01/18/2023 Agreement GVS COURTq°
o: A Kevin Madok, CPA
-
�o ........ � Clerk of the Circuit Court& Comptroller Monroe County, Florida
�z cooN
DATE: January 26, 2023
TO: Cary Knight, Director
Project Management
Breanne Erickson, Contract/Budget Administrator
Project Management
FROM: Liz Yongue, Deputy Clerk
SUBJECT: January 18th BOCC Meeting
Attached is the following item, which has been executed and added to the record:
C8 Administrative Agreement with the Florida Keys Council of the Arts to utilize
10% of the 1% Art in Public Places allocation for capital projects, to pay for administrative
expenses.
Should you have any questions please feel free to contact me at(305) 292-3550.
cc: County Attorney
Finance
File
KEY WEST MARATHON PLANTATION KEY
500 Whitehead Street 3117 Overseas Highway 88770 Overseas Highway
Key West, Florida 33040 Marathon, Florida 33050 Plantation Key, Florida 33070
MONROE COUNTY ARTS IN PUBLIC PLACES
ADMINISTRATIVE AGREEMENT
This AGREEMENT dated the 181h day of January, 2023, is entered into by and between
the BOARD OF COUNTY COMMISSIONERS FOR MONROE COUNTY, ("County"), and the
FLORIDA KEYS COUNCIL OF THE ARTS ("FKCA").
WHEREAS, the Art in Public Places Ordinance 4022-2001, codified at MCC §2-233,
provides for an appropriation of 1% of the construction costs for new construction exceeding
$500,000.00 and renovations exceeding $100,000.00 for the acquisition, commission, installation,
and maintenance of works of art in said buildings; and
WHEREAS, the ordinance establishes an Arts in Public Places Committee (AIPP
Committee) to advise the County Commission regarding art to be acquired and installed in each
public construction project subject to the AIPP allocation; and
WHEREAS,the AIPP Committee has elected to utilize ten percent(10%)of the art funding
for each project for certain reimbursements of administrative expenses incurred by the FKCA; and
WHEREAS, an Administrative Agreement for the FKCA to utilize ten percent (10%) of
the art funding for administrative expenses has been continuously in effect since the first BOCC
action on October 15, 2008;
WHEREAS, the current Administrative Agreement expired on September 30, 2022, with
no additional options available to renew the Agreement; and
WHEREAS,the FKCA has authorized its Executive Director to request to enter into a new
Administrative Agreement to utilize ten percent (10%) of the art funding for administrative
expenses effective retroactive to October 1, 2022, and expiring on September 30, 2025; and
NOW THEREFORE, in consideration of the mutual covenants and payment contained
herein,the parties have entered into this Agreement on the terms and conditions as set forth below:
1. REIMBURSABLE ADMINISTRATIVE EXPENSES: The County shall reimburse up to
ten percent (10%) of the funds allocated for each project to the FKCA for expenditures
directly related to each project. Expenses shall be reimbursed only after properly invoiced
by the FKCA with supporting receipts and documents.
Reimbursable expenses shall include:
a. The FKCA may be reimbursed for personnel (as listed below) for their time spent
associated with a project, at their hourly rate, including but not limited to issuance of
Page 1 1
RFQ's and RFP's, collating and distributing responses, providing administrative
support during evaluation meetings, and preparation and processing of contracts:
NAME FUNCTION HOURLY RATE
Elizabeth Young Administration $42.76
Martha Resk Administration $33.65
Cynthia Page Administration $31.00
The services performed by the above personnel shall be reimbursed at their hourly rate.
A schedule of services must be approved by the Director of Project Management.
b. Expense of transportation and living expenses,but only to the extent and in the amounts
authorized by Section 112.061, Florida Statutes.
c. Postage and handling of documents associated with the project.
d. Costs for printing, binding, copying costs associated with the project.
2. MODIFICATIONS AND AMENDMENTS: Any and all modifications of the terms of
this Agreement shall be amended in writing and approved by the Board of County
Commissioners of Monroe County.
