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Item C16Bulk Item: Yes No X Department: Fire Rescue Staff Contact Person/Ext: Camille Dubroff X 6010 AGENDA ITEM WORDING: Request approval from the Board to terminate the service agreement between Palm Beach Credit Adjustors Incorporated d/b/a Focus Financial Services and Monroe County Board of County Commissioners and the Board of Governors for the Lower and Middle Keys Fire and Ambulance District effective midnight October 17, 2007 and enter into a new service agreement between Gila Corporation d/b/a Municipal Services Bureau and Monroe County Board of County Commissioners and Monroe County Board of Governors Fire and Ambulance District 1 effective October 18, 2007 for the collection of outstanding ground and air ambulance account receivable balances. ITEM BACKGROUND: Palm Beach Credit Adjustors Inc. d/b/a Focus Financial Services has been our ambulance collection agency since April 17, 1996. On December 8, 2006, Focus Financial delivered a letter that stated that they no longer will be available to provide collection services due to the cost effectiveness of percentage of returns. (See attachment) The collections percentage average is S% recovery from placement which just covers the postage, credit reporting and phone contacts. In the interim, while we were locating a new agency to take their place, Focus Financial continued to work the existing accounts but no longer accepted any new account business from us. The average annual cost of this contract has been $3202.79 per year. As per the purchasing policy, two (2) or more written price quotes and proposals have been obtained. Municipal Services Bureau was selected due to cost effectiveness and quality of services required for our type of collections. PREVIOUS RELEVANT BOCC ACTION: On April 17, 1996 the Board granted approval and authorized execution of an Agreement between Monroe County and Palm Beach Credit Adjustors Inc. d/b/a Focus Financial Services to assist in collection of delinquent Emergency Medical Services (EMS) accounts receivables for District 1 ambulance service. CONTRACT/AGREEMENT CHANGES: Termination of Palm Beach Credit Adjustors Inc. d/b/a Focus Financial service agreement effective midnight October 17, 2007 and approval to enter into a new service agreement with Municipal Services Bureau effective October 18, 2007. STAFF RECOMMENDATIONS: Staff recommends terminating the Palm Beach Credit Adjustors Inc. d/b/a Focus Financial agreement and entering into a new agreement with Municipal Services Bureau. TOTAL COST: $3,300.00/year * BUDGETED: Yes X No _ *Estimate based on average amount paid over the past four 4 ears to our previous collection agency for round ambulance collections. COST TO COUNTY: same as above. SOURCE OF FUNDS. 13001-530-340 and 11001 530 340 REVENUE PRODUCING: Yes X o _ AMOUNT ER MONTH ear APPROVED BY: County Atty ?' OMB/Purchasing Risk Management DOCUMENTATION: Included X Not Required DISPOSITION: Revised 8106 MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract with: Municipal Services Bureau Contract # Effective Date: Expiration Date: 10/ 18/2007 09/30/2008 Contract Purpose/Description: Contract with Municipal Services Bureau for the collection of ground and air ambulance outstanding account receivable balances. Contract Manager: Camille Dubroff 6010 Emergency Services / Stop 14 (Name) (Ext.) (Department/Stop #) for BOCC meetin on 10/17/2007 Deadline: 10/02/2007 CONTRACT COSTS Total Dollar Value of Contract: $ FY 08- $3,300.00 Current Year Budgeted? Yes® Grant: $ County Match: $ FY 09 - $3,300.00 Portion: $ FY 10- $3,300.00 No ❑ Account Codes: 13001 530 340 - FY OR/FY 09/FY 10-$1650.001year 11001 530 340 - FY OR/FY 091FY 10-$1650.00/year ADDITIONAL COSTS Estimated Ongoing Costs: $ /yr For: (Not included in dollar value above) (eg. maintenance, utilities,.janitorial, salaries, etc. CONTRACT REVIEW Changes Date Out Date In Needed Reviewe Division Director Yes❑ No[:] Risk Manag ent I1 Yes[]Noe/ O.M.B./Purchasing Yes❑ NoV---"-- �� County Attorney Yes[:] No® , to r to Comments: OMB Form Revised 2/27/01 MCP #2 THIM3 yr€ .1 1 .(f s e ig� & rg� 1 I and r �between A LM E-1 E DE ��Y..�'y��]JUSTORS Tj f � 0f %TED doing Ufa ,ss as FOCUS 7 FINAINCIAL SERVICES, a Florida corporation with its principal place of business of 500 C.IUlfstrec'm Boulevard Suite 209 Delray Beach, Florida 33483 (hereinafter referred to as "Agency"), and MONROE COUNTY BOARD OF COUNTY COIViMISSIONERS AND THE BOARD OF GOVERNORS FOR THE LOWER AND MIDDLE KEYS FIRE AND AMBULANCE DISTRICT (hereinafter referred to as "Client"). VVII-111TESSETH WHEREAS, Client wishes to avail itself of the services of FOCUS F`TNANCI A L, Incorporated an independent collector for assistance i11 collectiiag various uncollected accounts receivable which it now has or will in the f.tture have, and, VTIIE1EAS, Agency wishes to provide the necessary services as hereinafter• more specifically enumerated to the Client for said accotilts receivable: NOW THEREFORE, in consideration "of the promises and the mutcjal covenants and agreements contained herein, the parties agree as follows: 14. I. Agency agrees to worts diligently and to put forth a professional effort to collect all .monies due to Client on accounts receivable which are placed into the hands of ti-le Agency. 2. Agency agrees to familiarize itself, its agents,, servants, and employees with the provisions of the Florida Collection Practices act, Secs. 559.554559.785, F.S., and all other applicable state laws, the Fair Debt Collection Practices Act ( 15 U CA 1692), the Truth and Lending Act, 15 1•_TSC.A Sec. 1601, et sect., the Fair Credit Reporting Act, 15 USCA See. 1681, et seq., and 0 the United State, Code, including but not limited to, debtor -creditor relations, creditor's remedies, harassment, invasion of privacy, and OlraeFOUS other torts. Agency further agrees to abide by and not violqe arty ten-ns rc�r° provisions of said statutes and not to coirylit any torts or violate the civil rights of any person in its attempt to properly collect said accounts. 