleaning and sanitation of the assigned areas and oversee maintenance of kitchen equipment. All employees of the Contractor shall be instructed on proper hygiene and appropriate dress while catering/serving the County. In the event of an emergency or disaster, Contractor shall provide trained and competent culinary experts to manage and supervise the preparation of all meals. All employees of proposer that are involved with food preparation will have food handler's training and certificate. c� 1.5 Additional Services 0 The County requests that each potential contractor's proposal provide a complete list of additional services that can be provided in addition to those requested within this RFP. c� X E c� 10 Packet Pg.482 C.13.b APPENDIX B FEDERAL, STATE, PUBLIC RECORDS AND SCRUTINIZED BUSINESS CONTRACT CLAUSES 1.0 Provisions Required by Federal Law, 2 CFR part200. 1.1 Termination: 1.1 .1 Termination for Convenience: The COUNTY may terminate this Agreement for convenience, at any time, upon sixty (60) days written notice to CONTRACTOR. If the COUNTY terminates this agreement with the CONTRACTOR, COUNTY shall pay CONTRACTOR the sum due the CONTRACTOR under this agreement prior to termination, unless the cost of E completion to the COUNTY exceeds the funds remaining in the contract. The maximum amount due to CONTRACTOR shall not exceed the spending cap in this Agreement. In addition, the COUNTY reserves allrights available to recoup 0 monies paid under this Agreement, including the right to sue for breach of contract and including the right to pursue a claim for violation of the COUNTY's False Claims Ordinance, located at Section 2-721 et al. of the Monroe County Code. Either party may cancel this Agreement without cause upon sixty (60) days' written notice of its intention to do so to the other party; however, this provision may not be exercised during hurricane season (June 1 to November 30) unless both parties mutually agree to terminate. In the event oftermination, the County shall owe for all goods and services delivered prior to the date of termination. 1.1 .2 Termination for Cause and Remedies: In the event of breach of any contract terms, the COUNTY retains the right to terminate this Agreement. The COUNTY may also terminate this agreement for cause with CONTRACTOR should CONTRACTOR fail to perform the covenants herein contained at the time and in the manner herein provided. In the event of such termination, prior to termination, the COUNTY shall provide CONTRACTOR with five (5)calendar days' notice and provide the CONTRACTOR with an opportunity to cure the breach that has occurred. If the breach is not cured, the Agreement will be terminated for cause. If the COUNTY terminates this agreement with the CONTRACTOR, COUNTY shall pay CONTRACTOR the sum due to the CONTRACTOR under this agreement prior to termination, unless the cost of completion to the COUNTY exceeds the funds remaining in the contract; however, the COUNTY reserves the right to assert and seek an offset for damages caused by the breach. The maximum amount due to CONTRACTOR shall not in any event exceed the spending cap in this Agreement. In addition, the COUNTY reserves all rights available to recoup monies paid under this Agreement, including the right to sue for breach of contract and including the right to pursue a claim for violation of the COUNTY's False Claims Ordinance, located at Section 2-721 et al. of the Monroe County Code. In the eventthat the CONTRACTOR shall be found to be negligent in any aspect of service,the 11 Packet Pg.483 C.13.b COUNTY shall have the right to terminate this agreement after five (5) days written notification to the CONTRACTOR. 1.2 Equal Employment Opportunity, No Discrimination Provisions: CONTRACTOR and COUNTY agree that there will be no discrimination against any person, and it is expressly understood that upon a determination by a court of competent jurisdiction that discrimination has occurred, this Agreement automatically terminates without any further action on the part of any party, effective the date of the court order. CONTRACTOR or COUNTY agrees to comply with all Federal and Florida statutes, and all local ordinances, as applicable, relating to nondiscrimination. These include butare not limited to: 1) Title VI I 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 c� 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 0 504 of the Rehabilitation Act of 1973, as amended (20 USC s. 794), which 4- 0 prohibits discrimination on the basis of handicaps; 4) The Age Discrimination Act of 1975, as amended (42 USC ss. 6101-6107) which prohibits 0 discrimination on the basis of age; 5) The Drug Abuse Office and Treatment Act of 1972 (PL 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; 6) The Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (PL 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; 7)The Public Health Service Act of 1912, ss. 523 and 527 (42 USC ss. 690dd-3 and 290ee-3), as amended, relating to confidentiality of alcohol and drug abuse patient records; 8)Title VI I I of the Civil Rights Act of 1968 (42 USC s. 3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; 9)The Americans with Disabilities Act of 1990(42 USC s. 12101 Note), as may be amended from time to time, relating to nondiscrimination on the basis of disability; 10) Monroe County Code Chapter 14, Article II, which prohibits discrimination on the basis of race, color, sex, religion, national origin, ancestry, sexual orientation, gender identity or expression, familial status or age; 11) Any other nondiscrimination provisions in any Federal or state statutes which may apply to the parties to, or the subject matter of, this Agreement. During the performance of this Agreement, the CONTRACTOR, in accordance with Equal Employment Opportunity (30 Fed. Reg. 12319, 12935, 3 C.F.R. Part, 1964-1965 Comp., p. 339), as amended by Executive Order 11375, Amending Executive Order 11246 Relating to Equal Employment Opportunity, and implementing regulations at 41C.F.R. Part 60 (Office of Federal Contract Compliance Programs, Equal Employment Opportunity, Department of Labor). See 2 C.F.R. Part 200, Appendix II, T C agrees as follows: 12 Packet Pg.484 C.13.b 1) The contractor will not discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, or national origin. The contractor will take affirmative action to ensure that applicants are employed, and that employees are treated during employment, without regard to their race, color, religion, sex, sexual orientation, gender identity, or national origin. Such action shall include, but not be limited to the following: Employment, upgrading, demotion, or transfer, recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. The contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided by the contracting officer setting forth the provisions of this nondiscrimination clause. 