3. AGREEMENT PERIOD: This Agreement is for the period of three (3) years beginning
retroactive to October 1, 2022, and ending September 30, 2025. There will be one (1)
option to renew this Agreement for one (1) additional three-year term. Renewal must be
requested in writing by the FKCA and approved by the Board of County Commissioners
of Monroe County.
4. SEPARATE ENTITY: At all times and for all purposes hereunder,the FKCA is a separate
entity and not an employee of the Board of County Commissioners of Monroe County. No
statement contained in this Agreement shall be construed as to find the FKCA or any of its
employees, contractors, servants, or agents to be employees of the Board of County
Commissioners of Monroe County, and they shall be entitled to none of the rights,
privileges or benefits of employees of Monroe County.
5. HOLD HARMLESS/INDEMNIFICATION: The FKCA hereby agrees to indemnify and
hold harmless the BOCC, and any of its officers and employees from and against any and
all claims, liabilities, litigation, causes of action, damages, costs, expenses (including but
not limited to fees and expenses arising from any factual investigation, discovery or
preparation for litigation), and the payment of any and all of the foregoing or any demands,
settlements or judgments arising directly or indirectly under this Agreement. The FKCA
shall immediately give notice to the County of any suit, claim, or action made against the
County that is related to the activity under this Agreement, and will cooperate with the
Page 1 2
County in the investigation arising as a result of any suit, action, or claim related to this
Agreement.
6. CONSENT TO JURISDICTION: This Agreement, its performance, and all disputes
arising hereunder, shall be governed by the laws of the State of Florida, and both parties
agree that the proper venue for any actions shall be in Monroe County.
7. ETHICS CLAUSE: The FKCA warrants that it has not employed,retained, or otherwise
had act on its behalf any former County officer or employee in violation of Section 2 of
Ordinance No. 10-1990 or any County officer or employee in violation of Section 3 of
Ordinance No. 10-1990. For breach or violation of the provision the County may, at its
discretion, terminate this Agreement without liability and may also, at its discretion,
terminate this Agreement without liability and may also, at 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 or present County officer or employee.
8. 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 an agreement to provide any goods or services to a public entity, may not submit a
bid, proposal, or reply on a contract to provide any goods or services to a public entity,
may not submit a bid, proposal, or reply on a contract with a public entity for the
construction or repair of a public building or public work, may not submit bids on leases
of real property to public entity, may not be awarded or perform work as a contractor,
supplier, sub-contractor, or consultant under a contract with any public entity, and may not
transact business with any public entity in excess of the threshold amount provided in
Section 287.017, Florida Statutes, for CATEGORY TWO for a period of thirty-six (36)
months from the date of being placed on the convicted vendor list.
9. NOTICE: Any written notice to be given to either party under this Agreement or related
hereto shall be addressed and delivered as follows:
For AIPP & FKCA For County
Executive Director
Florida Keys Council of the Arts Monroe County Project Management
1100 Simonton Street 1100 Simonton Street
Key West, FL 33040 Key West, FL 33040
&
Monroe County Attorney
1111 121h Street, Suite 408
Key West, FL 33040
Page 13
10. Public Records Compliance. Contractor must comply with Florida public records laws,
including but not limited to Chapter 119, Florida Statutes and Section 24 of article I of the
Constitution of Florida. The County and Contractor shall allow and permit reasonable
access to, and inspection of, all documents,records,papers, letters or other"public record"
materials in its possession or under its control subject to the provisions of Chapter 119,
Florida Statutes, and made or received by the County and Contractor in conjunction with
this contract and related to contract performance. The County shall have the right to
unilaterally cancel this contract upon violation of this provision by the Contractor. Failure
of the Contractor to abide by the terms of this provision shall be deemed a material breach
of this contract and the County may enforce the terms of this provision in the form of a
court proceeding and shall, as a prevailing party, be entitled to reimbursement of all
attorney's fees and costs associated with that proceeding. This provision shall survive any
termination or expiration of the contract.
The Contractor is encouraged to consult with its advisors about Florida Public Records
Law in order to comply with this provision.