3 Agency agrees to inderin ify and save harmless and defend Client at its own expense from any and every claim, demand, suit, loss, damage, cost and expense which Client may herea er suffer or incur y reason, of a. claim asserted against Client as a result of Agency's acts, omission, or conduct under this agreement. � EI nb �'"0 a e `sus ?Rf'_fw !: �d±aJu± LUIS ...'J`_ m'�_ rfThis -eqponov7fill ii3for -I,-;I (a) Debtor's Name (b) Debtor's Account Ni umber (c) Amount paid on the acdoz-nt doling the preceding month including amounts received by client as reported to Agency (d) Unpaid balance of account fie) Amount of commission due Agency 5. Agency will remit to Client on or before the 15th of each month, the proceeds, of ALL Monies collected by it on Client's accounts receivable during the preceding month. 6. Agency mid Client covenant and agree that Client: may receive payments on accounts receivable held by Agency, whether over the counter or by mail, and shall not be. required to refuse any such payment. Client shall notify Agency of all such monies received on a daily basis. 7. Client will remit to ,Agency within thirty (30) days of receipt of Agency monthly statement, the total z-11-fielint of Commission dlie and s hall be computed as follows: ?fir% of tot-q1 ji-nonjes collected oil ragulaycollet oq acco� its �rl icla a±e less than 365 days since date of service. 33% of total monies collected on regular collection accounts which -, greater than 365 days since date of service. 35% of total monies collected on accounts referred to an attorney for legal letter service, 50% of total monies collected on accounts referred to an attozney. Agency will pay all cust®rrlary court cons and attorneys' fees. Agency shall maintain records in such a manner that it can provide to the Clielit, Within a reasonable length of time, the present stattIs of and the collection effol exp�.nded on any and/or all accounts receivable held by it for Client. The Agency shall hire at their expense an independent certified public accotuntant and provide to the client an audit report by the f1hst day of August within each twelve month period €he agreement is in place. Client reserves the right to audit all financial records of the Agency, to assure Client that proper reporting and remittance is being made. Said auditing may be made by Client's personal or independent accountants at the sole expense of Client. �:" e _t# _ __ _�`_aaa.,uk,�r a r;. all fili€ rimadon gi-!en i; Agen�,y a_s t�r a� ar'ld o p ;t. Oiice a blennish is placed on a credit report h' - clierk-i x' ll 1105' be able t'a request J`haa Ages oy ov-vs iha bler isle credit rcport. if the Client alaJuses an account after a blemish has been, placed on a credit report, the Agency will indicate that the account has been paid and satisfied. 10. agency shall make no settlement for less that the total principal amount owed without the prior approval of Client. 11 • Agency will place accounts with art attorney for legal action, only with the written authorization of Client. 12. Client will only place those accounts with Agency that have not been previously placed with any other agency or collection service other then their own in-house billing service. 13. Client agrees that once an account is placed with Agency, .Agency is to receive all commissions due in the event that monies are collected. Agency agrees that if the continued collection of an account',,�,rould damage the reputation of the. Client or if suit is seriously threatened or filed, the Client may request; in writing, the iru ediate return of the account. 14. Each of the parties to the Agreement are independent contractors and nothing contained in this Agreement shall be construed as creating a joint venture, partnership, principal -agent or mutual agency relationship between or among the parties hereto and no party shall, by virtue of the Agreement, have a riglrt or power to create any obligation, express or implied, on behalf of any other party. No party, nor any employee of a party, shall be deemed to be an employer or employee of another party by virtue of this agreement. . _ MT IS. This agreement shall constitute the entire agreement betwean the parties and' -my Prior understanding or representation of any kind preceding the date of the Agreement shall not be binding upon eldrff party except to the egktent incorporated in this agreement. 16. Any modification of this agreement or additional oblig-dtion assumed by either panty in con:n� .aeon 3zaitlr this agreernein, shall be banding only if placed in w���iting: and srgd ed by (--ach 13 zcy o= :In anthorrzcd pr°eU���€a€rT of ,^cis par€y. any eiflll. r pz'2' v .p-'Ci dhrs agr(�amlzni M, ins st III of of the terms and conditions of this Agreement, or the waiver of any breach of any of the terms and conditions of this Agreement, shall not be construed as thereafter waiving any such terms a'nd conditions, all of which shall continue and remain in IfUll force and effect as if no such forbsearance or waiver had occurred. IS. The invalidity ofany portion of this agreement will not and shall not be deeuned to effect the validity of any other provision. In the event that any provision of this agreement is held to be invalid, the parties agree that the remaining provisions shall be deemed to be in full force and effect as if they had been executed by both parties subsequent to the expungement of the invalid provision. VIT. FA r, 19. The titles to the paragraphs of this Agreement are solely for the conveulience of the parties and stall riot be used co explain, modily� simplify, or aid in the interpretation of the provisions of this agreement. ' Vi[I. VFN[IF 20, In the event of litigation, the Parties agree that all proceedings shall he venuaed exclusively, in a State or Federal Court sitting in Monroe County, Florida. iX. FxrarRrTc 21. All exhibits attached hereto are a part of this Agreement a -id arc expressly incorporated herein and all blanks in such exhibits, if any,- will be compl -�ted as required in order to consummate the transactions contemplated and in accorclance with this Agreement. 22. This Agreement shall not be binding on either party until it has bt ,-, r ,ecuted by bo,ffi parties. �-1 $...'