2) The contractor will, in all solicitations or advertisements for employees placed by or on behalf of the contractor, state that all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, or nationalorigin. 3) The contractor will not discharge or in any other manner discriminate against any employee or applicant for employment because such employee or applicant has inquired about, discussed, or disclosed the compensation of the employee or applicant or another employee or applicant. This provision shall not apply to instances in which an employee who has access to the compensation information of other employees or applicants as a part of such employee's essential job functions discloses the compensation of such other employees or applicants to individuals who do not otherwise have access to such information, unless such disclosure is in response to a formal complaint or charge, in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or is consistent with the contractor's legal duty to furnish information. 4) The contractor will send to each labor union or representative of workers with which it has a collective bargaining agreement or other contract or understanding, a notice to be provided by the agency contracting officer, advising the labor union or workers' representative of the contractor's commitments under section 202 of Executive Order 11246 of September 24, 1965, and shall post copies of the notice in conspicuous places available to employees and applicants foremployment. 5) The contractor will comply with all provisions of Executive Order 11246 of September 24, 1965, and of the rules, regulations, and relevant orders of the Secretary of Labor. 6) The contractor will furnish all information and reports required by Executive Order 11246 of September 24, 1965, and by the rules, regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit 13 Packet Pg.485 C.13.b access to his books, records, and accounts by the contracting agency and the Secretary of Labor for purposes of investigation to ascertain compliance with such rules, regulations, and orders. 7) In the event of the contractor's non-compliance with the nondiscrimination clauses of this contract or with any of such rules, regulations, or orders, this contract may be canceled, terminated or suspended in whole or in part and the contractor may be declared ineligible for further Government contracts in accordance with procedures authorized in Executive Order 11246 of September 24, 1965, and such other sanctions may be imposed and remedies invoked as provided in Executive Order 11246 of September 24, 1965, or by rule, regulation, or order of the Secretary of Labor, or as otherwise provided bylaw. 8) The Contractor will include the portion of the sentence immediately preceding paragraph (1) and the provisions of paragraphs (1) through (7) in every subcontract or purchase order unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to section 204 of U Executive Order 11246 of September 24, 1965, so that such provisions will be binding upon each subcontractor or vendor. The Contractor will take such action with respect to any subcontract or purchase order as the administering 0 agency may direct as a means of enforcing such provisions, including sanctions for non-compliance; provided, however, that in the event a contractor becomes involved in, or is threatened with, litigation with a subcontractor or vendor as a result of such direction by the administering agency the contractor may request the United States to enter into such litigation to protect the interests ofthe United States. 1.3 OTHER FEDERAL CONTRACT REQUIREMENTS CONTRACTOR and its subcontractors must follow the provisions, as applicable, as set forth in 2 C.F.R. §200.326 Contract provisions and Appendix II to 1 C.F.R. Part 200, as amended, including but not limited to: A. Contract Work Hours and Safety Standards Act (40 U.S.C. 3701-3708). Where applicable, which includes all FEMA grant and cooperative agreement programs, all contracts awarded by the COUNTY in excess of $100,000 that involve the employment of mechanics or laborers must comply with 40 U.S.C.§§ 3702 and 3704, as supplemented by Department of Labor regulations (29 CFR Part 5). Under 40 U.S.C. §3702 of the Act, each contractor must compute the wages of every mechanic and laborer on the basis of a standard work week of 40 hours. Work in excess of the standard work week is permissible provided that the worker is compensated at a rate of not less than one and a half times the basic rate of pay for all hours worked in excess of 40 hours in the work week. The requirements of40 U.S.C. 3704 are applicable to construction work and provide that no laborer or mechanic must be required to work in surroundings or under working conditions which are unsanitary, hazardous or dangerous. These requirements do not apply to 14 Packet Pg.486 C.13.b the purchases of supplies or materials or articles ordinarily available on the open market, or contracts for transportation or transmission of intelligence. Compliance with the Contract Work Hours and Safety Standards Act. (1) Overtime requirements. No contractor or subcontractor contracting for any part of the contract work which may require or involve the employment of laborers or mechanics shall require or permit any such laborer or mechanic in any workweek in which he or she is employed on such work to work in excess of forty hours in such workweek unless such laborer or mechanic receives compensation at a rate not less than one and one-half times the basic rate of pay for all hours worked in excess of forty hours in such workweek. (2) Violation; liability for unpaid