03/06/2023 Agreement, BOCC Monroe County Purchasing Policy and Procedures
ATTACH ENT D S
COUNTY ADMINISTRATOR
CONTRACT SUMMARY FORM FOR CONTRACTS LESS THAN $50,000.00
t ntra t > :Jan Purdin retract NIA
Effective Date: 03.06.2023
Expiration Date:03.10.2023
Contract Purpose/Description:
Professional Services Agreement with Jan Purdin to review the EMS Billing&Collections processes.This management services
_engagement commences on03.06.20 a„ ex i
23 and pires on 03.10.2023.Given this is a Professional Services Agreement for manage-
ment services additional guotes are not required, An Informal uote of 17,QW.00 was obtained from EMS Man ement
Consultants for price reasonableness.Tan Purdin was chosen due to her experience with EMS Billing&Collections as a prior
Contract is Original Agreement Contract Amendment/Extension Renewal
Contract Manager: Cheri Tamborski 305.289.6088 MCFRISt #1(Na4
eeww:wuunrcmnuur .�WyN
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CONTRACT COSTS
Total Dollar Value of Contract: $ 11,000.00 Current Year Portion: $ 11,000.00
(must be less than$50,000) (If multiyear agreement then _� ................ -
requires BOCC approval,unless the
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„��.�tlVnIP1�K�IIP1�,.�NIPD pl,.
Budgeted?Yes❑■ No ❑
Grant: $N/A County Match: $N/A
Fund/Cost Center/Spend Category:
ADDITIONAL COSTS
Estimated Ongoing Costs: $ /yr For: NUA
(Not included in dollar value above) (e.g.maintenance,utilities,janitorial,salaries,etc.)
Insurance Required: YES 0 NO 8
CONTRACT REVIEW
Reviewer Date In
Department Head Signature: James K. Callahan
County Attorney Signature: Christina Cory DDele mz'3.a2a39a,ae.43-WW
Risk Management Signature: way
., .0
Purchasing Signature: Lisa Abreu �
o.os 2aa3.ox 74 a ore°ar
OMB Signature: John Quinn DaW2023"°"� "2
Dale°2023.022414 39.21
Comments:
Revised BOCC 2/15/2023
Page 85 of 106
PROFESSIONAL SERVICES AGREEMENT
MONROE COUNTY,FLORIDA
AND
JAN PURDIN
THIS AGREEMENT is made and entered into this Bth day of March ,2023,
by and between MONROE COUNTY("COUNTY'),a political subdivision of the State of
Florida,whose address is 1100 Simonton Street,Key West,Florida 33040 and Jan Purdin
("CONTRACTOR'),whose address is 10725 S Ocean Dr Lot 140;Jensen geach, FL 34957
WHEREAS,Monroe County Fire Rescue has determined there is a need for a consultant to
review their existing EMS Billing and Collections process; and
WHEREAS,Contractor,Jan Purdin,was previously employed as the supervisor of EMS Billing
and Collections;and
WHEREAS,the parties desire to enter into an Agreement with Contractor whereby Contractor
will review the existing EMS Billing and Collections process over the course of one week,
March 6-March 10,2023,and provide feedback to Monroe County Fire Rescue;and
NOW THEREFORE,in consideration of the mutual promises contained herein,the County and
Contractor set forth herein,it is mutually agreed as follows:
Section 1. SCOPE OF SERVICES
CONTRACTOR shall do, perform and carry out in a professional and proper manner the
professional services described in the Proposal which is attached hereto as Exhibit A and made a
part of this agreement.
IN THE EVENT OF A CONFLICT IN TERMS BETWEEN THIS AGREEMENT AND
EXHIBIT A,THE TERMS OF THIS AGREEMENT PREVAIL.
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 this Agreement.
B. To the extent that CONTRACTOR uses employees, subcontractors or independent
contractors, this Agreement specifically requires that the employees, subcontractors and
independent contractors shall not be an employee of or have any contractual relationship with
COUNTY.
C. All personnel engaged in performing services under this Agreement shall be fully qualified,
and,if required,be authorized or permitted under State and local law to perform such services.
D. The CONTRACTOR shall not disclose to any person, party or entity any confidential,
proprietary, time-sensitive, or non-public (including HIPAA) information relating to the County
1
or its operations unless required to do so by law.
E. Upon termination of this Agreement,the CONTRACTOR shall immediately surrender all
documents,information,property,and assets to Monroe County Fire Rescue.
F. CONTRACTOR shall receive a one-time lump sum fee as outlined in Exhibit A.
CONTRACTOR is not receiving any additional benefits as part of this Agreement.