Pursuant to Fla. Stat., Sec. 119.0701 and the terms and conditions of this contract, the
Contractor is required to:
(1) Keep and maintain public records that would be required by the County to
perform the service.
(2) Upon receipt from the County's custodian of records, provide the County with a
copy of the requested records or allow the records to be inspected or copied within a
reasonable time at a cost that does not exceed the cost provided in this chapter or as
otherwise provided by law.
(3) Ensure that public records that are exempt or confidential and exempt from public
records disclosure requirements are not disclosed except as authorized by law for the
duration of the contract term and following completion of the contract if the contractor
does not transfer the records to the County.
(4) Upon completion of the contract, transfer, at no cost, to the County all public
records in possession of the Contractor or keep and maintain public records that would
be required by the County to perform the service. If the Contractor transfers all public
records to the County upon completion of the contract,the Contractor shall destroy any
duplicate public records that are exempt or confidential and exempt from public records
disclosure requirements. If the Contractor keeps and maintains public records upon
completion of the contract, the Contractor shall meet all applicable requirements for
retaining public records. All records stored electronically must be provided to the
County, upon request from the County's custodian of records, in a format that is
compatible with the information technology systems of the County.
(5) A request to inspect or copy public records relating to a County contract must be
made directly to the County, but if the County does not possess the requested records,
the County shall immediately notify the Contractor of the request, and the Contractor
Page 14
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 sectionl 19.10, 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, BRADLEY-
BRIAN(&,MONROECOUNTY-FL.GOV, MONROE COUNTY ATTORNEY'S
OFFICE, 1111 12TH STREET, SUITE 408, KEY WEST, FL 33040.
11. Interpretation, Costs, and Fees. The County and FKCA agree that, in the event of
conflicting interpretations of the terms or a term of this Agreement by or between any of
them the issue shall be submitted to mediation prior to the institution of any other
administrative or legal proceeding. The County and FKCA agree that in the event any
cause of action or administrative proceeding is initiated or defended by any parry relative
to the enforcement or interpretation of this Agreement,the prevailing parry shall be entitled
to reasonable attorney's fees, court costs, investigative, and out-of-pocket expenses, as an
award against the non-prevailing parry, and shall include attorney's fees, court costs,
investigative,and out-of-pocket expenses in appellate proceedings. Mediation proceedings
initiated and conducted pursuant to this Agreement shall be in accordance with the Florida
Rules of Civil Procedure and usual and customary procedures required by the Circuit Court
of Monroe County.
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 Agreement would
prevent the accomplishment of the original intent of this Agreement. The County and
Page 15
FKCA agree to reform the Agreement to replace any stricken provision with a valid
provision that comes as close as possible to the intent of the stricken provision.
13. Binding Effect. The terms, covenants, conditions, and provisions of this Agreement shall
bind and inure to the benefit of the County and FKCA and their respective legal
representatives, successors, and assigns.
14. Authority. Each parry 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.
15. Claims for Federal or State Aid. FKCA and County agree that each shall be, and is,
empowered to apply for, seek, and obtain federal and state funds to further the purpose of
this Agreement; provided that all applications, requests, grant proposals, and funding
solicitations shall be approved by each parry prior to submission.
16. Adjudication of Disputes or Disagreements. County and FKCA 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 the issue or issues are still not resolved to the
satisfaction of the parties, then any party shall have the right to seek such relief or remedy
as may be provided by this Agreement or by Florida law. This Agreement is not subject
to arbitration. This provision does not negate or waive the provisions of Paragraph 18
concerning termination or cancellation.
17. Cooperation. In the event any administrative or legal proceeding is instituted against either
parry relating to the formation, execution, performance, or breach of this Agreement,
County and FKCA agree to participate, to the extent required by the other parry, 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 FKCA
specifically agree that no parry to this Agreement shall be required to enter into any
arbitration proceedings related to this Agreement.