wages; liquidated damages. In the event of any violation of the clause set forth in paragraph 29 C.F.R. § 5.5(b)(1) the contractor and any subcontractor responsible therefor shall be liable for the unpaid wages. In addition, such contractor and subcontractor shall be liable to the United States (in the case of work done under contract for the District of U Columbia or a territory, to such District or to such territory), for liquidated damages. Such liquidated damages shall be computed with respect to each individual laborer or mechanic, including watchmen and guards, employed in violation of the clause set forth in paragraph 29 C.F.R. § 5.5 (b)(1), in the sum of $27 for each calendar day on which such individual was required or permitted to work in excess of the standard workweek of forty hours without payment of the overtime wages required by the clause set forth in paragraph 29 C.F.R. § 5.5 (b)(1). (3) Withholding for unpaid wages and liquidated damages. The Federal agency shall upon its own action or upon written request of an authorized representative of the Department of Labor withhold or cause to be withheld from any moneys payable on account of work performed by the contractor or subcontractor under any such contract or any other Federal contract with the same prime contractor, or any other federally-assisted contract subject to the Contract Work Hours and Safety Standards Act, which is held by the same prime contractor, such sums as may be determined to be necessary to satisfy any liabilities of such contractor or subcontractor for unpaid wages and liquidated damages as provided in the clause set forth in paragraph29 C.F.R. § 5.5 (b)(2). (4) Subcontracts. The contractor or subcontractor shall insert in any subcontracts the clauses set forth in paragraph 29 C.F.R. § 5.5 (b)(1) through (4) and also a clause requiring the subcontractors to include these clauses in any lower tier subcontracts. The prime contractor shall be responsible for compliance by any subcontractor or lower tier subcontractor with the clauses set forth in paragraphs 29 C.F.R. § 5.5 (1) through (4). B. Rights to Inventions Made Under a Contract or Agreement. If the Federal award meets the definition of "funding agreement" under 37 CFR §401.2 (a) and the recipient or subrecipient wishes to enter into a contract with a small business firm or nonprofit organization regarding the substitution of parties, assignment or 15 Packet Pg.487 C.13.b performance of experimental, developmental, or research work under that "funding agreement," the recipient or subrecipient must comply with the requirements of 37 CFR Part 401, "Rights to Inventions Made by Nonprofit Organizations and Small Business Firms Under Government Grants, Contracts and Cooperative Agreements," and any implementing regulations issued by the awarding agency. C. Clean Air Act (42 U.S.C. 7401-7671 q.) and the Federal Water Pollution Control Act (33 U.S.C. 1251-1387). Contractor agrees to comply with all applicable standards, orders or regulations issued pursuant to the Clean Air Act, as amended (42 U.S.C. §§7401-7671q) and the Federal Water Pollution Control Act, as amended (33 U.S.C. §§1251-1387) and will report violations to FEMA/Federal Agency and the appropriate Regional Office of the Environmental Protection Agency (EPA). The Clean Air Act (42 U.S.C. 7401-7671q.) and the Federal Water Pollution Control Act (33 U.S.C. 1251-1387), as amended—applies to Contracts and subgrants of amounts in excess of $150,000. The contractor agrees to include these requirements in each subcontract exceeding $150,000 financed in whole or in part with Federal assistance provided by FEMA/Federal agency. The contractor agrees to report each violation to the COUNTY and understands and agrees that U the COUNTY will, in turn, report each violation as required to assure notification to FEMA/Federal Agency and the appropriate EPA Regional Office. 0 D. Debarment and Suspension (Executive Orders 12549 and 12689)—A contract award under a "covered transaction" (see 2 CFR 180.220) must not be made to parties listed on the governmentwide exclusions in the System for Award Management (SAM), in accordance with the OMB guidelines at 2 CFR Part 180 that implement Executive Orders 12549 (3 CFR part 1986 Comp., p. 189) and 12689 (3 CFR part 1989 Comp., p. 235), "Debarment and Suspension" and the Department of Homeland Security's regulations at 2 C.F.R. Part 3000 (Nonprocurement Debarment and suspension) SAM Exclusions contains the names of parties debarred, suspended, or otherwise excluded by agencies, aswell as parties declared ineligible under statutory or regulatory authority other than Executive Order 12549. SAM exclusions can be accessed at www.sam.gov. Contractor is required to verify that none of the contractor's principals (defined at 2 C.F.R. §180.935) or its affiliates (defined at 2 C.F.R. §180.905) are excluded (defined at 2 C.F.R. §180.940) or disqualified (defined at 2 C.F.R. §180.935). The contractor must comply with 2 C.F.R. pt. 180, subpart C and 2 C.F.R. pt. 3000, subpart C, and must include a requirement to comply with these regulations in any lower tier covered transaction it enters into. This certification is a material representation of fact relied upon by the COUNTY. If it is later determined that the contractor did not comply with 2 C.F.R. pt. 180, subpart C and 2 C.F.R. pt. 3000, subpart C, in addition to remedies available to the COUNTY, the Federal Government may pursue available remedies, including but not limited to suspension and/or debarment. Bidders or Proposers agree to comply with the requirements of 2 C.F.R. pt. 180, subpart C and 2 C.F.R. pt. 3000, subpart C while this offer is valid and throughout the period of any contract that may arise from this offer. The Bidder or Proposer further agrees to include a provision requiring such compliance in its lower tier covered transactions. 