G. CONTRACTOR agrees that he or she will not perform any work, consulting services, or
other activities for any other person or entity,whether for remuneration or no charge,during the
period of this Agreement,without prior express written approval of Monroe County Fire Rescue.
Section 2. COUNTY'S RESPONSIBILITIES
2.1 The COUNTY will provide such equipment,resources,and refreshments as provided in
Exhibit A.
2.2 The COUNTY will make payments as outlined in Section 4 of this Agreement.
Section 3. TERM OF AGREEMENT
3.1 This Agreement is effective beginning on March 6, 2023 and terminating at the close of
business on March 10,2023.
Section 4. PAYMENT TO CONTRACTOR
4.1 The lump sum fees that will be paid by the COUNTY are as shown on Exhibit A. The
COUNTY is exempt from sales and use taxes. The dollar amount of this Agreement shall not
exceed$49,999.99.
4.2 The lump sum fees are inclusive of all actual costs incurred,including by way of example
and not limitation,photocopies,long distance telephone charges,overnight delivery services,and
travel expenses.
4.3 Payment will be made according to the Florida Local Government Prompt Payment Act,
Sections 218.70-218.80, Florida Statutes. CONTRACTOR shall submit to the COUNTY an
invoice with supporting documentation in a form acceptable to the Clerk. Invoices may be
submitted upon completion of the services.Acceptability of the invoice 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. Invoices shall be sent to the COUNTY's Fire Rescue Department who
will review the documents and route them to appropriate COUNTY Staff for approval. Upon
receiving all required approvals, the invoice(s)will be forwarded to the COUNTY Clerk's office
for payment.
Smdon S. CONTRACT TERMINATION
The COUNTY reserves the right to terminate this Agreement by written notice given 48 hours
prior to the date the services listed in Exhibit A are provided In the event of such termination no
payment shall be due the CONTRACTOR-
Section 6. 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
2
following:
To the COUNTY: Roman Gastesi,Monroe County Administrator
1100 Simonton St.
Key West,Florida 33040
And
Monroe County Attorney's Office
1111 12a'St.,Suite 408
Key West,Florida 33040
To the CONTRACTOR: Jan Purdin
10725 S Ocean Drive Lot 140
.tensen Beach. FL 34957
Section 7. 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 o�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 m 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.
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 and their authorized representatives shall have
reasonable and timely access to such records of each other party to this Agreement for public
records and auditing 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, CONTRACTOR and its subcontractors shall comply with all public
records laws of the State of Florida,including but not limited to:
a. Keep and maintain public records required by COUNTY in order to perform the service.
b. Upon request from the public agency's custodian of public records,provide the public agency
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 Florida Statutes,Chapter 119
or as otherwise provided by law.
c. Ensure that public records that are exempt or confidential and exempt fiiom 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 public agency.
d. Upon completion of the contract, transfer, at no cost, to COUNTY all public records in
possession of the CONTRACTOR or keep and maintain public records required by the public
agency to perform the service. If the CONTRACTOR transfers all public records to the public
agency 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 COUNTY, upon request from the public agency's
custodian of records, in a format that is compatible with the information technology systems of
COUNTY.
If the CONTRACTOR does not comply with the COUNTY's request for records, the COUNTY
shall enforce the public records contract provisions in accordance with the contract,
notwithstanding the COUNTY's option and right to unilaterally cancel this contract upon violation
of this provision by the CONTRACTOR A CONTRACTOR who fails to provide the public
records to the COUNTY or pursuant to a valid public records request within a reasonable time
may be subject to penalties under Section 119-10,Florida Statutes.
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 1191 FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY
TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT,
CONTACT THE CUSTODIAN OF PUBLIC RECORDS,BRIAN BRADLEY,AT
(305) 292-3470, bradte -brian onroecoun -fl. ov do Monroe County
Attomey's Office, 1111 12d' St., Suite 408, Key West FL 33040.
4
Section 8. EMPLOYEES SUBJECT TO COUNTY ORDINANCE NOS.010 AND 020-1990
The CONTRACTOR wan-ants 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 9. 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 10. GOVERNING LAW,VENUE,INTERPRETATION
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 11. SEVERABILIITY
If any terns, covenant,condition or provision of this Agreement(or the application thereof to any
circumstance or person) shall be declared invalid or unenforceable to any extent by a court of
competent jurisdiction, the remaining terms, covenants, conditions and provisions of this
Agreement, shall not be affected thereby. and each remaining term, covenant, condition and
provision of this Agreement shall be valid and shall be enforceable to the fullest extent permitted
by law unless the enforcement of the remaining terms,covenants,conditions and provisions of this
Agreement would prevent the accomplishment of the original intent of this Agreement. The
COUNTY and CONTRACTOR agree to reform the Agreement to replace any stricken provision
with a valid provision that comes as close as possible to the intent of the stricken provision.