� t�i 1 E L $3 di»gJs � = CCU+: '+ v. Z;:L sa, U, wllu eAMH V6,; klGV'e 7ggy UU10D defi ek ;r by S.S cis fol v : CLIENT: MONROE COUNTY EMERGENCY MEDICAL SE NICES 490 63ad Street, .Ocean Marathon, Florida 33050 AGENCY: FOCUS FIN NCIAL SERVICES 500 Gulfstrearn Boulevard, Suite 209 Delray Beach, Florida 33433 214. Without cause, Client may tei inate this Agreement at any time upon thirty (30) days written notice to Agency. In such. event, Agency will no longer actively pursue collection of accounts in its possession, and will not assinne new accounts, but shall be paid its regular compensation for any accounts collected up to the date of the contract termination. All money received on accounts, by the Agency, after the termination date will be forwarded to the Client without regular compensation being paid to the A.geiicye Without cause, Agency may terminate this agreement upon sixty (60) days written notice to Client. 1-NI TESTIMONY WHEREOF witness the signature 8bf the parties hereto on day and date first above entered. CLIENT: Y: MONROE COUNTY BOARD OF COUNTY COMM 1ONERS AND THE BOARD OF GOVERNORS FOR THE DOWER .III ID . � FIRE AND AMBULANCE DISTRICT j AGEINC Y: FOCUS FINANCIAL SERVICES (Si at�n ••iI� N E g'" �J �3"`Y �Lt4 ht�N ,i (Name Please Print tSEAQ ATTEST. N*,Imle L. fir;: POW if Fl N. lh1�! DATE DEPUi CLER 1'i�t `r- Focus, Ffijnjjcka� Sel-,,ices 11,lsnrallis flint it has 110� ye-akilhied Or aeNrwis"� had Eici ori its behaii any former County officer 017 elflpioyee 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 this provision the County may, in its discretion, terminate this contract without liability and may also, in its discretion deduct from the contract or purchase price, or otherwise recover, the full amount of any fee, commission, Percentage, gift, or consideration paid to the former County officer or employee. (signature) Date- State of County )f e PERSNALLY A EARED BEFORE ME, the undersigned authority, - , 0 L6� A 7 who, after first being sworn by rne, affixed his/her signature in the space provided on the 1-day of__ 12-plZI ( ,1996. Notary Public MY commission expires: FM' A; M 2 q. I VR, RW Lft person or a is een Placed on the convicted vendor list following a conviction for public entity crime may not submit eq. 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 cons ruction or repair of a public building or public work, may not subinit bids on leases of real property to a public enCty, may not be awarded of perform work as a contractor, supplier, subcontractor, or consultant under a contract with any public entity, and may not transact business with any public entity in excess of the threshold amount provided in Section 287.017 for CATEGORY TIA70 for a period -of 36 months from the date of being placed on flee convicted vendor list 0 EMPLOYEE DISHONESTY ll-\ISUR-A--NCE REQUIREMENTS FOR COLLECTION OF DELINQUENT ACCOUNTS BETWEEN MONROE COUNTY, FLORIDA AND FOCUS Frl\TAi\TCIAL SERVICES The Contractor, Focus Financial Services shall purchase and maintain, throughout the terns offlic contract, Employee Dishonesty/ETrors & Ornissions Liability will pay for losses to County property or inonqy caused by the fraudulent of dishonest acts of the Contractor's employees or its agents, whet -her acting alone or in collusion of others. The rninimum ifinits shall be: $ 100,000 per Occurrence oNonmeas 002sallu [MG Candus BOBYam' NT 490 031rd stroot, ocean SuRe 0175 Imavothomy FL 330140 Dow ConAme q cowdoaolyq Olmoelos" Cool"090mos, pe-Ims FOR 2-, n--on, a swulcof s SO" COMMS AmInue 0 SURe 3 0 Doi llon Becidn, Floilckl 33126 -�65-0-iiO2 :-: fo�0,3� 'Q rmicsyidlc- (561) 24,3-254� �£ M-I Oi II �• � �, � F � y fro i ern Di,:ie fri spvi�ar, U�` �r i:� r j M �ai E � George Neucgent, District 2 Kr" WEST B--' FLo^Ip;a 11;0.°0 �(„ ' :w'llai-les "Sonny" McCoy Disti'Ici (305)2N-4&J1 W Sylvia J. Murphy, District 5 OFFICE of FIRE RESCUE 490 63rd Street Marathon, Fl. 33050' PHONE: (305) 289-6010 � FAX: (305) 289-6013 , September 18, 2007 Focus Financial Services Danielle Castellanos, Client Service Manager 3800 South Congress Avenue Suite 3 Boynton Beach, Florida 33426 FEE: I'er ination of Contract Dear Ms. Castellanos, As per your letter elated December 3, 2006, Focus Financial has requested to terminate the contract dated April 17, 1996 between Palm Beach Credit Adjustors Inc. doing business as Focus Financial Services and Monroe County Board of County Commissioners and the Board of Governors for the Lower and diddle Keys Fire and Ambulance District. This contract provides independent assistance in collecting various uncollected accounts receivables from ambulance transports. Per the contract, you have the right to terminate this agreement upon sixty (60) days written notice to us, which you have Provided. On October 17, 2007 we will be presenting the termination of your contract before our Board of County Commissioners and upon their approval this will officially terminate the contract. With this termination Focus will no longer actively pursue collection of accounts in its possession, and will riot assume new accounts, but shall be paid its regular compensation for any accounts collected up to the date of the contract termination. All money received on accounts, by Focus Financial, after the termination date of October 17, 2007 shall be forwarded to Monroe County without regular compensation being paid to Focus Financial. (See section 24 of the contract attached). Upon cancellation of the contract we respectfully request the following items: 1. A final detail report for October 2007 with any money collected through the termination date. 2. A final invoice for October 2007 with monies owed for the final month of service ending on October 17, 2007. 3. A detailed list of all patients with a date of service of 2004 through 2005 to include account number, contact information, collections and the current balance which will be used to pass off to the new agency. We appreciate the Bard wort; and efforts that Focus Financial has provided us since 1996 and appreciate your cooperation in the change over. Thank you for your patience while we have been searching for a new collection agency. If you have any questions, please do #hesitate to contact me at 305-289-6010. 