18. Nondiscrimination. County and FKCA agree that there will be no discrimination against
any person, and it is expressly understood that upon a determination by a court of
competent jurisdiction that discrimination has occurred, this Agreement automatically
terminates without any further action on the part of any parry, effective the date of the court
order. County or FKCA agree to comply with all Federal and Florida statutes, and all local
ordinances, as applicable,relating to nondiscrimination. These include but are not limited
to: 1)Title VII of the Civil Rights Act of 1964 (PL 88-352)which prohibits discrimination
on the basis of race, color or national origin; 2) Title IX of the Education Amendment of
1972, as amended(20 USC ss. 1681-1683, and 1685-1686),which prohibits discrimination
on the basis of sex; 3) Section 504 of the Rehabilitation Act of 1973, as amended(20 USC
Page 16
s. 794), which prohibits discrimination on the basis of handicaps; 4) The Age
Discrimination Act of 1975, as amended (42 USC ss. 6101-6107) which prohibits
discrimination on the basis of age; 5) The Drug Abuse Office and Treatment Act of 1972
(PL 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; 6) The
Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation
Act of 1970(PL 91-616), as amended,relating to nondiscrimination on the basis of alcohol
abuse or alcoholism; 7) The Public Health Service Act of 1912, ss. 523 and 527 (42 USC
ss. 690dd-3 and 290ee-3), as amended,relating to confidentiality of alcohol and drug abuse
patient records; 8) Title VIII of the Civil Rights Act of 1968 (42 USC s. 3601 et seq.), as
amended, relating to nondiscrimination in the sale, rental or financing of housing; 9) The
Americans with Disabilities Act of 1990(42 USC s. 12101 Note), as may be amended from
time to time, relating to nondiscrimination on the basis of disability; 10) Monroe County
Code Chapter 14, Article II,which prohibits discrimination on the basis of race, color, sex,
religion, national origin, ancestry, sexual orientation, gender identity or expression,
familial status or age; and 11) Any other nondiscrimination provisions in any Federal or
state statutes which may apply to the parties to, or the subject matter of, this Agreement.
19. Covenant of No Interest. County and FKCA 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.
20. Code of Ethics. County agrees that officers and employees of the County recognize and
will be required to comply with the standards of conduct for public officers and employees
as delineated in Section 112.313,Florida Statutes,regarding,but not limited to, solicitation
or acceptance of gifts; doing business with one's agency; unauthorized compensation;
misuse of public position, conflicting employment, or contractual relationship; and
disclosure or use of certain information.
21. No Solicitation/Payment. The County and FKCA 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, FKCA 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.
Page 17
22. Non-Waiver of Immunity. Notwithstanding the provisions of Sec. 768.28,Florida Statues,
the participation of the County and FKCA in this Agreement and the acquisition of any
commercial liability insurance coverage, self-insurance coverage, or local government
liability insurance pool coverage shall not be deemed a waiver of immunity to the extent
of liability coverage, nor shall any contract entered into by the County be required to
contain any provision for waiver.
23. 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.
24. 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 a 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.
25. 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-parry claim or
entitlement to or benefit of any service or program contemplated hereunder, and the County
and FKCA agree that neither the County nor FKCA 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.
26. Attestations. FKCA agrees to execute such documents as the County may reasonably
require, to include a Public Entity Crime Statement, an Ethics Statement, Non-Collusion
Statement, and a Drug-Free Workplace Statement.
27. 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.
Page 18
28. Annual Appropriation. The County's performance and obligation to pay under this
Agreement is contingent upon an annual appropriation by the Board of County
Commissioners. In the event that the County funds on which this Agreement is dependent
are withdrawn, this Agreement is terminated, and the County has no further obligation
under the terms of this Agreement to the Contractor beyond that already incurred by the
termination date.
29. Florida E-Verify System. Beginning January 1, 2021, in accordance with Fla. Stat., Sec.
448.095,the Contractor and any subcontractor shall register with and shall utilize the U.S.
Department of Homeland Security's E-Verify system to verify the work authorization
status of all new employees hired by the Contractor during the term of the Contract and
shall expressly require any subcontractors performing work or providing services pursuant
to the Contract to likewise utilize the U.S. Department of Homeland Security's E-Verify
system to verify the work authorization of all new employees hired by the subcontractor
during the Contract term. Any subcontractor shall provide an affidavit stating that the
subcontractor does not employ, contract with, or subcontract with an unauthorized alien.