Section 12. 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 13. 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 14. 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 15. 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 16. 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.
Seaton 17. NONDISCREWMATION
The parties 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 fiuther action on the part of any
party,effective the date ofthe court order. The parties 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 prohibit
discrimination in employment on the basis of race,color,religion,sex,and national origin;2)Title
IX of the Education Amendment of 1972, as amended(20 USC §§ 1681-1683, and 1685-1686),
which prohibits discrimination on the basis of sex;3)Section 504 of the Rehabilitation Act of
6
1973, as amended(20 USC § 794), which prohibits discrimination on the basis of handicaps; 4)
The Age Discrimination Act of 1975, as amended (42 USC §§ 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 91616),
as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; 7) The
Public Health Service Act of 1912,§§523 and 527(42 USC§§690dd-3 and 290ee-3),as amended,
relating to confidentiality of alcohol and drug abuse patient records; 8) Title VHI of the Civil
Rights Act of 1968 (42 USC §§ 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 §§
12101), as amended from time to time,relating to nondiscrimination in employment on the basis
of disability; 10)Monroe County Code Chapter 14, Article 11,which prohibits discrimination on
the basis of race,color,sex,religion,national origin,ancestry, sexual orientation, gender identity
or expression,familial status or age;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.
Section 18. COVENANT OF NO 11NTEREST
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 19. CODE OF ETHICS
The parties understand 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 20. NO SOLICITATIONIPAYMENT
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 malting 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 21_ 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
7
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 22. PRIVILEGES AND EMMIUNITIES
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 fimctions and
duties of such officers, agents, volunteers, or employees outside the territorial limits of the
COUNTY.
Section 23. 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 24. 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 25. ATTESTATIONS
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
Vendor Certification Regarding Scrutinized Companies.
Section 26. 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 COUNTY in his or her individual capacity,and no member,
officer,agent or employee of 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 27. 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.
8
Section ZS. SECTION READINGS
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 29. INDEMNIFICATION,DEFEND,HOLD HARMLESS
The CONTRACTOR does hereby consent and agree to indemnify, defend and hold harmless the
COUNTY,its Mayor,the Board of County Commissioners,appointed Boards and Commissions,
Officers, and the Employees, and any other agents, individually and collectively, from all fines,
suits,claims,demands,actions, costs, obligations,attorney's fees,or liability of any kind arising
out of the sole negligent actions of the CONTRACTOR or substantial and unnecessary delay
caused by the willful nonperformance of the CONTRACTOR and shall be solely responsible for
any and all accidents or injuries to persons or property arising out of its performance of this
contract. The amount and type of insurance coverage requirements set forth hereunder shall in no
way be construed as limiting the scope of indemnity set forth in this paragraph. Further the
CONTRACTOR agrees to defend and pay all legal costs of the COUNTY for claims or acts
attributable to the sole negligent act of the CONTRACTOR or any of CONTRACTOR's
employees or representatives.
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.
(signatures on neat page)
IN WITNESS WHEREOF,the parties hereto have caused these presents to be executed
on the 1yst clay of March ,2023.
ON BEHALF OF MONROE COUNTY
Roman Gastesi
CONTRACTOR
.fan Purdin
Approved as to Form and Leo S deny
Date:2AM3
1
EXHIBIT A
kPin of Work
• Review the current EMS Billing and Collections Processes and Procedures from an efficiency
and best practices standpoint.
• Meet with the MCFR Fire Chief to discuss the findings and any recommendations for
Improvement prior to the expiration of engagement.
• Provide Fire Chief with a written Assessment Report of findings upon completion of the
engagement.
Term of Eng RgWnt '
The engagement will commence on or around March 6,2023,and extend on or around through
March 10, 2023.
Pricing
The total one-time fixed fee for the engagement is$11,000.00. There will not be any travel and
expenses due from or to be reimbursed by the County.
ATTACEMENT D.8
PUBLIC ENTifTY CRIME STATEMENT
"A person or affiliate who has been placed on the convicted vendor list following a conviction for public
entity mime 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 a public
entity,may not be awarded or perform work as a CONTRACTOR,supplier,subcontractor,or consultant
under a contract with any public entity,and may not transact business with any public entity in excess of
the threshold amount provided in Section 287.017, Florida Statute, far CATEGORY TWO for a period of
36 months from the date of being placed on the convicted vendor lint."