9 ayne Hinnant County Fire Rescue Enclosuresab.. Compensation: 25% i the amount collected MSB provides all of our services on a contingency fee basis with no up4ront or additional costs associated with those services. We have included a gF ph below outlining our unique services that are included in our contingency fee: P WI 9 > 2 . % - All accounts placed less than 365 days from date of service. 30% - All accounts placed greater than 365 days from date of service. 30% - All ship accounts. AG .EERIEi T BETWEEN THE. BOARD OF COUNTY COMMISSIONERS AND THE BOARD OF GOVERNORS FIRE AND AM[BUL-4INCE DISTV-ICT OF fn0ftROE_C*A'JNTY, FLORIDA AND CORPORATIONGILA BUREAU FOR COLLECTION OF OUTSTANDING THIS AGREEMENT, ("AGREEMENT") made and entered into this 18"' day of October, 2007 by and between the Board of County Commissioners and the Board Governors of Fire and Ambulance District I of Monroe County, Florida, (herein referred to as the "COUNTY") and Gila Corporation d/b/a Municipal Services Bureau (herein referred to as "MSB"); WITNESSETH: WHEREAS, MSB represents that they wish to provide services as hereinafter more specifically enumerated to the COUNTY for collections of said outstanding accounts receivables from ground and air ambulance transports; WHEREAS, the COUNTY wishes to enter into an Agreement with MSB for collecting various uncollected ground and air ambulance accounts receivables; NOW, THERFORE, in consideration of the promises contained herein, the parties agree as follows: 1. DEBT COLLECTION SERVICES — MSB will mail notices, telephone or otherwise contact debtors with outstanding accounts with the COUNTY in order to attempt to collect those monies owed by the Debtors. Demand for payment of each collection item, will be in a non -threatening manner and subject to all applicable Federal, State and local laws, rules and regulations. As payment of collection items are collected by MSB, it shall be remitted to the COUNTY by the fifteenth of the month for the previous month's activity. Each remittance shall include a statement for the commission due and shall be accompanied by a dated report which, as to each collection time included in the remittance, shall state the name of the person from whom it was collected, the amount remitted and identifying account number. 2. RESPONSIBILITY OF THE COUNTY — The COUNTY will provide, in addition to the names and last known addresses of the Debtors, all information regarding the date(s) of the alleged debt(s), the amount of such debt(s) and the date the judgment was entered against the debtor, if applicable. The information supplied to MSB by the COUNTY must be in an ANSI file format which is acceptable to MSB and shall be provided not less frequently than monthly. The COUNTY will update and correct any information it has provided MSB as soon as it is practicable. The COUNTY will notify MSB of any payment of other satisfaction of judgment made directly to the COUNTY. The COUNTY may provide this information in either hard copy or electronically. 3. CONTRACT PERIOD AND RENEWAL - The effective date of this Agreement shall be October 18, 2007 through September 30, 2008. This Agreement may be renewed annually for one (1) year terms, not to exceed two (2) renewals, subject to approval of the Fire Chief of Monroe County Fire Rescue, the Office of Management and Budget and the Monroe County Board of County Comnussioners and the Monroe County Board of Governors Fite and A - abulance District 1. 4. CONTRACT TERMINATION — Either party may terminate this agreement by providing ninety (90) days written notice. Upon notice of ternnation MSB shall take all steps necessary to close out any accounts with an open balance and will be responsible for complying with all provisions of this contract until the termination date. MSB will not assume new accounts after such notice of termination. MSB will be paid for its services through the termination date and MSB will not incur any expenses after notice of termination except those necessary to properly wind up its obligations under this contract and properly perform this contract. All money received on accounts, by MSB, after the termination date will be forwarded to the COUNTY without regular compensation being paid to MSB. MSB will further cooperate with any successor, debt collection service provider by turning over all records and any other documents or equipment in hard copy to useable electronic format to the COUNTY or the debt collection service provider. MSB will pay the COUNTY all funds due and owing to it as of the termination date of this contract. The provision for MSB to turn over documents and to provide all funds due and owing the COUNTY will survive the termination of this contract. 5. CAPABILITY TO PROVIDE SERVICE — MSB represents that it is an established debt collection service provider licensed to do business in the State of Florida and capable of providing all services required pursuant to this contract and that MSB has all necessary permits, occupational licenses or any other license or permits required to provide services under this agreement required by any local, state, government or the federal government. MSB further represents that it has experience with debt collection practices and it has the requisite financial resources, personnel and experience to perform all services required under this agreement. 6. REPORTS — MSB shall provide the COUNTY with monthly aging reports as of the last day of each month, by the twenty-first day of the following month reflecting the status of all accounts that are currently active and MSB's collection results. This report will include the following information: a. Debtor's Name b. Debtor's Account Number c. Amount paid on the account during the preceding month including amounts received by COUNTY as reported to MSB. d. Unpaid balance of account e. Amount of commission due Agency. The COUNTY has the absolute right to audit any and all financial records of MSB pertaining to the collection activities carried on by MSB pursuant to this contract. MSB shall retain such records not provided to the COUNTY for a period of three (3) years after the termination of this contract unless such records are required for pending litigation then such records shall be maintained until at least ninety (90) days after the conclusion of litigation including appeals. 