Item P6 P.6
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: P.6
Agenda Item Summary #11449
BULK ITEM: Yes DEPARTMENT: County Attorney's Office
TIME APPROXIMATE: STAFF CONTACT: Brian Bradley (305) 295-3177
N/A
AGENDA ITEM WORDING: Approval to Advertise a Request for Proposals for Public
Adjusting Claim Services. The services of the Contractor will be used following catastrophic events
resulting in significant damage, such as hurricanes.
ITEM BACKGROUND:
The contract, when awarded, will serve as a retainer agreement and the County will use the services
of the contractor following catastrophic events resulting in significant damage, such as hurricanes.
Minor/incidental events are handled internally by staff and the assistance of an adjusting firm is not
required. The firm's fee is based on a percentage of the insurance claims' gross amount adjusted or
otherwise recovered. If there are no claims (i.e. no hurricanes/major disasters assigned to Monroe
County to the Contractor), there is no fee paid to the Contractor.
PREVIOUS RELEVANT BOCC ACTION:
Current contract with Goodman, Gable, Gould Adjusters expires May 31, 2023.
CONTRACT/AGREEMENT CHANGES:
N/A
STAFF RECOMMENDATION: Approval to Advertise.
DOCUMENTATION:
2022 RFP Public Adjuster clean 11.15.2022
SOV Updated 10 19 2022
FINANCIAL IMPACT:
Effective Date: June 1, 2023
Expiration Date: May 31, 2024
Packet Pg. 1909
P.6
Total Dollar Value of Contract:
Total Cost to County:
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:
Additional Details:
N/A
REVIEWED BY:
Brian Bradley Completed 11/16/2022 11:37 AM
Cynthia Hall Completed 11/16/2022 2:39 PM
Bob Shillinger Completed 11/16/2022 4:47 PM
Purchasing Completed 11/16/2022 4:51 PM
Budget and Finance Completed 11/17/2022 8:36 AM
Lindsey Ballard Completed 11/17/2022 9:47 AM
Board of County Commissioners Pending 12/07/2022 9:00 AM
Packet Pg. 1910
MONROE COUNTY
REQUEST FOR PROPOSALS
FOR
PUBLIC ADJUSTING CLAIM SERVICES
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BOARD OF COUNTY COMMISSIONERS
Mayor, Craig Cates, District 1
Mayor Pro Tem, Holly Merrill Raschein, District 5
Michelle Lincoln, District 2
James K. Scholl, District 3
David Rice, District 4
COUNTY ADMINISTRATOR
Roman Gastesi
CLERK OF THE CIRCUIT COURT COUNTY ATTORNEY
Kevin Madok, CPA Risk Management
June 1, 2023
Bid Opening: 3:00pm, March 23, 2023
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NOTICE OF REQUEST FOR COMPETITIVE SOLICITATIONS
NOTICE IS HEREBY GIVEN that on Thursday, March 23, 2023, at 3:00 P.M., the Monroe
County Purchasing Office will receive and open sealed responses for the following:
Public Adjusting Claim Services
Monroe County, Florida
Pursuant to F.S. 50.0211(3)(a), all published competitive solicitation notices can be viewed at:
www.floridapublicnotices.com, a searchable Statewide repository for all published legal notices.
Requirements for submission and the selection criteria may be requested from DemandStar at
www.demandstar.com OR www.monroecounty-fl.gov/bids. The Public Record is available upon
request.
Monroe County Purchasing Department receives bids electronically. Please do not mail or attempt
to deliver in person any sealed bids. Mailed/physically delivered bids/proposals/responses WILL
NOT be accepted.
The Monroe County Purchasing Department hereby directs that bids be submitted via email
to: OMB-BIDS(amonroecounty-fl.gov, no later than 3:OOP.M., on Thursday, March 23, 2023.
Please submit your confidential financial information in a SEPARATE EMAIL from your bid
and required documents. Your subject line on both emails must read as follows:
Public Adjusting Claim Services 3-23-2023
Files that do not contain this subject line WILL BE REJECTED. Please note that the maximum file
size that will be accepted by email is 25MB. Please plan accordingly to ensure that your bid is
not rejected due to the file size. Should your bid documents exceed 25MB, in advance of the
bid opening, please email: omb-purchasing(&monroecounty-fl.gov so accommodations for
delivery of your bid can be made prior to the bid opening. Please be advised that it is the bidder's
sole responsibility to ensure delivery of their bid and waiting until the bid opening to address or
confirm your bid submission delivery will result in your bid being rejected.
The bid opening for this solicitation will be held virtually, via the internet, at 3:00 P.M., on
Thursday, March 23, 2023. You may call in by phone or internet using the following:
Join Zoom Meeting
https://mcbocc.zoom.us/i/4509326156
Meeting ID: 4509326156
One tap mobile:
+16465189805„4509326156# US (New York)
+16699006833„4509326156# US (San Jose)
Dial by your location:
+1 646 518 9805 (New York)
+1 669 900 6833 (San Jose)
Publication dates:
Keys Weekly: Thur., 2/2/2023
News Barometer: Fri., 2/3/2023
Citizen: Sat, 2/4/2023
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TABLE OF CONTENTS
Section Pages
SECTION ONE Instructions to Proposers 4-16
• General information
• Coverages requested
• Evaluation Criteria
SECTION TWO Sample Agreement 17-34
• Exhibit A, Scope of Services
SECTION COUNTY FORMS AND INSURANCE FORMS 35-49
THREE . Response Form
• Lobbying and Conflict of Interest Clause
• Non-Collusion Affidavit
• Drug-Free Workplace Form
• Public Entity Crime Statement
• Vendor Certification Regarding Scrutinized
Companies
• Certification Regarding Debarment, Suspension,
Ineligibility, and Voluntary Exclusion
• Certification Regarding Lobbying (Appendix A to
44 C.F.R. Part 18) and Disclosure of Lobbying
Activities Form with instructions (Appendix B to 44
C.F.R. Part 18).
• Respondent's Insurance and Indemnification
Statement incl. Hold Harmless
• Insurance Agent's Statement
• Request for Waiver of Insurance Requirements (if
applicable)
SECTION FOUR STATEMENT OF VALUES 50
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SECTION ONE: INSTRUCTIONS TO PROPOSERS
1. Objective of the Request for Proposals
Monroe County is requesting proposals for the following:
➢ Public Adjusting Claim Services
The County desires to establish a retaining agreement that will govern the activities and pricing
of the services that will be provided. All services will be provided as deemed necessary by the
County. No services will be performed until authorized by the County to do so.
The effective date of the agreement will be June 1, 2023 or as soon thereafter as is possible and
renewable at the County's option for two (2) additional consecutive one year terms.
Items contained in this Request for Proposals (RFP) are considered to be an integral part of the
proposed programs. Adherence to the items listed here is intended by the County unless
specifically otherwise accepted by both the Proposer and the County. Acceptance of
modification of any portion of the items contained herein will not serve to waive or modify any
other portion of the proposed agreement.
The County is seeking a firm that will enter into a retainer agreement with the County that will
evaluate damage to County property and negotiate maximum settlements with its insurers
following catastrophic events resulting in significant damage. In addition, the firm will assist the
County in coordinating Public Assistance from the Federal Emergency Management Agency
(FEMA).
It is not anticipated that services will be required for minor/incidental events. The County will
not be responsible for any payments to the successful proposer unless a formal request for
services is issued by the County. The following services will be expected of the successful
proposer:
➢ Investigate and analyze all property damage associated with claims assigned to the
adjuster.
➢ Review all insurance policies and determine the recoveries available to the County
from each policy.
➢ Review pre-loss estimates that could affect recovery and recommend
modifications if necessary.
➢ Prepare a concise, well documented replacement cost estimate of buildings and personal
property damaged and determine the Actual Cash Value (ACV) if
applicable.
➢ Evaluate "code upgrade" coverages and costs, if applicable
➢ Negotiate interim and final settlements with the County insurers.
➢ Advise County management regarding the capture and development of loss information
(including direct damage, extra expenses, and loss of income).
➢ Coordinate and integrate all areas of the claim effort on behalf of the County.
➢ Assist in the coordination of advance payments with the County insurers.
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➢ Coordinate all inspections and meetings with the County's insurers.
➢ Provide regular status reports.
➢ Review all claim data with County representatives prior to being submitted to the insurers.
➢ Conduct and/or participate in all settlement discussions with the County's insurers.
➢ Maintain all information obtained during the services provided to the County as
confidential.
➢ Expedite and maximize all recoveries available to the County.
➢ Coordinate with the Federal Emergency Management Agency (FEMA) if required.
➢ Any and all services required to resolve County claims with its insurers.
2 Background Information
Monroe County ("County") is a non-chartered county established under the Constitution and
the laws of the State of Florida. The Clerk of the Circuit Court serves as the fiscal agent of the
board of county commissioners.
The population of the County is estimated at approximately 82,170; the County's total current
real and personal property values are approximately $268.5 million. Approximately 90
locations are currently insured by the County. Various smaller buildings used for maintenance
and other activities are currently self-insured. A Statement of Values of the County's Real and
Personal Property is attached.
The Board of County Commissioners, constituted as the governing body, has all the powers of
a body corporate, including the powers to contract; to sue and be sued; to acquire, purchase,
hold, lease and convey real estate and personal property; and to generally exercise the
powers of a public authority organized and existing for the purpose of providing community
services to citizens within its territorial boundaries. In order to carry out this function, the
County is empowered to levy taxes to pay for the cost of operations and to provide services.
The County has a full time Risk Manager who oversees the County's insurance program to
include the settlement of property claims. The program extends to all County owned
properties, including properties used by the County's agencies, boards, and Constitutional
Officers.