I have read the above and state that neither Jan Purdin (Respondent's name) nor any
Affiliate has been placed on the convicted vendor fist within the last 36 months.
(Signature)
Date:
STATE OF: F--k
COUNTY OF: rAA/-4�'
Subscribed and sworn to (or affirmed) before me, by means of W physical presence or O online
notarization, on 13, (date) by
(name of affiant). He/She is personally known to me or
has produced of identification)as identification.
2--7-
NOTARY p BLIC
My Commission Expires:
�•� Notary Public•State of flarlda
Commission s HH 033067
My Comm.Expires Aug 2S,2024
RevimdBOCC 6/15/2022 sanded through National Notary Assn.
Page 89 of 106
Monroe County Purchasing Policy and Procedures
ATTACHMENT D.9
SWORN STATEMENT UNDER ORDINANCE NO.010.1990
MONROE COUNTY, FLORIDA
ETHICS CLAUSE
"
—Jan PUWin
(Company)
"...warrants that helit 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.010-19W or any County officeror
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: !� 3
STATE OF: D Y i
COUNTYOF:
Subscribed and sworn to(or affirmed)before me, by means oKphysical presence or❑online
notarization, on -cl 7.D 2,3
(date)by (name of affiant). He/She Is personally
known to me or has produced el'/01— (type of identification)as
Identification.
NOTARY PUBLIC
My Commission Expires:
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DAKI E.NE"
y Public•State of FI{-dda
Page 90 of 106 mmisom 0 HH 031067
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Monroe County Purchasing Policy and Procedures
ATTACHMENT D.11
DRUG-FREE WORKPLACE FORM
The undersigned vendor in accordance with Florida Statute Section 287.087 hereby certifies that:
Jan Purdin
(Name of Business)
1. Publish a statement notifying employees that the unlawful manufacture, distribution, dispensing,
possession, or use of a controlled substance Is prohibited in the workplace and specifying the
actions that will be taken against employees for violations of such prohibition.
2. Inform employees about the dangers of drug abuse in the workplace, the business' policy of
maintaining a drug-free workplace, any available drug counseling, rehabilitation, and employee
assistance programs, and the penalties that may be imposed upon employees for drug abuse
violations.
3. Give each employee engaged in providing the commodities or contractual services that are under
bid a copy of the statement specified In subsecdon(1).
4. In the statement specified in subsection(1), notify the employees that, as a condition of working
on the commodities or contractual services that are under bid, the employee will abide by the
terms of the statement and will notify the employer of any conviction of,or plea of guilty or nolo
contendere to.any violation of Chapter 893(Florida Statutes)or of any controlled substance law
of the United States or any state, for a violation occurring in the workplace no later than five(5)
days after such conviction.
5. Impose a sanction on, or require the satisfactory participation in a drug abuse assistance or
rehabilitation program if such is available in the employee's community, or any employee who is
so convicted.
6. Make a good faith effort to continue to maintain a drug-free 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.
C -
(Signature)
Date:
STATE OF: PUY04—
COUNTY OF: ryk +I�,
Subscribed and swom to (or affirmed) before me, by means of physical presence or 0 online
notarizalgn, on fG tea-!:4 I J, (date) by
�Xa1 ►`— ( ame of afliant). He/She is personally known to me or
has produced t0kopme o entification)as identification.
Notary Public
My Commission Expires:
Revised BOCC 3/18/2020
Page 92 of 106 ;a�r"' DAACI E.�
+� ��33 Notary Public-State of Florida
f Commissim 0 NH 033067
My Comm.Expires Aug 2S,2024
Bonded through National Notary Astir.
Monroe County Purchasing Policy and Procedures
ATTACHMENT DA 2
OR C!]FRTI ON
Project Description(s): Review current EMS Fll� P. raliertinn
current - A - -- - S_PrnrAr3t,r�c
Respondent Vendor Name:
Vendor FEW: 297-50-7753
Vendor's Authorized Representative Name and Title:. Jan Purdin -Owner
Address._10725 S Ocean Drive Lot 140
City: Janson Beach _ State:,,,_ Zip: 34957
Phone Number:(561)7144211
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 Lsrael 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 Ln=Sector List or been engaged in business operations in Cuba or Syria.
Certified By: Jan Purdin who is authorized to sign
on behalf of the above ref ampatty.
Authorized Signature:
Print Name: Jan Purdin
Title:_Owner
Note. The List axe available at the following Department of Management Services Site:
http://www.dms.mAorida.comAN&ess opqrationgstate urelmin vendor information/convicted susnended
discri6pto comp faints vendor lists
Revised BOCC 1/18/2020
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