7. VALID DEBTS - The COUNTY agrees that accounts placed with MSB for collection are valid and legally enforceable debts and are not disputed or subject to any bankruptcy proceedings, unless otherwise disclosed in writing by the COUNTY. 8. CO1ViI+11ISSIOI� RATES —1~or all accounts referred by the COUNTY to MSB for collection for which the COUNTY is paid, regardless of whether payment is accepted directly by the COUNTY or by MSB on the COUNTY'S behalf, the COUNTY will pay to MSB a twenty-five (25) percent rate on the gross amount collected. Service will be provided on a contingency fee basis with no up -front or additional costs associated with the services. The following services will be provided at no additional costs: On line access to accounts, bi- lingual collection notices and staff, letter creation and distribution, background checks/fingerprints scans for all current and future MSB employees, National Skip tracking services, toll -free telephone numbers for debtors, independent security audit, and electronic interface (in-house programmers). The COUNTY will not be responsible to MSB for any commissions or fees for payments returned to the COUNTY or MSB for insufficient funds. 9. NOTIFICATION OF COLLECTION — The COUNTY will immediately notify MSB of accounts referred to MSB for collection that have been paid or disputed by the Debtors directly to the COUNTY whenever that payment or dispute occurs. MSB agrees that once an account is placed, that the COUNTY is to receive all cormmission due in the event that monies are collected. By the fifteenth of each month, MSB will provide a detailed reporting to the COUNTY to identify all accounts known to be collected during the prior month and to remit monies collected on the County's behalf. MSB is required to invoice the COUNTY for commissions due; the COUNTY agrees to review the invoice and forward payment to MSB in accordance with the Florida Local Government Prompt Payment Act. MSB makes no warranties or representation, expressed or implied., about the amount of funds that will be collected, and MSB shall have no liability for any amounts uncollected. The only liability of MSB will be to forward any funds collected to the COUNTY subjected to MSB collecting its cozutnission amount. 10. LEGAL ACTION - MSB shall make no settlement for less than the total principal amount owed without prior approval of the COUNTY. MSB may not affect any debtor's credit history as a result of unsuccessful collection efforts. MSB will place accounts for litigation only with prior written consent of County. MSB agrees that if the continued collection of an account would damage the reputation of the COUNTY or if suit is seriously threatened or filed, the COUNTY may request, in writing, the immediate return of the account. If the COUNTY has been given legal authorization to write-off obligations which have been referred to MSB, MSB will not collect any fees from the COUNTY relative to the accounts which have been withdrawn from MSB's collection efforts. 11. NOTICES — All notices specified pursuant to this contract shall be sent to the following: COUNTY: Monroe County Emergency Services 490 63`d Street Ocean Marathon, F133050 MSB: Municipal Services Bureau 6505 Airport Blvd., Suite 100 Austin, TX 78752 12. INDEPENDENT CONTRACTOR — Neither MSB, nor any of its employees, agents, or subcontractors are employees of the COUNTY. MSB is solely responsible and liable for any action taken or made by MSS its' employees, agents or subcontractors. 13. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT of 1996 (HIPAA) — MSB will carry out its obligations under this contract in compliance with the privacy regulations pursuant to Public Law 104-191 of August 21, 1996, known as the Health Insurance Portability and Accountability Act of 1996, Subtitle P — Administrative Simplification, Section 261, et seq., as amended ("HIPAA"), to protect the privacy of any personally identifiable protected health information (PHI) that is collected, processed or learned as a result of the Collection services provided hereunder. In conformity therewith, MSB agrees that it will: a. Not use or further disclose PHI except as permitted under this contract or required by law; b. Use appropriate safeguards to prevent use or disclosure of PHI except as permitted by this contract; c. To mitigate, to the extent practicable, any harmful effect this is known to MSB of a use or disclosure of PHI by MSB in violation of this contract; d. Report to Monroe County any use or disclosure of PHI not provided for by this contract of which MSB becomes aware; e. Ensure that any agents or subcontractors to whom MSB provides PHI, or who have access to PHI, agree to the same restrictions and conditions that apply to MSB with respect to such PHI; f. Make PHI available to Monroe County and to the individual who has a right to access as required under HIPAA within 30 days of the request by Monroe County regarding the individual; g. Incorporate any amendments to PHI when notified to do so by Monroe County; h. Provide an accounting of all uses or disclosures of PHI made by MSBH as required under HIPAA privacy rule within sixty (60) days; i. Make their internal practices, books and records relating to the use and disclosure of PHI available to the Secretary of the Department of Health and Human Services for purposes of determining MSB's and Monroe County's compliance with HIPAA; and j. At the termination of the contract, return or destroy all PHI received from, or created or received by MSB on behalf of Monroe County, and if return is infeasible, the protections of this contract will extend to such PHI. 4 The specific uses and disclosures of PHI that may be made by MSB on behalf of Monroe County include: a. Preparation of invoices and reminder notices and documents pertaining to collections of overdue accounts to patients and others who are responsible for payment of the services provided by Monroe County; b. Uses required for the proper management of MSB as a business associate. c. Other uses or disclosures of PHI as permitted by the HIPAA privacy rule. Notwithstanding any other provisions of this contract may be tenninated by Monroe County if MSB has violated a tens or provisions of this contract pertaining to MSB's material obligations under the HIPAA privacy rule, or if MSB engages in conduct which would, if committed by Monroe County, result in a violation of the HIPAA privacy rule by Monroe County. 