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3 RFP Schedule
Posting of RFP on Demandstar 2/4/2023
Deadline for Requests for Additional 3/1/2023
Information
Proposal Return and Bid Opening 3/23/23
Obtain Board Approval 4/19/23 and
4/20/23
No extensions will be honored.
4 Evaluation Criteria
The proposer with the highest cumulative Evaluation Points based on the following Evaluation
Schedule will be selected.
Evaluation Factor/ Tab Range of Possible
Evaluation Points
1 - Experience in providing public adjusting
claim services with emphasis placed on 0 to 15
services provided to governmental entities
2 - Familiarity with Monroe County operations 0 to 10
3 - Ability and timing to provide licensed
adjusters onsite when requested by the 0 to 35
Count
4 - Pricing expressed as a percentage of
recoveries from the County's insurers. The
Maximum fee that will be considered by the 0 to 40
County is that expressed in Florida Statute §
626.854 10 b .
5 - Other Y/N
6 - Liti ation/Customer/Credit/Financial Y/N
7 - County Forms Y/N
Possible Points 100
Interisk (the Consultant) is acting in a consulting capacity for the Monroe County BOCC under
the terms of an agreement between the County and Interisk. Interisk along with a Selection
Committee will be analyzing proposals and providing recommendations to the County with
regard to this RFP.
5. Requests for Additional Information
Requests for additional information relating to the specifications of this Request for Proposals
shall be submitted in writing directly to:
Brian Bradley RMLO, FCRM
Risk Manager
Monroe County Attorney's Office
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1111 12th Street, Suite 408
Key West, FL 33040
Email: bradley-brian cr monroecounty_fl•gov
Email requests will be honored.
All requests for additional information must be received no later than 3:00 PM, March 1, 2023.
All requests for additional information will be answered by way of an addendum to the RFP,
which will be issued approximately March 7, 2023. The addendum will be posted on Demand
Star. Oral requests will not be answered.
6. Content of Submission / Proprietary and Confidential Information
The proposal submitted in response to this Request for Proposals (RFP) shall be clear
and concise, tabulated, and provide the information requested herein. All proposals shall be
submitted as specified in the Notice of Request for Competitive Solicitations that is made part
of this RFP. Proposals submitted without the required information will not be considered.
Responses shall be organized as indicated below. The Proposer should not withhold any
information from the written response in anticipation of presenting the information orally or in a
demonstration, since oral presentations or demonstrations may not be solicited. Each
Proposer must submit adequate documentation to certify the Proposer's compliance with the
County's requirements. Proposer should focus specifically on the information requested.
All Proposals received as a result of this RFP are subject to Chapter 119, Florida Statutes, and
will be made available for inspection upon request by any person in accordance with Florida
Statutes. Any Proposer asserting that any portion of its Proposal is confidential or exempt
from disclosure under Florida's public records law must specifically identify the portions of the
Proposal asserted to be confidential by marking the information as confidential and submitting
the information in a separate email in accordance with the instructions in the Notice of Request
for Competitive Solicitation.
If that material is requested through a public records request, the County will notify the
Proposer of the request, and give the Proposer five (5) calendar days to obtain a court order
blocking the production of the material. If the court order is not issued during that time to block
the production, the material will be produced.
By the Proposer's designation of material in its proposal as "Public Records Exempt," the
Proposer agrees to defend and hold harmless the County from any claims, judgments,
damages, costs and attorney's fees incurred by the County by reason of any legal action
challenging the designation of the material.
Please be advised that the designation of material as confidential or exempt from disclosure as
a Public Record may impact the ability of the Evaluating Body to adequately assess the
Proposal and may therefore affect the ultimate award of the contract.
7. Format.
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The response, at a minimum, shall include the following:
A. Cover Page,
A cover page that states"PROPOSAL FOR PUBLIC ADJUSTING CLAIM SERVICES" must be
included. The cover page should contain Proposer's name, address, telephone number, email, fax
number, and the name of the Proposer's contact person(s).
Tabbed Sections
Tab 1. Experience in providing public adjusting claims services with emphasis
placed on services provided to governmental entities.
The Proposer shall provide a history of the firm or organization demonstrating
experience with services that are similar in scope and size to the requested
services.
The Proposer shall provide a list of at least five (5) past projects within the past
eight (8) years, indicating the following for each:
Name and full address of the referenced project client
Name and telephone number of client contact for referenced project
Date of initiation and completion of contract
Summary of the project and services
The Proposer shall provide a narrative of the firm's capabilities and qualifications
that demonstrates how the firm will work with the County to fulfill the requirements
of this Service. Describe the firm's methods of providing Public Adjusting Claim
Services listed in Section 1, both in the office and at locations affected by the
catastrophic events resulting in significant damage.
Tab 2. Familiarity with Monroe County operations
Describe any experience that shows the Proposer's familiarity with Monroe
County's operations.
Tab 3. Ability and timing to provide qualified licensed adjusters onsite when
requested by the County.
The Proposer shall describe the composition and structure of the firm (sole
proprietorship, corporation, partnership, joint venture) and include names of
persons with an interest in the firm.
The Proposer shall include a list of the proposed staff that will perform the work
required if awarded this contract. An organizational chart and management plan
should be included in this section. The Proposer shall also include minimum
qualifications for each class of employee of the project team and identify his/her
role on the
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team. Include in this section the location of the main office and the location of the
office proposed to work on this project. In addition, Proposer should indicate when
adjusters assigned to the County's loss will arrive in Monroe County to start the
adjustment process.
The Proposer shall describe the approach and methodology it will use to
accomplish the work defined herein. The project approach shall include
information on schedule and availability, and any other relevant information
explaining how the services will be accomplished.
Tab 4. Pricing expressed as a percentage of recoveries from the County's insurers.
Please include proposed pricing expressed as a percentage of recoveries from
insurers. The maximum fee that will be considered by the County are those
expressed in Florida Statute 626.854 (10) (b).
Tab 5. Other Information
If the Proposer cannot fully comply with any of the terms contained in the draft
contract, shown in Section Two, all deviations to the terms must be spelled out in
this section, i.e. Tab 6.
Tab 6. Litigation, Customer, Credit, and Financial History
In accordance with Section 2-347(h)of the Monroe County Code, each proposer must provide the
following information:
(1) A list of the person's or entity's shareholders with five (5) percent or more of the stock or, if a
general partnership, a list of the general partners; or, if a limited liability company, a list of its
members; or, if a solely owned proprietorship, name(s)of owner(s);
(2) A list of the officers and directors of the entity;
(3) The number of years the person or entity has been operating and, if different, the number of
years it has been providing the services, goods, or construction services called for in the bid
specifications (include a list of similar projects);
(4) The number of years the person or entity has operated under its present name and any prior
names;
(5) Answers to the following questions regarding claims and suits:
a. Has the person, principals, entity, or any entity previously owned, operated or
directed by any of its officers, major shareholders or directors, ever failed to
complete work or provide the goods for which it has contracted? If yes, provide
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details;
b. Are there any judgments, claims, arbitration proceeding or suits pending or
outstanding against the person, principal of the entity, or entity, or any entity
previously owned, operated or directed by any of its officers, directors, or general
partners? If yes, provide details;
c. Has the person, principal of the entity, entity, or any entity previously owned,
operated or directed by any of its officers, major shareholders or directors, within
the last five (5) years, been a party to any lawsuit, arbitration, or mediation with
regard to a contract for services, or goods services similar to those requested in
the specifications with private or public entities? If yes, provide details;
d. Has the person, principal of the entity, or any entity previously owned, operated
or directed by any of its officers, owners, partners, major shareholders or
directors, ever initiated litigation against the county or been sued by the county in
connection with a contract to provide services, goods or construction services? If
yes, provide details;
e. Whether, within the last five (5) years, the owner, an officer, general partner,
principal, controlling shareholder or major creditor of the person or entity was an
officer, director, general partner, principal, controlling shareholder or major
creditor of any other entity that failed to perform services or furnish goods similar
to those sought in the request for competitive solicitation. If yes, provide details;
f. Customer references (minimum of three), including name, current address and
current telephone number;
g. Credit references (minimum of three), including name, current address and
current telephone number;
h. Financial statements for the prior three years for the responding entity or for
any entity that is subsidiary to the responding entity; and
i. Any financial information requested by the county department involved in the
competitive solicitation, related to the financial qualifications, technical
competence, the ability to satisfactorily perform within the contract time
constraints, or other information the department deems necessary to enable
the department and board of county commissioners to determine if the person
responding is responsible.
Tab 7. County Forms
Proposer shall complete and execute the forms specified below and located in Section Three
in this RFP and shall include them in this section, i.e. Tab 7:
Forms
Submission Response Form
Lobbying and Conflict of Interest Ethics Clause
Non-Collusion Affidavit
Drug Free Workplace Form
Public Entity Crime Statement
Vendor Certification Regarding Scrutinized Companies Lists
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Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion
Appendix A, 44 C.F.R. Part 18 — Certification Regarding Lobbying
Respondent's Insurance and Indemnification Statement
Insurance Agent's Statement
Request for Waiver of Insurance Requirements (if applicable)
COPIES OF RFP DOCUMENTS
A. Only complete sets of RFP Documents will be issued and shall be used in
preparing responses. The County does not assume any responsibility for errors
or misinterpretations resulting from the use of incomplete sets.
B. Complete sets of RFP Documents may be obtained in the manner and at the
locations stated in the Notice of Request for Proposals.
8. STATEMENT OF PROPOSAL REQUIREMENTS
Interested firms or individuals are requested to indicate their interest by submitting their
proposal in accordance with the Notice of Request for Competitive Solicitations clearly
identified by including "Monroe County Proposal for Public Adjusting Claim Services," in
the email. All proposals must be received on or before 3:00 P.M. local time on March 14,
2019. No proposals will be accepted after 3:00 P.M. Faxed proposals shall be automatically
rejected. It is the sole responsibility of each Proposer to ensure its proposal is received in a
timely fashion.