16 Packet Pg.488 C.13.b E. Byrd Anti-Lobbying Amendment (31 U.S.C. 1352)-Contractors that apply or bid for an award exceeding $100,000 must file the required certification. Each tier certifies to the tier above that it will not and has not used Federal appropriated funds to pay any person or organization for influencing or attempting to influence an officer or employee of any agency, a member of Congress, officer or employee of Congress, or an employee of a member of Congress in connection with obtaining any Federal contract, grant or any other award covered by 31 U.S.C. § 1352. Each tier must also disclose any lobbying with non-Federal funds that takes place in connection with obtaining any Federal award. Such disclosures are forwarded from tier to tier up to the recipient who in turn will forward the certification(s) to the awarding agency. If award exceeds $100,00, the attached certification must be signed and submitted by the contractor to the COUNTY. F. Compliance with Procurement of recovered materials as set forth in 2 CFR§ 200.323. CONTRACTOR must comply with section 6002 of the Solid Waste disposal Act, as amended, by the Resource Conservation and Recovery Act. The requirements of Section 6002 include procuring only items designated in guidelines of the Environmental Protection Agency (EPA) at 40 CFR part 247 that contain the U highest percentage of recovered materials practicable, consistent with maintaining a satisfactory level of competition, where the purchase price of the item exceeds $10,000 or the value of the quantity acquired during the preceding fiscal year exceeded $10,000; procuring solid waste management services in a manner that maximizes energy and resource recovery; and establishing an affirmative procurement program for procurement of recovered materials identified in theEPA guidelines. In the performance of this contract, the Contractor shall make maximum use of products containing recovered materials that are EPA-designated items unless the productcannotbeacquired- 1. Competitively within a timeframe providing for compliance with the contract performance schedule; 2. Meeting contract performance requirements;or 3. At a reasonable price. Information about this requirement, along with the list of EPA-designated items, is available at EPA's Comprehensive Procurement Guidelines web site, I� :// .e: s. cv/ n n / cn ire: li e: dive: irc uire: nee: i .... elide: 111 ne:.... irc irsn ,,,,,,,,,,,q ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,'r,q,,,,,,, ,,,,,,,,,,,,,,,,g,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, The Contractor also agrees to comply with all other applicable requirements of Section 6002 of the Solid Waste Disposal Act. G. Prohibition on certain telecommunications and video surveillance services or equipment as set forth in 2 CFR § 200.216. Recipients and subrecipients and their contractors and subcontractors may not obligate or expend any federal funds to (1) Procure or obtain; (2) Extend or renew a contract to procure or obtain; or (3) Enter into a contract (or extend or renew a contract) to procure or obtain equipment, services, or systems that uses covered telecommunications equipment or services as a substantial or essential component of any system, or as critical technology as part of any system. As described in Public Law 115-232, section 889, covered telecommunications equipment is telecommunications equipment produced by Huawei Technologies 17 Packet Pg.489 C.13.b Company or ZTE Corporation (or any subsidiary or affiliate of such entities). (i) For the purpose of public safety, security of government facilities, physical security surveillance of critical infrastructure, and other national security purposes, video surveillance and telecommunications equipment produced by Hytera Communications Corporation, Hangzhou Hikvision Digital Technology Company, or Dahua Technology Company (or any subsidiary or affiliate of such entities). (ii) Telecommunications or video surveillance services provided by such entities or using such equipment. (iii) Telecommunications or video surveillance equipment or services produced or provided by an entity that the Secretary of Defense, in consultation with the Directorof the National Intelligence or the Director of the Federal Bureau of Investigation, reasonably believes to be an entity owned or controlled by, or otherwise connected to, the government of a covered foreign country. H. Domestic preference for procurements as set forth in 2 CFR §200.322 The COUNTY and CONTRACTOR should, to the great extent practicable, provide a preference for the purchase, acquisition, or use of goods, products, or materials produced in the United States (including but not limited to iron, aluminum, steel,cement, U and other manufactured products). These requirements of this section must be included in all subawards including contracts and purchase orders for work or products under federal award. For purposes of this section- (1) "Produced in the United States" means, for iron and steel products, that all manufacturing processes, from the initial melting stage through the application of coatings, occurred in the United States. (2) "Manufactured products" means items and construction materials composed in whole or in part of non-ferrous metals such as aluminum; plastics and polymer-based products such as polyvinyl chloride pipe; aggregates such as concrete; glass, including optical fiber; and lumber. G. Americans with Disabilities Act of 1990, as amended (ADA) - The CONTRACTOR will comply with all the requirements as imposed by the ADA, the regulations of the Federal government issued thereunder, and the assurance by the CONTRACTOR pursuantthereto. H. Disadvantaged Business Enterprise (DBE) Policy and Obligation - It is the policy of the COUNTY that DBEs, as defined in 49 C.F.R. Part 26, as amended, shall have the opportunity to participate in the performance of contracts financed in whole or in part with COUNTY funds under this Agreement. The DBE requirements of applicable federal and state laws and regulations apply to this Agreement. The COUNTY and its CONTRACTOR agree to ensure that DBE's have the opportunity to participate in the performance of this Agreement. In this regard, all recipients and contractors shall take all necessary and reasonable steps in accordance with 2 C.F.R. § 200.321( as set forth in detail below), applicable federal and state laws and regulations to ensure that the DBE's have the opportunity to compete for and perform contracts. The COUNTY and the CONTRACTOR and subcontractors shall not discriminate on the basis of race, color, national origin or sex in the award and performance of contracts, entered pursuant to this Agreement. 