14. INDEMNIFICATION - MSB covenants and agrees to indemnify, hold harmless and defend the Monroe County Board of County Cominissioners and the Monroe County Board of Governors District 1, 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 bind, including attorney's fees, court costs and expenses, which arise out of, in connection with, or by reason of services provided by MSB or any of its Subcontractors in any tier, occasioned by the negligence, errors, or other wrongful act or omission of MSB or its Subcontractor(s) in any tier, their officers, employees, servants or agents. In the event that the service is delayed or suspended as a result of MSB's failure to purchase or maintain the required insurance, MSB shall indemnify the County from any and all increased expenses resulting from such delay. 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. (See Attachment A). 15. INSURANCE - During the term of this Agreement, MSB must keep in force and affect the following insurance: Worker's Compensation- Prior to the commencement of work govemcd by this contract, MSB shall obtain Worker's Compensation Insurance with limits sufficient to respond to Chapter 440 , Florida Statutes. In addition, MSB shall obtain Employer's Liability Insurance with limits not less than: $100,000 Bodily Injury by Accident $500,000 Bodily Injury by Disease, policy limits $100,000 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. If MISB has been approved by the Florida's Department of Labor, as an authorized self -insurer, the County shall recognize and honor MSB's status. MSB may be required to submit a Letter of Authorization issued by the Department of Labor and a Certificate of Insurance, providing details on MSB's Excess Insurance Program. If MSB participates in a self-insurance fund, a Certificate of Insurance will be required. In addition, MSB may be required to submit updated financial statements from the fund upon request from the County. General Liability — Prior to the commencement of work governed by this contract, MSS shall obtain General Liability Insurance. Coverage shall be maintained throughout the life of the contract and include as a minimum: Premises Operations Products and Completed Operations Blanket Contractual Liability Personal Injury Liability Expanded Definition of Property Damage The minimum limits acceptable shall be: $300,000 Combined Single Limit (CSL) If split limits are provided, the minimum limits acceptable shall be: $100,000 per Person $300,000 per Occurrence $ 50,000 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 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 policies issued to satisfy the above requirements. Professional Liabilitv Insurance —Recognizing that the work governed by this contract involves the furnishing of advice or services of a professional nature, MSB 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 MSB arising out of work governed by this contract. The minimum lints of liability shall be: $250,000 per Occurrence/$500,000 Aggregate Monroe County shall be named as an Additional insured on all policies. The provisions of Attachment B are attached and incorporated into this agreement. 16. PAYMENTS - Payments shall be made by the COUNTY pursuant to the Florida Local Government Prompt Payment Act after the completion of the rendered services and proper invoicing by MSB. 0 17. CONTINGENC l'- ivlonroe County"s performanee and obligation to pay under this Agreement is contingent upon an annual appropriation by the Board of County Conu-nissioners. 18. 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. 19. OWNERSHIP OF THE PROJECT DOCUMENTS - The documents prepared by MSB for this Project belong to the COUNTY and may be reproduced and copied without acknowledgement or permission of MSB. 20. SUCCESSORS AND ASSIGNS - MSB shall not assign its right hereunder, except its right to payment, nor shall it delegate any of its duties hereunder without the written consent of the COUNTY. MSB will not employ any subcontractor to perform any duties under this agreement unless such fact is made known to the COUNTY and prior written permission is granted. The COUNTY shall have the right to prohibit a subcontractor from performing any part of the contract; such right shall be reasonable exercised. Subject to the provisions of the in'unediately preceding sentence, each party hereto binds itself, its successors, assigns and legal representatives to the other and to the successors, assigns and legal representatives of such other party. 21. NO THIRD PARTY BENEFICIARIES -Nothing contained herein shall create any relationship, contractual or otherwise, with or any rights in favor of, any third party. 