9. DISQUALIFICATION OF PROPOSER
A. NON-COLLUSION AFFIDAVIT: Any person submitting a proposal in response to
this RFP must execute the enclosed NON-COLLUSION AFFIDAVIT. If it is
discovered that collusion exists among the Proposers, the proposals of all
participants in such collusion shall be rejected, and no participants in such collusion
will be considered in future proposals for the same work...
B. PUBLIC ENTITY CRIME: A person or affiliate who has been placed on the
convicted vendor list following a conviction for a public entity crime may not submit
a proposal on a contract to provide any goods or services to a public entity, may not
submit a proposal on a contract with a public entity for the construction or repair of
a public building or public work, may not submit Proposals on leases or perform
work as a contractor, supplier, subcontractor, or contractor under a contract with
any public entity, and may not transact business with any public entity in excess of
the threshold amount provided in Section 287.017, for CATEGORY TWO for a
period of 36 months from the date of being placed on the convicted vendor list.
Category Two: $25,000.00.
C. DRUG-FREE WORKPLACE FORM: Any person submitting a bid or proposal in
response to this invitation must execute the enclosed DRUG-FREE WORKPLACE
FORM
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and submit it with his/her proposal. Failure to complete this form in every detail and
submit it with the bid or proposal may result in immediate disqualification of the bid
or proposal.
D. LOBBYING AND CONFLICT OF INTEREST ETHICS CLAUSE: Any person
submitting a bid or proposal in response to this invitation must execute the
enclosed LOBBYING AND CONFLICT OF INTEREST CLAUSE and submit it with
his/her bid or proposal. Failure to complete this form in every detail and submit it
with the bid or proposal may result in immediate disqualification of the bid or
proposal.
10. EXAMINATION OF RFP DOCUMENTS
A. Each Proposer shall carefully examine the RFP and other contract documents,
and inform himself/herself thoroughly regarding any and all conditions and
requirements that may in any manner affect cost, progress, or performance of
the work to be performed under the contract. Ignorance on the part of the
Proposer shall in no way relieve him/her of the obligations and responsibilities
assumed under the contract.
B. Should a Proposer find discrepancies or ambiguities in, or omissions from, the
specifications, or should he be in doubt as to their meaning, he shall at once
notify the County's representative addressed in item #4 of this RFP. The County
encourages all interested proposers to monitor Demand Star for any and all
addendum.
11. INTERPRETATIONS, CLARIFICATIONS, AND ADDENDUM
No oral interpretations will be made to any Proposer as to the meaning of the contract
documents. Any inquiry or request for interpretation received by the Request for
Information Cut-Off Date will be given consideration. All such changes or interpretation
will be made in writing in the form of an addendum and, if issued, will be furnished to all
known prospective Proposers prior to the established Proposal opening date. Each
Proposer shall acknowledge receipt of such addenda in his/her Proposal. In case any
Proposer fails to acknowledge receipt of such addenda or addendum, his/her response
will nevertheless be construed as though it had been received and acknowledged and the
submission of his/her response will constitute acknowledgment of the receipt of same. All
addenda are a part of the contract documents and each Proposer will be bound by such
addenda, whether or not received by him/her. It is the responsibility of each Proposer to
verify that he/she has received all addenda issued before responses are opened.
12. GOVERNING LAWS AND REGULATIONS
The successful proposer must comply with the provisions of Florida Statute § 626.854 to
include fees charged to the County as specified by Florida Statutes. It is the intention of
the County to enter into a non-monetary retaining agreement with the successful
proposer and all fees earned by the proposer will be in accordance with Florida Statute
§ 626.854.
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The Proposer is required to be familiar with and shall be responsible for complying with
all federal, state, and local laws, ordinances, rules, professional license requirements
and regulations that in any manner affect the work. Knowledge of business tax
requirements and the responsibility for paying the tax in Monroe County and
municipalities within Monroe County are the responsibility of the Proposer.
13. PREPARATION OF RESPONSES
Signature of the Proposer: The Proposer must sign the response forms in the space
provided for the signature. If the Proposer is an individual, the words "doing business as
or "Sole Owner" must appear beneath such signature. In the case of a
partnership, the signature of at least one of the partners must follow the firm name and
the words "Member of the Firm" should be written beneath such signature. If the
Proposer is a corporation, the title of the officer signing the Response on behalf of the
corporation must be stated along with the Corporation Seal Stamp and evidence of his
authority to sign the Response must be submitted. The Proposer shall state in the
response the name and address of each person having an interest in the submitting
entity.
14. MODIFICATION OF RESPONSES
Written modification will be accepted from Proposers if addressed to the entity and
address indicated in the Notice of Request for Proposals and received prior to Proposal
due date and time. Modifications must be submitted in the same manner as indicated in
the Notice of Request for Competitive Solicitation, with the Proposers name and
"Modification to Proposal - Monroe County Proposal for Public Adjusting Claims
Services" on the subject line. Faxed or e-mailed modifications shall be automatically
rejected.
15. RESPONSIBILITY FOR RESPONSE
The Proposer is solely responsible for all costs of preparing and submitting the response,
regardless of whether a contract award is made by the County.
16. RECEIPT AND OPENING OF RESPONSES
Responses will be received until the designated time and will be publicly opened.
Proposers names shall be read aloud at the appointed time and place stated in the
Notice of Request for Proposals. Monroe County's representative authorized to open
the responses will decide when the specified time has arrived and no responses received
thereafter will be considered. No responsibility will be attached to anyone for the
premature opening of a response not properly addressed and identified. Proposers or
their authorized agents are invited to be present.
17. DETERMINATION OF SUCCESSFUL PROPOSER
The
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contract shall be awarded based on the criteria and weighted points specified in Number
3 above. The County will attempt to negotiate a contract with the highest ranked firm with
highest cumulative points based on the sole discretion of the County. If a contract cannot
be agreed upon with the Proposer with the highest rank, attempts to negotiate a contract
with the firm with the next highest rank will commence. This process will continue until a
contract can be agreed upon by both parties.
The County reserves the right to reject any and all responses and to waive technical
errors and irregularities as may be deemed best for the interests of the County.
Responses that contain modifications that are incomplete, unbalanced, conditional,
obscure, or that contain additions not requested or irregularities of any kind, or that do not
comply in every respect with the Instruction to Proposer, may be rejected at the option of
the County.
18. AWARD OF CONTRACT
A. The County reserves the right to award separate contracts for the services based
on geographic area or other criteria, and to waive any informality in any
response, or to re-advertise for all or part of the work contemplated.
B. The County also reserves the right to reject the response of a Proposer who has
previously failed to perform properly or to complete contracts of a similar nature
on time.
C. The recommendation of staff shall be presented to the Board of County
Commissioners of Monroe County, Florida, for final selection and award of
contract.
D. The County reserves the right to reject all proposals.
19. CERTIFICATE OF INSURANCE AND INSURANCE REQUIREMENTS
The Proposer shall be responsible for all necessary insurance coverage as indicated
below. Certificates of Insurance must be provided to Monroe County within fifteen (15)
days after award of contract, with Monroe County BOCC listed as additional insured as
indicated. If the proper insurance forms are not received within the fifteen (15) day
period, the contract may be awarded to the next selected Proposer. Policies shall be
written by companies licensed to do business in the State of Florida and having an
agent for service of process in the State of Florida. Companies shall have an A.M. Best
rating of A- or better, the required insurance shall be maintained at all times while
Proposer is providing service to County.
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Worker's Compensation Statutory Limits
Employers' Liability Insurance
Bodily Injury by Accident $500,000
Bodily Injury by Disease, policy limits $500,000
Bodily Injury by Disease, each employee $500,000
General Liability, including
Premises Operation
Products and Completed Operations
Blanket Contractual Liability
Personal Injury Liability
Expanded Definition of Property Damage
The policy shall provide minimum limits of $500,000 Combined Single Limit
If split limits are provided, the minimum limits acceptable shall be:
$300,000 per person
$500,000 per occurrence
$200,000 property damage
Vehicle Liability
(Owned, non-owned and hired vehicles) $300,000 Combined Single Limit
If split limits are provided, the minimum limits acceptable shall be:
$200,000 per person
$300,000 per occurrence
$200,000 property damage
Professional Liability $1,000,000 per Occurrence
$2,000,OOOAggregate
Monroe County shall be named as an Additional Insured on the General Liability and
Vehicle Liability policies.
20. INDEMNIFICATION
The Proposer to whom a contract is awarded shall defend, indemnify and hold harmless
the County as outlined below.
The Proposer covenants and agrees to indemnify, hold harmless and defend Monroe
County, its commissioners, officers, employees, agents and servants from any and all
claims for bodily injury, including death, personal injury, and property damage,
including damage to property owned by Monroe County, and any other losses,
damages, and expenses of any kind, including attorney's fees, court costs and
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expenses, which arise out of, in connection with, or by reason of services provided by
the Proposer or any of its Subcontractor(s), occasioned by the negligence, errors, or
other wrongful act or omission of the Proposer, its Subcontractor(s), their officers,
employees, servants or agents.
In the event that the service is delayed or suspended as a result of the
Proposer/Vendor's failure to purchase or maintain the required insurance, the Vendor
shall indemnify the County from any and all increased expenses resulting from such
delay.
21. EXECUTION OF CONTRACT
The Proposer will be required to execute a contract with the County for the services
provided for in this RFP together with the required certificates of insurance.
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SECTION TWO: SAMPLE AGREEMENT
These contract documents should be used only after consultation with counsel. The
documents are not intended as legal advice appropriate to any specific situation, nor do they
purport to address all issues which may arise between the contracting parties. The documents
may be amended or supplemented where appropriate.