The Contractor shall comply with and be subject to the provisions of Fla. Stat., Sec.
448.095.
30. 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 any of the parties hereto may execute this
Agreement by signing any such counterpart.
31. 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.
32. Final Understanding. This Agreement is the parties' final mutual understanding. It
replaces any earlier agreements or understandings, whether written or oral. This
Agreement cannot be modified or replaced except by another written and signed
agreement.
Page 19
r
1
IN WITNESS WHEREOF, the parties have caused these presents to be executed in
4-.. their respective names.
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, i BOARD OF COUNTY COMMISSIONERS
WI go-It, ..--,.„..(go* 0
-;r---k,v;,,:l.'s•-gtA F-7-144::e 'EVIN MADOK,Clerk OF MONIi0E CO INTY, FLORIDA
,,,
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BY: atA(2
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As Deputy Cler' By _
:
MayoriC h a i run an
FLORIDA KEYS COUNCIL OF illE ARTS
Witness: ,
c .,....- 6.4... ,
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, . Elizalvth S. Yo ng
Print Name: C 1 CI i t6),, 2(-4 VnLy ExecutiNre Dir.'ctor
Date: N°VCril 'er 21 I 2-02-2- Date: V ..2/ 2o2-2_
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ASSISTANT'coutryA'TTOFtNEY
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Page I 10
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AFFIDAVIT
'fOUI �
of th ci � ���� ' m" �M � � f,� j
according to law on my oath, and under penalty of erjury, Alepose and say that:
I am
of the of r� f "` ;�� �s " ' � Il,
�� � � M,i� m z"
the proposer making the Proposal for the project described in the notice for tailing for
proposals for: PON I.,
�nd that l executed the saidproposal with full authority t ;
. The prices in this r s f have been arrived at independently wio collusion,
consultation, communication or agreement for the purposeof restricting competition, s
to any matter relating to such pricesit y other proposer or with any competitor; and
3. Unless otherwise required l , the prices which have beennot in this r I
Ave not been knowingly disclosed by the proposer and will not knowingly be disclosed
by the proposer prior to proposal opening, directlyr indirectly, to any other proposer or
to any competitor; and
4. o attempt has been made or will be made by the proposer to induce t r person,
partnership or corporation to submit, or not to submit, a proposal for the purpose
restricting competition; n
. The,,itatements contained in this affidavit are truecorrect, and made withfull
dyle of said
e of roposer (Dat }
TAT : ,,, "
COUNTY : kiloy
Subscribed and swornto (or affirmed) before me, by mearilphysical presence or El online
notarization, an ,...
((date)
y L- I ,„ � (name of affial Che Js Rerson Ily
known to me or has produced (type of identification) as
identification.
NOTARVPLI
(SEAL) My commission expires:
N
a l -state of Florida
® ° mill HN 105516
my Comm, 1 Mb.2 35
National Notary Alin.
LOBBYING AND CONFLICT OF INTEREST CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO. 010-1990
MONROE COUNTY, FLORIDA
ETHICS CLAUSE
cI
(Company)
warrants thathe/it has not employed, retained or otherwise had act on hislitsshelf any
former County officer or employee in violation f Section 2 of Ordinance No. 010-1990 or any
County officer or employee in violation of Section 3 of Ordinance . 010-1990. For breach or
violation of this provision the County may, in its discretion, terminate this contract without liability
and may also, in its discretion, deduct from the contract or purchase price, or otherwise recover,
the full amount of any fees; commission, percentage, gift, or consideration pai to the former
County officer or employee".,
1g,, tur )
ate:
STATE OF: r
Subscribed (or affirmed) for s of physical presence or 0 online
notarization, #, tom) ; „-(...�
y 11 tJ-r i ), is personally
knownto me or has produced (type of identification) s
identification.
t
NOTARY PUBLI w,m
(SEAL) My commission expires:!Q ",
-
R.,°•., KRYSTAL ASN GOMEZ
w a1 Notary Pubiit m State of Florl a
p Commission #H 1 516
` . My CDMm.Expires Jul 6,2025
lonttd throuth National Notary Asir..