18 Packet Pg.490 C.13.b 2 C.F.R. § 200.321 CONTRACTING WITH SMALL AND MINORITY BUSINESSES, WOMEN'S BUSINESS ENTERPRISES, AND LABOR SURPLUS AREA FIRMS a. If the CONTRACTOR, with the funds authorized by this Agreement, seeks to subcontract goods or services, then, in accordance with 2 C.F.R. §200.321, the CONTRACTOR shall take the following affirmative steps to assure that minority businesses, women's business enterprises, and labor surplus area firms are used whenever possible. b. Affirmative steps must include- (1) Placing qualified small and minority businesses and women's business enterprises on solicitation lists; Assuring that small and minority businesses, and women's business enterprises are solicited whenever they are potential sources; (2) Dividing total requirements, when economically feasible, into smaller tasks or quantities to permit maximum participation by small and minority businesses, and women's business enterprises; U (3) Establishing delivery schedules, where the requirement permits, which encourage participation by small and minority businesses,and 0 women's business enterprises- (4) Using the services and assistance, as appropriate, of such organizations as the Small Business Administration and the Minority Business Development Agency of the Department of Commerce. (5) Requiring the Prime contractor, if subcontractor are to be let, to take the affirmative steps listed in paragraph (1) through (5)of this section. I. E-Verify - The Contractor shall utilize the U.S. Department of Homeland Security's E-Verify system to verify the employment eligibility 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 employment eligibility of all new employees hired by the subcontractor during the Contractterm. J. Energy Efficiency- CONTRACTOR will comply with the Energy Policy and Conservation Act (P.L. 94-163; 42 U.S.C. 6201-6422) and with all mandatory standards and policies relating to energy efficiency and the provisions of the state Energy Conservation Plan adopted pursuant thereto. Additional FEMA Requirements- K. Access to Records - Contractor and their successors,transferees, assignees, and subcontractors acknowledge and agree to comply with 19 Packet Pg.491 C.13.b applicable provisions governing the Department of Homeland Security (OHS) and the Federal Emergency Management Agency's (FEMA) access to records, accounts, documents, information, facilities, and staff. Contractors must; 1 . cooperate with any compliance review or complaint investigation conducted by OHS, 2. Give OHS access to and the right to examine and copy records, accounts, and other documents and sources of information related to the grant and permit access to facilities, personnel, and other individuals and information as may be necessary, as required by OHS regulations and other applicable laws or program guidance, 3. Submit timely, complete, and accurate reports to the appropriate OHS officials and maintain appropriate backup documentation to support the reports. L. DHS Seal, Logo and Flags - Contractor shall not use the Department of Homeland Security seal(s), logos, crests, orreproduction of flags or likeness of DHS agency officials without specific FEMA pre-approval. The Contractorshall include this provision in any subcontracts. 0 M. Changes to Contract - The Contractor understands and agrees that any U cost resulting from a change or modification, change order, or constructive change of the agreement must be within the scope of any Federal grant or cooperative agreement that may fund this Project and be reasonable for the completion of the Project. Any contract change or modification, change orderor constructive change must be approved in writing by both the COUNTY and Contractor. X N. Maintenance of 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. Records shall be retained for a period of seven years from the termination of this agreement or for a period of five years from the submission of the final expenditure report as per 2 CFR §200.333, whichever is greater. Each party to this Agreement or its authorized representatives shall have reasonable and timely access to such records of each other party to this Agreement for public records purposesduring 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, or were wrongfully retained by the CONTRACTOR, the CONTRACTOR shall repay the monies together with interest calculated pursuant to Sec. 55.03, of the Florida Statutes, running from the date the monies were paid by the COUNTY. O. Compliance with Federal Law, Regulations, and Executive Orders. This is an acknowledgement that FEMA financial assistance may be used to fund all or aportion of the contract. The contractor will comply will all applicable Federal Law, regulations, executive orders, FEMA policies, procedures, and directives 20 Packet Pg.492 C.13.b P. No Obligation by Federal Government. The Federal Government is not a party to this contract and is not subject to any obligations or liabilities to the COUNTY/non- Federal entity, contractor, or any other party pertaining to any matter resulting from the contract. Q. Program Fraud and False or Fraudulent Statements or Related Acts. If applicable, the contractor acknowledges that 31 U.S.C. Chap. 38 (Administrative Remedies for False Claims and Statements) applies to the contractor's actions pertaining to this contract. 