MONROE COUNTY
CONTRACTFOR
PUBLIC ADJUSTING CLAIM SERVICES
THIS AGREEMENT is made and entered into this day of , by
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS ("COUNTY"), a political
subdivision of the State of Florida, whose address is 1100 Simonton Street, Key West, Florida
33040 and ("CONTRACTOR" or "CONSULTANT"), whose address is
This Agreement shall consist of the terms, conditions and covenants contained in this
Agreement, including all exhibits, and shall also include any and all representations contained
in the Proposal submitted by the Contractor in response to the Request for Proposal (RFP) for
Public Adjusting Claims Services.
Section 1. SCOPE OF SERVICES
CONTRACTOR shall do, perform and carry out in a professional and proper manner certain
duties as described in the Scope of Services — Exhibit A— which is attached hereto and made
a part of this agreement.
CONTRACTOR shall provide the scope of services in Exhibit A for COUNTY. CONTRACTOR
warrants that it is authorized by law to engage in the performance of the activities herein
described, subject to the terms and conditions set forth in these Agreement documents. The
CONTRACTOR shall at all times exercise independent, professional judgment and shall
assume professional responsibility for the services to be provided. Contractor shall provide
services using the following standards, as a minimum requirement:
A. The CONTRACTOR shall maintain adequate staffing levels to provide the services
required under the Agreement resulting from this RFP process.
B. The personnel shall not be employees of or have any contractual relationship with
the County. To the extent that Contractor uses subcontractors or independent
contractors, this Agreement specifically requires that subcontractors and
independent contractors shall not be an employee of the County.
C. All personnel engaged in performing services under this Agreement shall be fully
qualified, and, if required, to be authorized or permitted under State and local law
to perform such services.
Section 2. COUNTY'S RESPONSIBILITIES
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2.1 Upon occurrence of an event that requires the Contractor's assistance, the County shall
issue a notice to proceed to the Contractor. The County shall also provide a schedule
of the structures that need to be evaluated.
Section 3. TERM OF AGREEMENT
4.1 The initial Agreement term will be for one (1) year beginning the day of
, 2023 ("Effective Date"). The Agreement shall be renewable at the
County's sole option for two (2) additional consecutive one year terms.
4.2 Modification: If either party desires to modify this Agreement, it shall notify the other
in writing at least thirty (30) days prior to the effective date of such modification. In
the case of proposed modification, the party receiving the notification of the
proposed modification shall itself notify the other party within ten (10) days after
receipt of notice of its agreement to the proposed modification. Failure to do so shall
terminate this Agreement.
Section 4. PAYMENT TO CONTRACTOR
4.1 Payment will be made according to the Florida Local Government Prompt Payment Act,
Section 218.70, Florida Statutes. The Provider shall submit the invoice and supporting
documentation acceptable to the Clerk to the County's Risk Manager. 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. The Risk Manager shall review
the request, note his/her approval on the request and forward it to the Clerk for payment.
4.2 Continuation of this Agreement beyond the initial fiscal year is contingent upon annual
appropriation by Monroe County.
Section 5. CONTRACT TERMINATION
5.1 Termination for Cause: Either party may terminate this Agreement because of the failure
of the other party to perform its obligations under the Agreement. In the event of such breach,
the party shall provide notice to the other party, and shall give the other party at least business
days within which to cure the breach. If the breach is not cured within that time period, the
Agreement may be terminated for cause.
5.2 Termination for Convenience: The COUNTY may also terminate this Agreement without
cause upon thirty (30) days' notice to the CONTRACTOR. The COUNTY shall pay
CONTRACTOR for work performed through the date of termination.
Section 6. CONTRACTOR'S ACCEPTANCE OF CONDITIONS
A. CONTRACTOR hereby agrees that he has carefully examined the RFP, his/her response,
and this Agreement and has made a determination that he/she has the personnel,
equipment, and other requirements suitable to perform this work and assumes full
responsibility therefore. The provisions of the Agreement shall control any inconsistent
provisions contained in the specifications. All specifications have been read and carefully
considered by CONTRACTOR, who understands the same and agrees to their sufficiency
for the work to be done. Under no circumstances, conditions, or situations shall this
Agreement be more strongly construed against COUNTY than against CONTRACTOR.
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B. Any ambiguity or uncertainty in the specifications shall be interpreted and construed by
COUNTY, and its decision shall be final and binding upon all parties.
C. The passing, approval, and/or acceptance by COUNTY of any of the services furnished
by CONTRACTOR shall not operate as a waiver by COUNTY of strict compliance with
the terms of this Agreement, and specifications covering the services.
D. CONTRACTOR agrees that County Administrator or his designated representatives may
visit CONTRACTOR'S facility (ies) periodically to conduct random evaluations of services
during CONTRACTOR'S normal business hours.
E. CONTRACTOR has, and shall maintain throughout the term of this Agreement,
appropriate licenses and approvals required to conduct its business, and that it will at all
times conduct its business activities in a reputable manner. Proof of such licenses and
approvals shall be submitted to COUNTY upon request.
Section 7. NOTICES
Any notice required or permitted under this agreement shall be in writing and hand delivered or
mailed, postage prepaid, to the other party by certified mail, returned receipt requested, to the
following:
To the COUNTY: Risk Manager
1111 12th Street, Suite 408
Key West, Florida 33040
To the CONTRACTOR:
Section 8. RECORDS
CONTRACTOR shall maintain all books, records, and documents directly pertinent to
performance under this Agreement in accordance with generally accepted accounting principles
consistently applied. Each party to this Agreement or their authorized representatives shall have
reasonable and timely access to such records of each other party to this Agreement for public
records purposes during the term of the agreement and for five (5) years following the
termination of this Agreement. If an auditor employed by the COUNTY or Clerk determines that
monies paid to CONTRACTOR pursuant to this Agreement were spent for purposes not
authorized by this Agreement, the CONTRACTOR shall repay the monies together with interest
calculated pursuant to Section 55.03 of the Florida Statutes, running from the date the monies
were paid to CONTRACTOR.
Pursuant to F.S. 119.0701 and the terms and conditions of this contract, the CONTRACTOR
is required to:
(1) Keep and maintain public records that would be required by the County to perform
the service.
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(2) Upon receipt from the County's custodian of records, provide the County with a copy
of the requested records or allow the records to be inspected or copied within a
reasonable time at a cost that does not exceed the cost provided in this chapter or as
otherwise provided by law.
(3) Ensure that public records that are exempt or confidential and exempt from public
records disclosure requirements are not disclosed except as authorized by law for the
duration of the contract term and following completion of the contract if the
CONTRACTOR does not transfer the records to the County.
(4) Upon completion of the contract, transfer, at no cost, to the County all public
records in possession of the CONTRACTOR or keep and maintain public records that
would be required by the County to perform the service. If the CONTRACTOR transfers
all public records to the County upon completion of the contract, the CONTRACTOR
shall destroy any duplicate public records that are exempt or confidential and exempt
from public records disclosure requirements. If the CONTRACTOR keeps and maintains
public records upon completion of the contract, the CONTRACTOR shall meet all
applicable requirements for retaining public records. All records stored electronically
must be provided to the County, upon request from the County's custodian of records,
in a format that is compatible with the information technology systems of the County.
(5) A request to inspect or copy public records relating to a County contract must be
made directly to the County, but if the County does not possess the requested records,
the County shall immediately notify the CONTRACTOR of the request, and the
CONTRACTOR must provide the records to the County or allow the records to be
inspected or copied within a reasonable time.
If the CONTRACTOR does not comply with the County's request for records, the County shall
enforce the public records contract provisions in accordance with the contract,
notwithstanding the County's option and right to unilaterally cancel this contract upon violation
of this provision by the CONTRACTOR. A CONTRACTOR who fails to provide the public
records to the County or pursuant to a valid public records request within a reasonable time
may be subject to penalties under section119.10, Florida Statutes.
The CONTRACTOR shall not transfer custody, release, alter, destroy or otherwise dispose of
any public records unless or otherwise provided in this provision or as otherwise provided by
law.
IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION
OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY
TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT,
CONTACT THE CUSTODIAN OF PUBLIC RECORDS, BRIAN BRADLEY AT
PHONE# 305-292-3470 BRAD LEY-BRIAN@MONROECOUNTY-FL.GOV,
MONROE COUNTY ATTORNEY'S OFFICE 1111 12TH Street, SUITE 408,
KEY WEST, FL 33040.
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Section 9. EMPLOYEES SUBJECT TO COUNTY ORDINANCE NOS. 010 AND 020-1990
The CONTRACTOR warrants that it has 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
agreement without liability and may also, in its discretion, deduct from the agreement or
purchase price, or otherwise recover the full amount of any fee, commission, percentage, gift,
or consideration paid to the former County officer or employee.
Section 10. CONVICTED VENDOR
By signing this agreement, CONTRACTOR represents that the execution of this Agreement will
not violate the Public Entities Crime Act (Section 287.133, Florida Statutes). Violation of this
section shall result in termination of this Agreement and recovery of all monies paid hereto, and
may result in debarment from County's competitive procurement activities.
A person or affiliate who has been placed on the convicted vendor list following a conviction for
public entity crime may not submit a bid on an Agreement with a public entity for the construction
or repair of a public building or public work, may not perform work as a CONTRACTOR, supplier,
subcontractor, or CONTRACTOR under Agreement with any public entity, and may not transact
business with any public entity in excess of the threshold amount provided in Section 287.017
of the Florida Statutes, for the Category Two for a period of 36 months from the date of being
placed on the convicted vendor list.
Section 11. GOVERNING LAW, VENUE, INTERPRETATION, COSTS AND FEES
This Agreement shall be governed by and construed in accordance with the laws of the State of
Florida applicable to Agreements made and to be performed entirely in the State.