22. PUBLIC ENTITIES CRIMES - 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 contracts 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 MSB, supplier, subcontractor, or MSB 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 of the Florida Statutes, for CATEGORY TWO for a period of 36 months from the date of being placed on the convicted vendor list. By signing this Agreement (including Attachment C), MSB represents that the execution of this Agreement will not violate the Public Entity Crimes 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 COUNTIES competitive procurement activities. In addition to the foregoing, MSB further represents that there has been no determination, based on an audit, that it or any subcontractor has committed an act defined by Section 287.133, Florida Statutes, as a "public entity crime" and that it has not been formally charged with committing an act defined as a "public entity crime" regardless of the amount of money involved or whether CONUSULTANT has been placed on the convicted vendor list. MSB will promptly notify the COUNTY if it or any subcontractor is formally charged with an act defined as a "public entity crime" or has been placed on the convicted vendor list. 23. MAINTENANCE OF RECORDS - MSB 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 its 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 four years 7 followinc, the termination of this Agreement. If an auditor employed by the COUI4TY or County Cleric detern-iines that monies paid to MSB pursuant to this Agreement were spent for purposes not authorized by this Agreement, the MSB shall repay the monies together with interest calculated pursuant to Sec. 55.03, of the Florida Statutes, running from the date the monies were paid by the COUNTY. 24. 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 contracts 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, COUNTY and MSB agree that venue shall lie in Monroe County, Florida, in the appropriate court or before the appropriate administrative body. The Parties waive their rights to a trial by jury. This Agreement is not subject to arbitration. 25. 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 teens, 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 MSB 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. 26. ATTORNEY'S FEES AND COSTS - The COUNTY and MSB 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, court costs, investigative, and out-of-pocket expenses, as an award against the non -prevailing party, and shall include attorney's fees, courts 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. 27. BINDING EFFECT - The terms, covenants, conditions, and provisions of this Agreement shall bind and inure to the benefit of the COUNTY and MSB and their respective legal representatives, successors, and assigns. 28. 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. 29. CLAIMS FOR FEDERAL OR STATE AID - MSB 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 party prior to submission. 30. ADJUDICATION OF DISPUTES OR DISAGREEMENTS - COUNTY and MSB 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 15 days after the first meet and confer session, the issue or issues shall be discussed at a public meeting of the Board of County Commissioners. If the issue or issues are still not resolved to the satisfaction 8 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. 31. 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 MSB 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 MSB specifically agree that no party to this Agreement shall be required to enter into any arbitration proceedings related to this Agreement. 32. NONDISCRIMINATION - MSB and COUNTY agree that there will be no discrimination against any person, and it is expressly understood that upon a determination by a court of competent jurisdiction that discrimination has occurred, this Agreement automatically terminates without any further action on the part of any party, effective the date of the court order. MSB or COUNTY agrees 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 VI 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 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 a vended, 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 patent records; 8) Title VIII of the Civil Rights Act of 1968 (42 USC s. 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. 1201 Note), as maybe amended from time to time, relating to nondiscrimination on the basis of disability; 10) Monroe County Code Chapter 13, Article VI, which prohibits discrimination on the basis of race, color, sex, religion, national origin, ancestry, sexual orientation, gender identity or expression, familial status or age; 11) Any other nondiscrimination provisions in any Federal or state statutes which may apply to the parties to, or the subject matter of, this Agreement. 33. COVENANT OF NO INTEREST - MSB and COUNTY 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. 34. 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. (Attachment D). 35. NO SOLICITATION/PAYMENT - MSB and COUNTY 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 finn, other than a bona fide employee worlang solely for it, any fee, connnission, 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, MSB 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. 36. PUBLIC ACCESS - MSB and COUNTY shall allow and permit reasonable access to, and inspection of, all documents, papers, letters or other materials in its possession or under its control subject to the provisions of Chapter 119, Florida Statutes, and made or received by MSB and COUNTY in connection with this Agreement; and the COUNTY shall have the right to unilaterally cancel this Agreement upon violation of this provision by MSB. 37. NON -WAIVER OF IMMUNITY - Notwithstanding the provisions of See. 768.28, Florida Statutes, the participation of MSB and the COUNTY 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. 38. 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. 39. LEGAL OBLIGATIONS AND RESPONSIBILITIES — no 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. 40. 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 MSB and the COUNTY agree that neither MSB nor the COUNTY 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. 41. ATTESTATIONS AND TRUTH IN NEGOTIATION --- Coincident with execution of this Agreement, MSB agrees to execute a Public Entity Crime Statement, Ethics Statement, and a Drug -Free Workplace Statement (Attachments C-E). 42. 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 10 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. 43. 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. IN WITNESS WHEREOF, each party hereto has caused this Agreement to be executed by its duly authorized representative. Attest: DANNY L. KOLHAGE, CLERIC MONROE COUNTYBOARD OF COUNTY COMMISSIONERS Deputy Clerk WITNESS: Print Nance and Title ao�,,,Illf,fY TIM M. YANIES �Bt Ppe44�. far Notary Public, State of Texas �.^ MY Commission Expires October 19, 2008 Lo Mayor/Chairman GILA CORPORATION INC. d/b/a MUNICIPAL SERVICES BUREAU By: Date: r I:A 7 /c Title: 0- M C MONROE COUNTY ATTORNEY PROVR©A TMFOM: CYNTHIA L. HALL ASSISTANT OUNTY ATTORNEY Date t ®�( r n 11 MONROE COUNTY, FLORIDA RISK MANAGEMENT POLICY AND PROCEDURES CONTRACT ADMINISTRATION MANUAL Indemnification and )Mold Harmless for Other Contractors The Contractor covenants and agrees to indemnify, hold harmless and defend the Monroe County Board of County Commissioners and the Monroe County Board f Governors District 1, 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 expenses, which arise out of, in connection with, or by reason of services provided by the contractor or any of its Subcontractors in any tier, occasioned by the negligence, errors, or other wrongful act or omission of the contractor or its Subcontractor(s) in any tier, their officers, employees, servants or agents. In the event that the service is delayed or suspended as a result of the contractor failure to purchase or maintain the required insurance, MSB shall indemnify the County from any and all increased expenses resulting from such delay. 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 s Signature G~ b? '7 4 Date m Attachment A (I Of 1) 12 WORKERS° COM PENSATI N INSURANCE REQUIREMENTS TS FOR CONTRACT BETWEEN MONROE COUNTY.FLORIDA Prior to the commencement of work governed by this contract, the Contractor shall obtain Workers' Compensation Insurance with limits sufficient to respond to Florida Statute 440. In addition, the Contractor shall obtain Employers' Liability Insurance with limits of not less than: $100,000 Bodily Injury by Accident $500,000 Bodily Injury by Disease, policy limits $100,000 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. If the Contractor has been approved by the Florida's Department of Labor, as an authorized self -insurer, the County shall recognize and honor the Contractor's status. The Contractor may be required to submit a Letter of Authorization issued by the Department of Labor and a Certificate of Insurance, providing details on the Contractor's Excess Insurance Program. If the Contractor participates in a self-insurance fund, a Certificate of Insurance will be required. In addition, the Contractor may be required to submit updated financial statements from the fund upon request from the County. WCI Attachment B (I of 3) 13 GENERAL LIABILITY INSURANCE REQUIREMENTS FOR CONTRACT BETWEEN MONROE COUNTY, FLORIDA AND 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 ® Products and Completed Operations ® Blanket Contractual Liability ® Personal Injury Liability ® Expanded Definition of Property Damage The minimum limits acceptable shall be: $300,000 Combined Single Limit (CSL) If split limits are provided, the minimum limits acceptable shall be: $100,000 per Person $300,000 per Occurrence $ 50,000 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 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 policies issued to satisfy the above requirements. GL1 Attachment B (2 of 3) 14 FOR CONTRACT Recognizing that the work governed by this contract involves the furnishing of advice or services 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: $250,000 per OcculTence/$500,000 Aggregate PROi Attachment B (3 of 3) 15 PUBLIC ENTITY GRIME STATEMENT "A person or affiliate who has been placed on the convicted bidder list following a conviction for public entity crime may not 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 cntity, may not be awarded or perform work as a bidder, supplier, subbidder, 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 bidder list." By executing this forin, I acknowledge that I/my company is in compliance with the above. STATE OF (Signa e of ontractor) COUNTY OF Date 2oo-7 PERSONALLY APPEARED BEFORE ME, the undersigned authority, t1C.e_ tv-, vn i who, after first being sworn by me, (name of individual signing) affixed hisAier signature in the space provided above on this 7 � dayof S-Cete-YA-ef— 20 0 7 vl_�Z_ a.! t�_' - My c missi n expires: 10 l ►q l2ooe NO ARY P LIC 5114111y! ao.+Nt r�e4n_ TIM M, YANTES Notary Public, State of Texas My Commission Expires October 19, 2000 Attachment C 16 SWOW STATEMENT UNDER ORDINANCE NO. 10-191 MONROE COUNTY, FLORIDA ETHICS CLAUSE ms—b warrants that he/it has not employed, retained or otherwise had act on his/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 this provision the County may, in its discretion, tenninate this contract without liability and may also, in its discretion, deduct from the contract or purchase price, or otherwise recover, the full amount of any fee, commission, percentage, gift, or consideration paid to the former or or employee. (Signatures ) Date: STATE OF COUNTY OF I KXVT PERSONALLY APPEARED BEFORE ME, the undersigned authority, who, after first being sworn by me, affixed his/her signature (name of inifividual signing) in the space provided above on this 9,- '"" day of t wi �...._ , 20 D-7. N ARY P LIC 1I1V1 M.FCy17jGs • .� Nota My commission expires: ! c3 e Public, stare or texas �. h�/�GFSEi` MOct commission 19n 008res +enina OMB - MCP FORM #4 Attachment D I7 DRUG -FREE WORIOLACE FORM The undersigned contractor in accordance with Florida Statute 287.087 hereby certifies that: 0- C'n, (flbk� MuniWod ...&Oees �UY&LLk C 6�,�S6 (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. Inforins employees about the dangers of drug abuse in the workplace, the business's policy of maintaining a drug -free workplace, any available drug counseling, rehabilitation, and employee assistance programs, and the penalties that may be imposed upon employees for drug abuse violations. 3. Gives each employee engaged in providing the commodities or contractual services that are under bid a copy of the statement specified in subsection (1). 4. In the statement specified in subsection (1), notifies the employees that, as a condition of working on the commodities or contractual services that are under 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 contendre 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. Contractor Date OMB - MCP FORM #5 Attachment E 18