1.4 Florida Division of Emergency Management Requirements: A. The Contractor is bound by any terms and conditions of the Federally- Funded Subaward and Grant Agreement between County and the Florida Division E of Emergency Management. B. The CONTRACTOR shall hold the Division and COUNTY harmless 0 against all claims of whatever nature arising out of the CONTRACTOR's performance of work under this Agreement, to the extent allowed and required by law. 0 1.5 Florida Public Records Requirements: Pursuant to F.S. 119.0701 and the terms and conditions of this contract, 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 bylaw. (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 21 Packet Pg.493 C.13.b must be made directly to the County, but if the County does not possess the requested records, the County shall immediately notify the CONTRACTOR of the request, and the CONTRACTOR must provide the records to the County or allow the records to be inspected or copied within a reasonable time. If the CONTRACTOR does not comply with the County's request for records, the County shall enforce the public records contract provisions in accordance with the contract, notwithstanding the County's option and right to unilaterally cancel this contract upon violation of this provision by the CONTRACTOR. A CONTRACTOR who fails to provide the public records to the County or pursuant to a valid public records request within a reasonable time may be subject to penalties under section 119.10, Florida Statutes. The CONTRACTOR shall not transfer custody, release, alter, destroy or otherwise dispose of any public records unless or otherwise provided in this provision or as otherwise provided by law. IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO U PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS, BRIAN BRADLEY AT PHONE# 305-292- 3470 BRADLEY-BRIAN@MONROECOUNTY-FL.GOV, MONROE COUNTY ATTORNEY'S OFFICE 1111 12TH Street, SUITE 408, KEY WEST, FL 33040. 1.6 Scrutinized Businesses: For Contracts of any amount, if the County determines that the Contractor has submitted a false certification under Section 287.135(5), Florida Statutes or 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. 1.7 Required County Forms: A. Public Entity Crime Statement. In accordance with F.S. 287.133, 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, proposal, or reply on a contract to provide any goods or services to a public entity, may not submit a bid, proposal, or reply 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 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. 22 Packet Pg.494 C.13.b B. Ethics Clause. In accordance with Section 5 (b) Monroe County Ordinance No. 010-1990 Contractor warrants that it had not employed, retained or otherwise had act on its behalf any former County officer or employee subject to the prohibition of Section 2 of Ordinance No. 010-1990 or any County officer or employee in violation of Section 3 of Ordinance No. 020-1990. For breach or violation of this provision the County may, in its discretion, terminate this contract without liability and may also, in its discretion, deduct from the contract or purchase price, or otherwise recover the full amount of any fee, commission, percentage, gift, or consideration paid to the former County officer oremployee. C. Non-Collusion Statement: The contractor shall provide the non-collusion certification. D. Drug Free Workplace: The contractor shall include an executed "Drug Free Workplace" form. c� 0 U 0 c� X E c� 23 Packet Pg.495 44 C.F.R. PART 18_ CERTIFICATION REGARDING LOBBYING (To be submitted with each bid or offer exceeding$100,000) Certification for Contracts, Grants, Loans, and Cooperative Agreements The undersigned certifies, to the best of his or her knowledge and belief, that: 1. No Federal appropriated funds have been paid or will be paid, by or on behalf ofthe undersigned, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of e Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. E � 2. |f any funds other than Federal appropriated funds have been paid orwill be paid to any person for influencing or attempting to influence an officer or employee of any agency, e Member of Congress, an officer or employee of Congress, or an 0 ennp|oyeeofeK�ennberof Congress in connection vviththis Federal contract, grant, loan, 4� or cooperative agreement, the undersigned shall complete and submit Standard Fornn LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. 3. The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. This certification is e material mu representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is e prerequisite for making or entering into this transaction imposed by section 1352, tit|e 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $1O,OOO and not more than $1OO,OOO for each such failure. The Contractor certifies or affirms the truthfulness and u� accuracy of each statement of its certification and disclosure, if any. In addition, the Contractor understands and agrees that the provisions of31U.S.C. Chap. 38, Administrative Remedies for False Claims and Statements, apply to this certification and disclosure, if any. < Signature of Contractor's Authorized Official Name and Title of Contractor's Authorized Official Date DISC."LOSIURE Of LOBBYING ACMITTE S C0:9IM11 T:-J�7Z FGIFAt TO DUKLOSE,10MYNG kC,rv.=s Pumsu.�uu TO 3 1 USA'� yea L, T'i,-pe,of Fedex-d Actiomr 2 Statusof Fedex-d _Actiom� 1, Repon. TN,-pe,: a coillyact =a.bA'offEr',mpphca6?om =a inihal. b grain b �mrfinlawazd b uuteha]change, po.'-'I-3Waz'd d lom For Maieriall Clugge.Oily: e. Loan p1mantee year quarter f loam imvmm.:e date of Lvit laparr 4. No mR.and Address af'Rhporti'Ong Emfity S. Eater Naine and Iddress,of Prim: ElPtmaa ElSubamudeia Tier if know, E Cam.gresumal Distrixt,ifkmowm Coagressiamall District,if known E 6. FL-djual,DepartmesUAgency: 7a FMJEE'JI,PHI,�TSIM.N'IM&'DeSlll:pl30a: u CTDA.N'ambex,ffappIcabLe 0 U 0. FL-djual Acti)mm'En::mber,if knvwu:: 9a Award Amount,if hmovm: -ra 0 11 ai. Namit,and ld&esss of Lobly Eatit CL F r b. luldhidtals,Per Semiles (ind)mIng CL (If injividada2,lm'l Maine,first name,,ml; adJzeis ifIffi-rein from.No. lay) CA, U- mume,first mule" m 1� x W (atuch Cocimuzifion Sheet.(.,-i4 if necesim,°i 11. Amount of'Piymient IrL,all thai appilly), 13. Fpi F—I ]AKned a reminer F-I b. ama-dmefee 12. Fam of Paymemi(chmi:all ffixt sWy): C. Coombs-rjou m 0a a": sh, d. contingent Le b in, iiLd E > yecify:� namire deharm vd�le other,specift U Rrief"Descriplinmi af'Sertices Perfurmed ac to b*perfdrmjed�and Diate(s)of Sedmile,imcluding offile*)",emplol'HO)",mr membey(s)coatalited,for P&Tmat hldicated�in Item 11: as E (atlach Coirtmuzibm Sheet(s" if mecessan,) I& Cambauadma Sheeil'*of ached: Yes No El 16. 2mf baza Tit.1;K U,TA'� TAcdcm 1.32, Tln&.,scl-cimm e4flchb-�sz llipamze:� rl;Lzm, -*mmi,yargd by tha,64sr ors v;hgm hi"s,transaic"I"am, wms mad;w aulgmd.intio, 7bis,4hudanuv is Pnht pmummt to 3., U,S'C�.1352, Mixuffwm'Z6,313 m,lu b'4 r;pc&Qd to Ccmgsfia%m3im=umH.-v will by rmilablg,f6�r Amy pwuim w ftaa re Eig,Win,:Kpdr;d. &.'sclic'sum,shau.bi;;'Tkj';'ct.to 1,cill.]pcm@�"l nfm'at lags.