In the event that any cause of action or administrative proceeding is instituted for the
enforcement or interpretation of this Agreement, the COUNTY and CONTRACTOR agree that
venue shall lie in the appropriate court or before the appropriate administrative body in Monroe
County, Florida.
Section 12. SEVERABILITY
If any term, covenant, condition or provision of this Agreement (or the application thereof to any
circumstance or person) shall be declared invalid or unenforceable to any extent by a court of
competent jurisdiction, the remaining terms, covenants, conditions and provisions of this
Agreement, shall not be affected thereby; and each remaining term, covenant, condition and
provision of this Agreement shall be valid and shall be enforceable to the fullest extent permitted
by law unless the enforcement of the remaining terms, covenants, conditions and provisions of
this Agreement would prevent the accomplishment of the original intent of this Agreement. The
COUNTY and CONTRACTOR agree to reform the Agreement to replace any
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stricken provision with a valid provision that comes as close as possible to the intent of the
stricken provision.
Section 13. ATTORNEY'S FEES AND COSTS
The COUNTY and CONTRACTOR agree that in the event any cause of action or administrative
proceeding is initiated or defended by any party relative to the enforcement or interpretation of
this Agreement, the prevailing party shall be entitled to reasonable attorney's fees, and court
costs, as an award against the non-prevailing party. Mediation proceedings initiated and
conducted pursuant to this Agreement shall be in accordance with the Florida Rules of Civil
Procedure and usual and customary procedures required by the Circuit Court of Monroe County.
Section 14. BINDING EFFECT
The terms, covenants, conditions, and provisions of this Agreement shall bind and inure to the
benefit of the COUNTY and CONTRACTOR and their respective legal representatives,
successors, and assigns.
Section 15. AUTHORITY
Each party represents and warrants to the other that the execution, delivery and performance of
this Agreement have been duly authorized by all necessary County and corporate action, as
required by law.
Section 16. ADJUDICATION OF DISPUTES OR DISAGREEMENTS
COUNTY and CONTRACTOR agree that all disputes and disagreements shall be attempted to
be resolved by meet and confer sessions between representatives of each of the parties. If no
resolution can be agreed upon within 30 days after the first meet and confer session, then any
party shall have the right to seek such relief or remedy as may be provided by this Agreement
or by Florida law. This Agreement shall not be subject to arbitration.
Section 17. COOPERATION
In the event any administrative or legal proceeding is instituted against either party relating to
the formation, execution, performance, or breach of this Agreement, COUNTY and
CONTRACTOR agree to participate, to the extent required by the other party, in all proceedings,
hearings, processes, meetings, and other activities related to the substance of this Agreement
or provision of the services under this Agreement. COUNTY and CONTRACTOR specifically
agree that no party to this Agreement shall be required to enter into any arbitration proceedings
related to this Agreement.
Section 18. NONDISCRIMINATION
During the performance of this Agreement, the CONTRACTOR agrees as follows:
1. The contractor will not discriminate against any employee or applicant for
employment because of race, color, religion, sex, sexual orientation, gender identity,
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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 national origin.
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 for employment.
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 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
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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 by law.
Section 19. COVENANT OF NO INTEREST
COUNTY and CONTRACTOR covenant that neither presently has any interest, and shall not
acquire any interest, which would conflict in any manner or degree with its performance under
this Agreement, and that only interest of each is to perform and receive benefits as recited in
this Agreement.
Section 20. CODE OF ETHICS
The parties understand and agree that officers and employees of the COUNTY are required to
comply with the standards of conduct for public officers and employees as delineated in Section
112.313, Florida Statutes, regarding, but not limited to, solicitation or acceptance of gifts; doing
business with one's agency; unauthorized compensation; misuse of public position, conflicting
employment or contractual relationship; and disclosure or use of certain information.
Section 21. NO SOLICITATION/PAYMENT
The COUNTY and CONTRACTOR warrant that, in respect to itself, it has neither employed nor
retained any company or person, other than a bona fide employee working solely for it, to solicit
or secure this Agreement and that it has not paid or agreed to pay any person, company,
corporation, individual, or firm, other than a bona fide employee working solely for it, any fee,
commission, percentage, gift, or other consideration contingent upon or resulting from the award
or making of this Agreement. For the breach or violation of the provision, the CONTRACTOR
agrees that the COUNTY shall have the right to terminate this Agreement without liability and,
at its discretion, to offset from monies owed, or otherwise recover, the full amount of such fee,
commission, percentage, gift, or consideration.
Section 22. FEDERAL CLAUSES
The County anticipates that some or all of the funds to pay for the services covered by this
Agreement may come from federal grant awards, as that term is defined in 2 CFR part 200.
Therefore, the following clauses are included in this Agreement:
22.1. Contractor agrees to comply with all applicable standards, orders or regulations issued
pursuant to the Clean Air Act (42 U.S.C. 7401-7671 q) and the Federal Water Pollution Control
Act as amended (33 U.S.C. 1251-1387) and will reports violations to FEMA and the Regional
Office of the Environmental Protection Agency (EPA).
22.2. Debarment and Suspension (Executive Orders 12549 and 12689)—A contract award (see
2 CFR 180.220) must not be made to parties listed on the government wide exclusions in the
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System for Award Management (SAM), in accordance with the OMB guidelines at 2 CFR 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." SAM Exclusions contains the names
of parties debarred, suspended, or otherwise excluded by agencies, as well as parties declared
ineligible under statutory or regulatory authority other than Executive Order 12549.
22.3. 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 Regarding Lobbying (and, if
applicable, the Disclosure of Lobbying Activities). Both forms are attached to this Agreement in
Section Three. 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 non-Federal award.
22.4. Americans with Disabilities Act of 1990 (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 pursuant thereto.
22.5. 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 Contract term.
22.6 SMALL AND MINORITY BUSINESSES, WOMEN'S BUSINESS ENTERPRISES, AND
LABOR SURPLUS AREA FIRMS. The County strongly encourages the use of women-, minority-
and veteran-owned business enterprises (SBEs) and wishes to see a of 5% of the contract or
subcontracts awarded pursuant to this RFP go to SBEs. Contractor shall provide good faith
effort and associated documentation. Contractors may search for Florida registered SBEs at:
http://www.dms.myflorida.com/agency administration/office of supplier diversity osd
Any proposal submitted in which the vendor is certified as an SBE, or in which the vendor
proposes to use subcontractors that are certified as SBEs, must submit proof of the registration
or certification from a federal, state or local authority in order to receive credit for the use of the
SBE.
22.7 AUDIT OF RECORDS: Contractor shall grant to the County, Florida Division of
Emergency Management (FDEM), Federal Emergency Management Agency (FEMA), Florida
Department of Transportation, the Federal Government, and any other duly authorized agencies
of the State or Federal Government or the County where appropriate the right to inspect and
review all books and records directly pertaining to the Contract resulting from this RFP for a
period of five (5) years after final grant close-out by FEMA or DEM, or as required by applicable
County, State and Federal law. Records shall be made available during normal working hours
for this purpose.
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In the event that FEMA, DEM, or any other Federal or State agency, or the County, issues
findings or rulings that the amounts charged by the Contractor, or any portions thereof, were
ineligible or were non-allowable under federal or state Law or regulation, Contractor may appeal
any such finding or ruling. If such appeal is unsuccessful, the Contractor shall agree that the
amounts paid to the Contractor shall be adjusted accordingly, and that the Contractor shall,
within 30 days thereafter, issue a remittance to the County of any payments declared to be
ineligible or non- allowable.
Contractor shall comply with federal and/or state laws authorizing an audit of Contractor's
operation as a whole, or of specific Project activities.
22.8 Debarment and Suspension (Executive Orders 12549 and 12689�—A contract award (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 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." SAM Exclusions contains the names
of parties debarred, suspended, or otherwise excluded by agencies, as well as parties declared
ineligible under statutory or regulatory authority other than Executive Order 12549.
22.9 Beginning January 1, 2021, 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 subcontractors during the Contract term. By entering into this
agreement, the contractor or consultant verifies that it registers with and uses the E-Verify
system. If the contractor enters into a contract with a subcontractor, the subcontractor must
provide the contractor with an affidavit stating that the subcontractor does not employ, contract
with, or subcontract with an unauthorized alien. The contractor must maintain the affidavit for the
duration of this contract.
22.10 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 non-Federal entity,
Contractor, or any other party pertaining to any matter resulting from the contract.
22.11 Prohibition on certain telecommunications and video surveillance services or equipment
(2 C.F.R. § 200.216: Recipients and subrecipients are prohibited from obligating or expending
loan or grant funds to (a) procure or obtain, (b) extend or renew a contract to procure or obtain,
or (c) enter into 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 critical technology as part of any system. As used herein, the term "covered
telecommunications equipment" means telecommunications equipment produced by Huawei
Technologies Company or ZTE Corporation (or any subsidiary or affiliate). By entering into this
agreement, both the County and the Contractor agree that it has complied with the provisions in
2 C.F.R. § 200.216.
22.12 Domestic preference for procurements (2 C.F.R. § 200.322): As appropriate and to the
extent consistent with law, the County should, to the greatest extent practicable under a Federal
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award, 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, and
other manufactured products). The requirements of this section must be included in all
subawards including all contracts and purchase orders for work or products under this award.
22.13 (If applicable): Procurement of recovered materials will apply as set forth in 2 CFR part
200.322.
Section 23. NON-WAIVER OF IMMUNITY
Notwithstanding the provisions of Sec. 768.28, Florida Statutes, the participation of the COUNTY
and the CONTRACTOR in this Agreement and the acquisition of any commercial liability
insurance coverage, self-insurance coverage, or local government liability insurance pool
coverage shall not be deemed a waiver of immunity to the extent of liability coverage, nor shall
any Agreement entered into by the COUNTY be required to contain any provision for waiver.