DRUG-FREE WORKPLACE FORM
e undersigned vendor in accordanpeit Florida Statute Section 287.087 h e y certifies at
A"I T') dbo
0-1 A)A I= (41
(Name ofBusiness) �
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 bet ken against employees for violations of such prohibition.
. Informs employees about the dangers of drug abuse in the workplace, thebusiness's policy of
maintaining adrug-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 ach employee engagedin providingthe commodities r contractual services that are under
proposal a copy oft the statement specified in subsection(1).
. In the statement specified in subsection(1), notifies the employees that, as a condition of working
on the commodities or contractual services that are under proposal,the employee will abide by the
terms of the statement and will notify the employer of any conviction o , or plea of guilty or nolo
cote ere to,any violation of Chapter 893(Floridatatte )or of any controlled substance law o
the United Statesor any state,for a violation occurring in the workplacelater than five( ) days
after such conviction.
. Imposes a sanction o , or require the satisfactory participationin a drug abuse assistance or
rehabilitation pro r if such is availablein the employee's i ,or any employee who is so
convicted,
6. Makes a goodfaith effort to continue to maintain a drug-free workplace through implementation of
this section.
s the person authorized to sin the statement, I certify that this firm complies fully with the above
requirements.
..................
ro 's Sign ure
to
STATE OF:
COUNTY OF: rn To t Qb
Subscribed and swornto(or ) before me, by means ofAphysical presence or 0 online
notarization, on A ,; "" (date) by VOYA (name of I t).
el6" Is� erson ally known to me or has produced (type of identification)
as identification.
NOTARY LIC
(SEA , My commission expire&� f �
iu.rlr
lFaJr� IfRYSTAL�H50N GO+MEI
t+etary Public•State of Florida
C miss! I H 1l6
2025
nd throw 1 !N
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 or , 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, Florida Statutes, 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
thirty-six ,' ) months.
(s,g ure)
Date:
STATE OF: miwir
COUNTY OF: VNN
Subscribed and sworn to (or affirmed) before me, by means of A",,physical presence or 0 online
notarization, on 7—L)IS (date)
by (name of affiant). He/QNs
T�r s a nally
known to me or has produced (type of identification) as
identification.
..........
NOTARY P)7U1 411
(SEAL) My commission expires:— 14-0 -4-2-0 2-!-
KXMAL AMN GOMEZ
Zftary Public-State of]Flortda
Commission 0 HN 105516
My Comm.Explr@sJW 6,2025
Bonded thfouith HAW&I Notary Ulm.
VENDOR CERTIFICATION i
1 � .
Project escription(s);
Respondent Vendor Name:
Vendor FEIN: be ,,. �
° I ) Z
i Title: ��% �I��" ..,.,
Vendor'sAuthorized
uQ p �tiv�m a and
Address:
city: )4,64 W ' ' 1State: i � i'�"tip zip:
Phone Number °j °. ' � � d Email Address:
.Section 287.135, Flodda Statutes prohibits a company from bidding n, submitting a proposal for, or
entering into or renewing 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
1 . 7 , Florida Statutes, or is engaged in a Boycott of Israel. Section 287.135, Florida Statutes, also
prohibits a company from bidding on, submitting proposal for, or entering into or renewing 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.
s 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 o
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 287135, 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, t 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 i
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 y: ��� a 't^°I �� ,who is authorized
g b referenced comp,
to sign behalf of the a
Authorized Signature:,,
�
Print Name'; W ,- "
Title. # 4
Note, The List are available at the following Department of Management Services Site,
htt.,�://�v d�.dms.u^rn °IlloriaJY .corru/busines.� o eirallions/state u�°chasin,./vendor inl'drmatk.mlconvictecf sago
eriidef.JI di.scriminatirory com¢alairds vendor lusts