&Im S UD000 mad M&.mczl&th2m, 11010"1000 frar msl ymcl Teliephone 140. t e: A xlhohzed tw LlocK Fyprot.,zlim Fftleral Us*OnJ7,-: Slandrd Funn-= 2-6c IPAIR7 III Packet Pg.497 C.13.b INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity,whether subawardee or prime Federal recipient,at the initiation or receipt of covered Federal action or a material change to previous filing pursuant to title 31 U.S.C.section 1352. The filing of a foram is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or eimployee of any agency,a Mermber of Congress an officer or eimployee of Congress or an employee of a Mermber of Congress in connection with a covered Federal action. Attach a continuation sheet for additional information if the space on the foram is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence,the outcome of a covered Federal action. 2. Identify the status of the covered Federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the q�s information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, E previously submitted report by this reporting entity for this covered Federal action. � 4. Enter the full name,address,city,state and zip code of the reporting entity. Include Congressional District if known. Check the E appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee,e.g.,the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts,subgrants and contract awards under grants. 5. If the organization filing the report in Iterm 4 checks"Subawardee"then enter the full narme,address,city,state and zip code of the prime Federal recipient. Include Congressional District,if known. U 6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organization level below 4- 0 agency name,if known. For example,Department of Transportation,United States Coast Guard. � 7. Enter the Federal program name or description for the covered Federal action(item 1). If known,enter the full Catalog of Federal Domestic Assistance(CFDA)number for grants,cooperative agreements,loans and loan commitments. L_ 8. Enter the most appropriate Federal identifying number available for the Federal action identification in item I(e.g., Request for � Proposal(RFP)number,Invitation for Bid(IFB)number,grant announcerment number,the contract grant.or loan award number, ., the application/proposal control number assigned by the Federal agency). Include prefixes,e.g., "RFP-DE-90-001." L3 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency,enter the Federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. C5 10. a Enter the full name,address,city, plobbying ty gag y p g entity X O ty,state and zip code of the entity engaged b there reporting enti identified in item 4 to � influenced the covered Federal action. _ (b)Enter the full names of the individual(s)performing services and include full address if different from 10(a). Enter Last � Name,First Name and Middle Initial(MI). q�p 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity(item 4)to the lobbying entity q�p (item IO). Indicate whether the payment has been made(actual)or will be made(planned). Check all boxes that apply. If this � is a material change report,enter the curmulative amount of payment made or planned to be made. � 12. Check the appropriate box. Check all boxes that apply. If payment is made through an in-kind contribution,specify the nature � and value of the in-kind payment. qp 13. Check the appropriate box. Check all boxes that apply. If other,specify nature. 14. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s)of any services rendered. Include all preparatory and related activity not just time spent in actual contact with Federal officials. Identify the Federal officer(s)or employee(s)contacted or the officer(s)employee(s)or Meruber(s) of Congress that were contacted. 15. Check whether or not a continuation sheet(s)is attached. 16. The certifying official shall sign and date the form,print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response,including time for reviewing instruction,searching existing data sources,gathering and maintaining the data needed,and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden,to the Office of Management and Budget,Paperwork Reduction Project (0348-0046),Washington,D.C.20503. SF-LLL-Instructions Rev.06-04- 90«ENDIF» 2-6d PART 2/COUNTY Packet Pg.498 l ® DATE(I C.13.c ACORO CERTIFICATE OF LIABILITY INSURANCE 12i20i2022 1 )/3/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THI: CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIE! BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZE[ REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement of this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONT PRODUCER LOckton Companies NAMEACT 3280 Peachtree Road NE,Suite#250 PHONE FAX Atlanta GA 30305 MANo Ext: A/C,Na E (404)460-3600 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Travelers Indemnity Company Of America 2566 i= INSURED INSURER B:Travelers Property Casual CO o1 America 2567 1514540 NationsMarket,LLC p y t3' and its direct and indirect subsidiaries INSURER C:PMA Insurance Group 3689 Do 1901 NW 66th Avenue INSURER D:Navigators Specialty Insurance Company 3605 Suite 100 INSURER E:Westchester Surplus Lines Insurance Co 1017 Plantation FL 33313 INSURER F: U COVERAGES CERTIFICATE NUMBER: 18978772 REVISION NUMBER: XXXXXXX THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIO1 INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THI: cj CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. O INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MMIDDIYYYY MMIDD/YYYY y COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 A X Y N Y-GGO-ST371482-TIA-22 9/21/2022 12/20/2022 DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES Ea occurrence $ 1 000 000 CL MED EXP(Any one person) $ 10,000 Ck PERSONAL&ADV INJURY $ 2,000,000 N C®1 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 N POLICY❑ PROJECT ❑ LOC PRODUCTS-COMP/OP AGG $ 4,000,000 N OTHER: $ CN A AUTOMOBILE LIABILITY Y N BA-8T374724-22-14-G 9/21/2022 12/20/2022 COMBINED SINGLE LIMIT $ x°"° Ea accident 1,000,()()o CL X ANY AUTO BODILY INJURY(Per person) $ XXXXXXX OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS XXXXXXX HIRED NON-OWNED PROPERTY DAMAGE $ XXXXXXX ONLY AUTOS ONLY Per accident $ XXXXXXX U) B X UMBRELLA LIAB OCCUR N N CUP-8T414714-22-14 9/21/2022 12/20/2022 EACH OCCURRENCE $ 10,000 qp EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1000 000 DED RETENTION$ $ 1,000,000 WORKERS COMPENSATION YIN PER OTH- C AND EMPLOYERS'LIABILITY N 744994-02 9/21/2022 9/21/2023 X STATUTE I I ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? NIA (� (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 D Excess Liability N N GA2IEXRZ09JOEIC 9/21/2022 9/21/2023 Each Occurrence: $3,000,000 C) Aggregate: $3,000,000 eee E Product Recall G7174985A003 9/21/2022 9/21/2023 Limit: $250,000 C'd C°J DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Q Monroe County or Monroe County Board of County Commissioners are Additional Insureds as respects General Liability and Auto Liability policies,as required by'written CN contract.30 days notice of cancellation to certificate holder except 10 days for non-payment. APPROVED BY RISK MANAGEMENT DATE 10/14/2022-"' WAIVER N/A YES CERTIFICATE HOLDER CANCELLATION 18978772 Monroe County and Monroe County Board of County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORI Commissioners THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED II 1100 Simonton Street ACCORDANCE WITH THE POLICY PROVISIONS. Key West FL 33040 AUTHORIZED REPRESENTATIVE u ©1988-201�ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Packet Pg.499 C.13.d Request for Taxpayer Give Form to the Form 9(Rev.October 2018) Identification Number and Certification requester.Do not Department of the Treasury send to the IRS. Internal Revenue Service ►Go to www.irs.gov1FormW9 for instructions and the latest information. I Name(as shown on your income tax return).Name is required on this line;do not leave this line blank. NationsMarket, LLC 2 Business name/disregarded entity name,if different from above 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1.Check only one of the 4 Exemptions(codes apply only to ar following seven boxes. certain entities,not individuals;sea a instructions on page 3): p ElIndividual/sole proprietor or ❑ C Corporation ❑ S Corporation ❑ Partnership ❑Trustiestate c single-member LLC Exempt payee code(if any) ao ,/❑ Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=Partnership)► P p « Note:Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check Exemption from FATCA reporting C ffi LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is cads(if any) another LLC that is not disregarded from the owner for U,S.federal tax purposes.Otherwise,a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner. .d Other(see Instructions)► (Applies to accounts malntalned outside Me U.S.) y 5 Address(number,street,and apt.or suite no.)See instructions. Requester's name and address(optional) 1801 NW 66th Ave,Suite 100 6 City,state,and ZIP code Plantation, FL 33313 7 List account number(s)here(optional) IED U Taxpayer Identification Number(TIN) Enter your TIN In the appropriate box.The TIN provided must match the name given on line 1 to avoid Social security number 0 backup withholding.For individuals,this is generally your social security number(SSN.However,for a - - U resident alien,sale proprietor,or disregarded entity,see the instructions for Part i,later.For other 4- entities,it is your employer identification number(EIN).If you do not have a number,see Now to get a TIN, later. or y Note:If the account Is in more than one name,see the instructions for line 1.Also see What Name and I Employer identification number 0- Number To Give the Requester for guidelines on whose number to enter. lL M88 - 3 1 7 1 2 1 1 1 0M47 Certification Under penalties of perjury,I certify that: 1.The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me);and 2.1 am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)1 have not been notified by the Internal Revenue Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that I am o no longer subject to backup withholding;and 3.1 am a U.S.citizen or other U.S.person(defined below);and 4.The FATCA code(s)entered on this form(if any)indicating that I am exempt from FATCA reporting is correct. Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return.For real estate transactions,item 2 does not apply.For mortgage Interest paid, acquisition or abandonment of secured property,cancellation of debt,contributions to an individual retirement arrangement(IRA),and generally,payments other than interest and dividends,you are not required to sign the certification,but you must provide your correct TIN.See the instructions for Part 11,later. Sign signature of � U Mere U.S.person► LA e Date► 17 2Ial fi ff General Instructions •Form 1099-DIV(dividends,including those from stocks or mutual funds) Section references are to the Internal Revenue Code unless otherwise .Form 1099-MISG(various types of income,prizes,awards,or gross noted. proceeds) Future developments.For the latest information about developments .Form 1099-8(stock or mutual fund sales and certain other related to Form W-9 and its instructions,such as legislation enacted transactions by brokers) after they were published,go to www.irs.gov1FormW3. •Form 1099-S(proceeds from real estate transactions) Purpose of Form •Form 1099-K(merchant card and third party network transactions) An individual or entity(Form W-9 requester)who is required to file an •Form 1098(home mortgage interest),1098-E(student loan interest), information return with the IRS must obtain your correct taxpayer 1098-T(tuition) identification number(TIN)which may be your social security number •Form 1099-C(canceled debt) (SSN),individual taxpayer identification number QTIN),adoption .Farm 1099-A(acquisition or abandonment of secured property) taxpayer identification number(ATIN),or employer identification number (EIN),to report on an information return the amount paid to you,or other Use Form W-9 only if you are a U.S.person(including a resident amount reportable on an information return.Examples of information alien),to provide your correct TIN. returns include,but are not limited to,the fallowing, ff you do not return Form W-9 to the requester with a TIN,you might •Form 1099-INT(interest earned or paid) be subject to backup withholding.See What Is backup withholding, later. Cat.No.10231X Form W-9(Rev.10-2018) Packet Pg. 500