Section 24. PRIVILEGES AND IMMUNITIES
All of the privileges and immunities from liability, exemptions from laws, ordinances, and rules
and pensions and relief, disability, workers' compensation, and other benefits which apply to the
activity of officers, agents, or employees of any public agents or employees of the COUNTY,
when performing their respective functions under this Agreement within the territorial limits of
the COUNTY shall apply to the same degree and extent to the performance of such functions
and duties of such officers, agents, volunteers, or employees outside the territorial limits of the
COUNTY.
Section 25. LEGAL OBLIGATIONS AND RESPONSIBILITIES
Non-Delegation of Constitutional or Statutory Duties. This Agreement is not intended to, nor shall
it be construed as, relieving any participating entity from any obligation or responsibility imposed
upon the entity by law except to the extent of actual and timely performance thereof by any
participating entity, in which case the performance may be offered in satisfaction of the obligation
or responsibility. Further, this Agreement is not intended to, nor shall it be construed as,
authorizing the delegation of the constitutional or statutory duties of the COUNTY, except to the
extent permitted by the Florida constitution, state statute, and case law.
Section 26. NON-RELIANCE BY NON-PARTIES
No person or entity shall be entitled to rely upon the terms, or any of them, of this Agreement
to enforce or attempt to enforce any third-party claim or entitlement to or benefit of any service
or program contemplated hereunder, and the COUNTY and the CONTRACTOR agree that
neither the COUNTY nor the CONTRACTOR or any agent, officer, or employee of either shall
have the authority to inform, counsel, or otherwise indicate that any particular individual or
group of individuals, entity or entities, have entitlements or benefits under this Agreement
separate and apart, inferior to, or superior to the community in general or for the purposes
contemplated in this Agreement.
Section 27. ATTESTATIONS
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CONTRACTOR agrees to execute such documents as the COUNTY may reasonably require,
including, but not being limited to, a Public Entity Crime Statement, an Ethics Statement, and a
Drug-Free Workplace Statement, Lobbying and Conflict of Interest Clause, and Non-Collusion
Agreement.
Section 28. NO PERSONAL LIABILITY
No covenant or agreement contained herein shall be deemed to be a covenant or agreement of
any member, officer, agent or employee of Monroe County in his or her individual capacity, and
no member, officer, agent or employee of Monroe County shall be liable personally on this
Agreement or be subject to any personal liability or accountability by reason of the execution of
this Agreement.
Section 29. EXECUTION IN COUNTERPARTS
This Agreement may be executed in any number of counterparts, each of which shall be
regarded as an original, all of which taken together shall constitute one and the same instrument
and any of the parties hereto may execute this Agreement by signing any such counterpart.
Section 30. SECTION HEADINGS
Section headings have been inserted in this Agreement as a matter of convenience of reference
only, and it is agreed that such section headings are not a part of this Agreement and will not be
used in the interpretation of any provision of this Agreement.
Section 31. INSURANCE POLICIES
31.1 General Insurance Requirements for Other Contractors and Subcontractors.
As a pre-requisite of the work governed, the CONTRACTOR shall obtain, at his/her own
expense, insurance as specified in any attached schedules, which are made part of this contract.
The CONTRACTOR will ensure that the insurance obtained will extend protection to all
Subcontractors engaged by the CONTRACTOR. As an alternative, the CONTRACTOR may
require all Subcontractors to obtain insurance consistent with the attached schedules; however,
CONTRACTOR is solely responsible to ensure that said insurance is obtained and shall submit
proof of insurance to COUNTY. Failure to provide proof of insurance shall be grounds for
termination of this Agreement.
The CONTRACTOR will not be permitted to commence work governed by this contract until
satisfactory evidence of the required insurance has been furnished to the COUNTY as specified
below. Delays in the commencement of work, resulting from the failure of the CONTRACTOR
to provide satisfactory evidence of the required insurance, shall not extend deadlines specified
in this contract and any penalties and failure to perform assessments shall be imposed as if the
work commenced on the specified date and time, except for the CONTRACTOR's failure to
provide satisfactory evidence.
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The CONTRACTOR shall maintain the required insurance throughout the entire term of this
contract and any extensions specified in the attached schedules. Failure to comply with this
provision may result in the immediate suspension of all work until the required insurance has
been reinstated or replaced and/or termination of this Agreement and for damages to the
COUNTY. Delays in the completion of work resulting from the failure of the CONTRACTOR to
maintain the required insurance shall not extend deadlines specified in this contract and any
penalties and failure to perform assessments shall be imposed as if the work had not been
suspended, except for the CONTRACTOR's failure to maintain the required insurance.
The CONTRACTOR shall provide, to the COUNTY, as satisfactory evidence of the required
insurance, either:
• Certificate of Insurance
or
• A Certified copy of the actual insurance policy.
The County, at its sole option, has the right to request a certified copy of any or all insurance policies
required by this contract.
All insurance policies must specify that they are not subject to cancellation, non-renewal, material
change, or reduction in coverage unless a minimum of thirty (30) days prior notification is given to the
County by the insurer.
The acceptance and/or approval of the Contractor's insurance shall not be construed as relieving the
Contractor from any liability or obligation assumed under this contract or imposed by law.
The Monroe County Board of County Commissioners, its employees and officials will be included as
"Additional Insured" on all policies, except for Workers' Compensation.
31.2Insurance Requirements For Contract Between County And Contractor
(Note: amounts of coverage are subject to change in final contract)
Prior to the commencement of work governed by this contract, the CONTRACTOR shall obtain General
Liability Insurance. Coverage shall be maintained throughout the life of the contract and include, as a
minimum:
• Premises Operations
• Bodily Injury Liability
• Expanded Definition of Property Damage
The minimum limits acceptable shall be:
$500,000 Combined Single Limit (CSL)
If split limits are provided, the minimum limits acceptable shall be:
$200,000 per Person
$500,000 per Occurrence
$200,000 Property Damage
An Occurrence Form policy is preferred. If coverage is provided on a Claims Made policy, its provisions
should include coverage for claims filed on or after the effective date of this contract. In addition, the
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period for which claims may be reported should extend for a minimum of twelve (12) months following
the acceptance of work by the County.
The Monroe County Board of County Commissioners shall be named as Additional Insured on all general
liability policies issued to satisfy the above requirements.
31.3Vehicle Liability Insurance requirements
Recognizing that the work governed by this contract requires the use of vehicles, the CONTRACTOR,
prior to the commencement of work, shall obtain Vehicle Liability Insurance. Coverage shall be
maintained throughout the life of the contract and include, as a minimum, liability coverage for:
• Owned, Non-Owned, and Hired Vehicles
The minimum limits acceptable shall be:
$300,000 Combined Single Limit (CSL)
If split limits are provided, the minimum limits acceptable shall be:
$200,000 per Person
$300,000 per Occurrence
$200,000 Property Damage
The Monroe County Board of County Commissioners shall be named as Additional Insured on all vehicle
liability policies issued to satisfy the above requirements.
31.4 Workers' Compensation Insurance Requirements
Prior to commencement of work governed by this contract, the CONTRACTOR shall obtain
Workers' Compensation Insurance with limits sufficient to respond to the applicable state
statutes.
In addition, the CONTRACTOR shall obtain Employers' Liability Insurance with limits of not less
than:
$500,000 Bodily Injury by Accident
$500,000 Bodily Injury by Disease, policy limits
$500,000 Bodily Injury by Disease, each employee
Coverage shall be maintained throughout the entire term of the contract.
Coverage shall be provided by a company or companies authorized to transact business in the
state of Florida.
31.5 Professional Liability Requirements
Recognizing that the work governed by this contract involves the furnishing of advice or services
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of a professional nature, the Contractor shall purchase and maintain, throughout the life of the
contract, Professional Liability Insurance which will respond to damages resulting from any claim
arising out of the performance of professional services or any error or omission of the Contractor
arising out of work governed by this contract.
The minimum limits of liability shall be:
$1,000,000 per occurrence/$2,000,000 Aggregate
Section 32. INDEMNIFICATION, HOLD HARMLESS AND DEFENSE
CONTRACTOR assumes and agrees to hold harmless, indemnify, protect, and defend the
COUNTY and the COUNTY's elected and appointed officers and employees, Boards and
Commissions, and any other agents, individually and collectively (collectively, "indemnified
parties"), against any and all fines, penalties, lawsuits, claims, actions, causes of action,
litigation, demands, obligations, administrative proceedings, appellate proceedings, or other
proceedings relating to any and all types of injury (including death), loss, damage, fine,
penalty, liability, judgment, or business interruption, and any and all costs, fees, attorney fees,
or expenses that may be asserted against, initiated with respect to, or sustained by, any of the
indemnified parties by reason of, arising out of, incident to, resulting from, or in connection
with, (A) any and all activities, operations, or work of CONTRACTOR or any of its employees,
agents, consultants, sub-contractors or other persons employed or utilized under any and all of
the obligations and terms of this Agreement, (B) the negligence, errors, omissions,
recklessness, or intentional or willful misconduct of CONTRACTOR or any of its employees,
agents, consultants, sub-contractors or other persons employed or utilized, or (C)
CONTRACTOR's non-conformance, breach, or default with respect to any of the obligations
and terms under this Agreement. Insofar as the claims, actions, causes of action, litigation,
proceedings, costs, fees, or expenses relate to events or circumstances that occur during the
term of this Agreement, this section will survive the expiration of the term of this Agreement or
any earlier termination of this Agreement. CONTRACTOR agrees that the indemnified parties
may select the attorneys to appear and defend such claims, actions, causes of action, or
litigation on behalf of the indemnified parties. CONTRACTOR further agrees to pay at the
CONTRACTOR's expense the attorneys' fees and costs incurred by those attorneys selected
by the indemnified parties to appear and defend such claims, actions, causes of action, or
litigation on behalf of the indemnified parties at the trial and appellate levels. CONTRACTOR
agrees that the first ten dollars ($10.00) of remuneration paid to CONTRACTOR represents
specific consideration for the indemnification obligation provided above. The extent of liability is
in no way limited to, reduced or lessened by the insurance requirements contained elsewhere
with in this Agreement.
The duty to defend under this Section is independent and separate from the duty to indemnify,
and the duty to defend exists regardless of any ultimate liability of the CONTRACTOR, the
COUNTY and any indemnified party. The duty to defend arises immediately upon presentation
of a claim by any party and written notice of such claim being provided to the CONTRACTOR.
The CONTRACTOR's obligation to indemnify and defend under this Section will survive the
expiration or earlier termination of this AGREEMENT until it is determined by final judgment
that an action against the COUNTY or an indemnified party for the matter indemnified
hereunder is fully and finally barred by the applicable statute of limitations.
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At all times and for all purposes hereunder, the CONTRACTOR is an independent contractor
and not an employee of the Board of County Commissioners. No statement contained in this
agreement shall be construed so as to find the CONTRACTOR or any of his/her employees,
contractors, servants or agents to be employees of the Board of County Commissioners for
Monroe County. As an independent contractor the CONTRACTOR shall provide independent,
professional judgment and comply with all federal, state, and local statutes, ordinances, rules
and regulations applicable to the services to be provided.
The CONTRACTOR shall be responsible for the completeness and accuracy of its work, plan,
supporting data, and other documents prepared or compiled under its obligation for this project,
and shall correct at its expense all significant errors or omissions therein which may be disclosed.
The cost of the work necessary to correct those errors attributable to the CONTRACTOR and
any damage incurred by the COUNTY as a result of additional costs caused by such errors shall
be chargeable to the CONTRACTOR. This provision shall not apply to any maps, official records,
contracts, or other data that may be provided by the COUNTY or other public or semi-public
agencies.
The CONTRACTOR agrees that no charges or claims for damages shall be made by it for any
delays or hindrances attributable to the COUNTY during the progress of any portion of the
services specified in this contract. Such delays or hindrances, if any, shall be compensated for
by the COUNTY by an extension of time for a reasonable period for the
CONTRACTOR to complete the work schedule. Such an agreement shall be made between
the parties.
IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed on the
day of 20_.
(SEAL)
Attest: KEVIN MADOK, CPA, CLERK BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By by
As Deputy Clerk Mayor/Chairman
(CORPORATE SEAL) (Name of Contractor)
ATTEST:
By by
Title:
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EXHIBIT A
SCOPE OF SERVICES
SPECIFICATIONS
The firm shall provide adjusting services on an as needed basis. The firm will evaluate
damage to County property and negotiate maximum settlements with its insurers following
catastrophic events resulting in significant damage. In addition, the firm will assist the County
in coordinating requests for Public Assistance from the Federal Emergency Management
Agency (FEMA).
The following services will be expected of the successful proposer:
➢ Investigate and analyze all property damage associated with claims assigned to the
adjuster.
➢ Review all insurance policies and determine the recoveries available to the County from
each policy.
➢ Review pre-loss estimates that could affect recovery and recommend modifications if
necessary.
➢ Prepare a concise, well documented replacement cost estimate of buildings
and personal property damaged and determine the Actual Cash Value (ACV) if
applicable.
➢ Evaluate "code upgrade" coverages and costs, if applicable.
➢ Negotiate interim and final settlements with the County insurers.
➢ Advise County management regarding the capture and development of loss information
(including direct damage, extra expenses, and loss of income).
➢ Coordinate and integrate all areas of the claim effort on behalf of the County.
➢ Assist in the coordination of advance payments with the County insurers.
➢ Coordinate all inspections and meetings with the County's insurers.
➢ Provide regular status reports.
➢ Review all claim data with County representatives prior to being submitted to the insurers.
➢ Conduct and/or participate in all settlement discussions with the County's insurers.
➢ Maintain all information obtained during the services provided to the County as
confidential.
➢ Expedite and maximize all recoveries available to the County.
➢ Coordinate with the Federal Emergency Management Agency (FEMA) if required.
➢ Any and all services required to resolve County claims with its insurers.
A copy of the County's Current Statement of Values is included as attachment for reference.
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EXHIBIT B
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SECTION THREE
COUNTY FORMS AND INSURANCE FORMS
SUBMISSION RESPONSE FORM
RESPOND TO: MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
Purchasing Department
GATO BUILDING, ROOM 2-213
1100 SIMONTON STREET
KEY WEST, FLORIDA 33040
1 acknowledge receipt of Addenda No. (s)
I have included
• Response Form
• Lobbying and Conflict of Interest Clause
• Non-Collusion Affidavit
• Drug Free Workplace Form
• Public Entity Crime Statement
Vendor certification regarding scrutinized companies list
• Appendix A, 44 C.F.R. part 18—certification regarding lobbying
• Respondent's Insurance and Indemnification Statement
• Insurance Agent's Statement
• Request for Waiver of Insurance Requirements (if applicable)
I have included a current copy of the following professional license and Monroe County business tax receipt:
If the applicant is not an individual (sole proprietor), please supply the following information:
APPLICANT ORGANIZATION:
(Registered business name must appear exactly as it appears on www.sunbiz.org.
Any applicant other than an individual (sole proprietor) must submit a printout of the "Detail by Entity
Name" screen from Sunbiz, and a copy of the most recent annual report filed with the Florida Department
of State, Division of Corporations.
Mailing Address: Telephone:
Fax:
Date:
Signed: Witness:
(Print Name)
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me by means of ❑ physical presence or ❑ online notarization, this
day of 2023, by (name of affiant). He/she is personally known to
me or has produced (type of identification) as identification.
NOTARY PUBLIC
My Commission expires:
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LOBBYING AND CONFLICT OF INTEREST CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO. 010-1990
MONROE COUNTY, FLORIDA
ETHICS CLAUSE
{ 11
(Company)
"...warrants that he/it has not employed, retained or otherwise had act on his/her behalf any
former County officer or employee in violation of Section 2 of Ordinance No. 010-1990 or any
County officer or employee in violation of Section 3 of Ordinance No. 010-1990. For breach or
violation of this provision the County may, in its discretion, terminate this Agreement without
liability and may also, in its discretion, deduct from the Agreement or purchase price, or
otherwise recover, the full amount of any fee, commission, percentage, gift, or consideration
paid to the former County officer or employee."
(Signature)
Date:
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me by means of ❑ physical presence or ❑ online notarization, this
day of 2023, by (name of affiant). He/she is personally known to
me or has produced (type of identification) as identification.
NOTARY PUBLIC
My Commission expires:
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NON-COLLUSION AFFIDAVIT
I, of the city of according to law on
my oath, and under penalty of perjury, depose and say that
1. 1 am of the firm of
the bidder making the
Proposal for the project described in the Request for Proposals for
and that I executed the said
proposal with full authority to do so;
2. The prices in this bid have been arrived at independently without collusion,
consultation, communication or agreement for the purpose of restricting
competition, as to any matter relating to such prices with any other bidder or with
any competitor;
3. Unless otherwise required by law, the prices which have been quoted in this bid
have not been knowingly disclosed by the bidder and will not knowingly be
disclosed by the bidder prior to bid opening, directly or indirectly, to any other
bidder or to any competitor; and
4. No attempt has been made or will be made by the bidder to induce any other
person, partnership or corporation to submit, or not to submit, a bid for the purpose
of restricting competition;
5. The statements contained in this affidavit are true and correct, and made with full
knowledge that Monroe County relies upon the truth of the statements contained in
this affidavit in awarding contracts for said project.
(Signature)
Date:
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me by means of ❑ physical presence or ❑ online notarization, this
day of 2023, by (name of affiant). He/she is personally known to
me or has produced (type of identification) as identification.
NOTARY PUBLIC
My Commission expires:
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DRUG-FREE WORKPLACE FORM
The undersigned vendor in accordance with Florida Statutes Section 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'
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 bid a copy of the statement specified in subsection (1).
4. In the statement specified in subsection (1), notify the employees that, as a condition of
working on the commodities or contractual services that are under bid, the employee will
abide by the terms of the statement and will notify the employer of any conviction of, or
plea of guilty or nolo contendere to, any violation of Chapter 893 (Florida Statutes) or of
any controlled substance law of the United States or any state, for a violation occurring in
the workplace no later than five (5) days after such conviction.
5. 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.
(Signature)
Date:
STATE OF:
COUNTY OF:
Subscribed and sworn to (or affirmed) before me on (date) by
(name of affiant). He/She is personally known to me or has
produced (type of identification)as identification.
NOTARY PUBLIC
My Commission Expires:
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PUBLIC ENTITY CRIME STATEMENT
"A person or affiliate who has been placed on the convicted vendor list following a conviction for
public entity crime may not submit a bid on a contract to provide any goods or services to a
public entity, may not submit a bid on a contract with a public entity for the construction or repair
of a public building or public work, may not submit bids on leases of real property to public entity,
may not be awarded or perform work as a contractor, supplier, subcontractor, or CONTRACTOR
under a contract with any public entity, and may not transact business with any public entity in
excess of the threshold amount provided in Section 287.017, for CATEGORY TWO for a period
of 36 months from the date of being placed on the convicted vendor list."
I have read the above and state that neither (Proposer's name) nor
any Affiliate has been placed on the convicted vendor list within the last 36 months.
(Signature)
Date:
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me by means of ❑ physical presence or ❑ online notarization, this
day of 2023, by (name of affiant). He/she is personally known to
me or has produced (type of identification) as identification.
NOTARY PUBLIC
My Commission expires:
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VENDOR CERTIFICATION REGARDING SCRUTINIZED COMPANIES LISTSVENDOR
CERTIFICATION REGARDING SCRUTINIZED COMPANIES LISTS
Project Description(s):
Respondent Vendor Name:
Vendor FEIN:
Vendor's Authorized Representative Name and Title:
Address:
City: State: Zip:
Phone Number:
Email Address:
Section 287.135, Florida Statutes prohibits a company from bidding on, submitting a proposal for, or
entering into or renewing a contract for goods or services of any amount if, at the time of contracting or
renewal,the company is on the Scrutinized Companies that Boycott Israel List,created pursuant to Section
215.4725, Florida Statutes, or is engaged in a Boycott of Israel. Section 287.135, Florida Statutes, also
prohibits a company from bidding on, submitting a proposal for, or entering into or renewing a contract
for goods or services of$1,000,000 or more, that are on either the Scrutinized Companies with Activities
in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector Lists
which were created pursuant to s. 215.473, Florida Statutes, or is engaged in business operations in Cuba
or Syria.
As the person authorized to sign on behalf of Respondent, I hereby certify that the company identified
above in the Section entitled"Respondent Vendor Name"is not listed on the Scrutinized Companies that
Boycott Israel List or engaged in a boycott of Israel and for Projects of$1,000,000 or more is not listed
on either the Scrutinized Companies with Activities in Sudan List, the Scrutinized Companies with
Activities in the Iran Petroleum Energy Sector List, or engaged in business operations in Cuba or Syria.
I understand that pursuant to Section 287.135,Florida Statutes,the submission of a false certification may
subject company to civil penalties, attorney's fees, and/or costs. I further understand that any contract with
the County may be terminated, at the option of the County, if the company is found to have submitted a
false certification or has been placed on the Scrutinized Companies that Boycott Israel List or engaged in
a boycott of Israel or placed on the Scrutinized Companies with Activities in Sudan List or the Scrutinized
Companies with Activities in the Iran Petroleum Energy Sector List or been engaged in business
operations in Cuba or Syria.
Certified By: , who is
authorized to sign on behalf of the above referenced company.
Authorized Signature:
Print Name:
Title:
Note: The List are available at the following Department of Management Services Site:
hqp://www.dms.myflorida.com/business_operations/state purchasing/vendor information/convicted_su
spended_discriminatory complaints_vendor lists
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CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY, AND
VOLUNTARY EXCLUSION
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APPENDIX A to 44 C.F.R. PART 18, CERTIFICATION REGARDING LOBBYING
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 of the 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 a Member of Congress in
connection with the awarding of any Federal contract, the making of any Federal grant, the malting 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.
(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any agency, a Member of Congress,
an officer or employee of Congress, or an employee of a Member of Congress in connection with this
Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit
Standard Form-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 a material representation of fact upon which reliance was placed when this
transaction was made or entered into. Submission of this certification is a prerequisite for making or
entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to
file the required certification shall be subject to a civil penalty of not less than $10,000 and not more
than $100,000 for each such failure.
The Contractor, , certifies or affirms the truthfulness and accuracy of
each statement of its certification and disclosure, if any. IN addition, the Contractor understands and
agrees that the provisions of 31 U.S.C. Ch. 38, Administrative Remedies for False Claims and
Statements, apply to this certification and disclosure, if any.
Date:
Signature of Contractor's Authorized Official
Printed Name:
Title:
Approved by OMB
0348-0046
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APPENDIX B to 44 CFR PART 18 - DISCLOSURE FORM TO REPORT LOBBYING
Disclosure of Lobbying Activities
Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352
See reverse for public burden disclosure
1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type:
a. contract X a.bid/offer/application X a.initial filing
X b. grant b.initial award b.material change
c. cooperative agreement c.post-award
d.loan For material change only:
e.loan guarantee Year quarter
f.loan insurance Date of last report
4. Name and Address of Reporting Entity: 5. If Reporting Entity in No.4 is Subawardee,
X Prime Subawardee Enter Name and Address of Prime:
Tier if Known:
N/A
Monroe County Board of County Commissioners
1100 Simonton Street
Key West,FL 33040-3110
Congressional District, if known: FL26 Congressional District, i known:
6. Federal Department/Agency: 7. Federal Program Name/Description:
U.S.Department of Justice
Office of Justice Programs
Bureau of Justice Assistance CFDA Number, if applicable: 16.738
8. Federal Action Number,if known: 9. Award Amount, if known:
BJA-2018-13626 $ 13,982
10.a.Name and Address of Lobbying Registrant b. Individuals Performing Services (including address if
(f individual, last name,first name,MI): differentfrom No. IOa)
(last name,first name,MI).-
N/A N/A
11. Information requested through this form is authorized by
title 31 U.S.C.section 1352. This disclosure of lobbying Signature:
activities is a material representation of fact upon which
reliance was placed by the tier above when this transaction Print Name:
was made or entered into.This disclosure is required
pursuant to 31 U.S.C.1352.This information will be reported Title:
to the Congress semi-annually and will be available for public
inspection.Any person who fails to file the required
disclosure shall be subject to a civil penalty of not less than Telephone No.: Date:
510,000 and not more than$100,000 for each such failure.
Federal Use Only Authorized for Local Reproduction
Standard Form-LLL(Rev.7-97)
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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 a covered Federal action,or a material change to a previous filing,pursuant to title 31 U.S.C. section
1352. The filing of a form is required for each payment or agreement to make payment to any lobbying entity for influencing
or attempting to influence an officer or employee of any agency,a Member of Congress,an officer or employee of Congress,
or an employee of a Member of Congress in connection with a covered Federal action. 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 followup report caused by a material change to the
information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last
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 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 1 st tier.
Subawards include but are not limited to subcontracts,subgrants and contract awards under grants.
5. If the organization filing the report in item 4 checks"subawardee,"then enter the full name,address,city, State and
zip code of the prime Federal recipient. Include Congressional District,if known.
6. Enter the name of the federal agency making the award or loan commitment. Include at least one organizational
level below 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.
8. Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 (e.g.,
Request for Proposal(RFP)number;invitations for Bid(IFB)number;grant announcement number;the contract,
grant,or loan award number;the application/proposal control number assigned by the Federal agency). Included
prefixes,e.g.,"RFP-DE-90-001."
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 commitment for the prime entity identified in item 4 or 5.
10. (a)Enter the full name,address, city, State and zip code of the lobbying registrant under the Lobbying Disclosure
Act of 1995 engaged by the reporting entity identified in item 4 to influence 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).
1 l. The certifying official shall sign and date the form,print his/her name,title, and telephone number.
According to the Paperwork Reduction Act,as amended,no persons are required to respond to a collection of information unless it displays
a valid OMB control Number. The valid OMB control number for this information collection is OMB No.0348-0046. Public reporting
burden for this collection of information is estimated to average 10 minutes per response,including time for reviewing instructions,
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,DC 20503
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MONROE COUNTY, FLORIDA
Respondent's Insurance and Indemnification Statement
Insurance Requirement Required Limits
Worker's Compensation Statutory Limits
Employer's Liability $500,000/$500,000/$500,000
General Liability $500,000 Combined Single Limit
Vehicle Liability $300,000 Combined Single Limit
Professional Liability $1,000,000 per occurrence
$2,000,000 aggregate
INDEMNIFICATION AND HOLD HARMLESS FOR CONSULTANTS AND SUBCONSULTANTS
The CONSULTANT covenants and agrees to indemnify and hold harmless COUNTY/Monroe County and Monroe
County Board of County Commissioners, its officers and employees from liabilities, damages, losses and costs,
including but not limited to, reasonable attorneys' fees, to the extent caused by the negligence, recklessness, or
intentional wrongful conduct of the CONSULTANT, subcontractor(s) and other persons employed or utilized by
the CONSULTANT in the performance of the contract.
In the event that the completion of the project(to include the work of others) is delayed or suspended as a result
of the CONSULTANT's failure to purchase or maintain the required insurance, the CONSULTANT shall
indemnify the County from any and all increased expenses resulting from such delay. Should any claims
be asserted against the COUNTY by virtue of any deficiency or ambiguity in the plans and specifications provided
by the CONSULTANT, the CONSULTANT agrees and warrants that CONSULTANT shall hold the County
harmless and shall indemnify it from all losses occurring thereby and shall further defend any claim or action
on the County's behalf.
The first ten dollars ($10.00) of remuneration paid to the CONSULTANT is consideration for the indemnification
provided for above.
The extent of liability is in no way limited to, reduced, or lessened by the insurance requirements contained
elsewhere within this agreement.
This indemnification shall survive the expiration or earlier termination of the Agreement.
RESPONDENT'S STATEMENT
I understand the insurance that will be mandatory if awarded the contract and will comply in full with all the
requirements.
Respondent Signature
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MONROE COUNTY, FLORIDA
Request For Waiver
of
Insurance Requirements
It is requested that the insurance requirements, as specified in the County's Schedule of
Insurance Requirements, be waived or modified on the following contract:
Contractor:
Contract for:
Address of Contractor:
Phone:
Scope of Work:
Reason for Waiver:
Policies Waiver
will apply to:
Signature of Contractor:
Approved Not Approved
Risk Management:
Date:
County Administrator appeal:
Approved Not Approved
Date:
Board of County Commissioners appeal:
Approved Not Approved
Meeting Date:
PROPOSER SIGNATURE
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INSURANCE AGENT'S STATEMENT
I have reviewed the above requirements with the bidder named below. The following
deductibles apply to the corresponding policy.
POLICY DEDUCTIBLES
Liability policies are Occurrence Claims Made
Insurance Agency Signature
Print Name:
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Monroe County Board of County Commissioners
Statement of Values as of 10/19/22
® ®
s e a s a ms
- @
Real & Personal Property $243,449,647
Contractors Equipment $1,251,225
Towers $11,559,245
EMAS $11,900,000
PITO $350,000
Total: $268,510,117
Signed and Dated: