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Item C02BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: 2/20/08 Division: Public Works Bulk Item: Yes X No Department: Fleet Mana eg_ment Staff Contact Person/Phone #: Roy Sanchez / 292-3572 AGENDA ITEM WORDING: Approval to renew the existing fuel contract with Dion Oil Company for delivery of diesel fuel and unleaded gasoline for one additional year. ITEM BACKGROUND: Our existing contract allows the County to renew the contract for two additional one-year periods, this being the first one-year extension. Dion Oil Company has agreed to the one year renewal at zero increase over the original agreement, for their delivery services. Fuel prices vary as they go up and down, due to nationwide changes at the terminal. Estimated annual fuel costs are up from $1,100,000.00 to $1,600,000.00 and the estimated annual cost to the County is up from $326,000.00 to $466,000.00. Estimated increases are due to higher than normal cost per gallon at the Port Everglades terminal where fuel is purchased. PREVIOUS RELEVANT BOCC ACTION: On April 18 , 2007, the Board executed the existing fuel contract with Dion Oil Company for delivery of diesel fuel and unleaded gasoline, which is then distributed though the County pumps and charged back to County Departments, the School Board, Sheriff Department and other agencies. CONTRACT/AGREEMENT CHANGES: Renew contract for one-year additional year. STAFF RECOMMENDATIONS: Approval. TOTAL COST: Approx. $1,600,000.00 COST TO COUNTY: Approx. $466,000.00 BUDGETED: Yes X No SOURCE OF FUNDS: 504-23502-530521 & 523 55% ad valorem/45% gas tax REVENUE PRODUCING: Yes No X AMOUNT PER MONTH Year APPROVED BY: County Atty OMB/Purchasing Risk Management DOCUMENTATION: Included X Not Required DISPOSITION: AGENDA ITEM # Revised 11 /06 MEMORANDUM TO: Dent Pierce, Director Public Works Division FROM: Roy Sanchez, Director Fleet Management Department DATE: January 22, 2008 RE: Agenda Submission / Information Memo The attached BOCC agenda item is to request approval to renew the current Diesel Fuel & Unleaded Gasoline Supplier Contract with Dion Oil Company, LLC. for one additional year. This will be the first of the two one-year renewals. Dion Oil Company, LLC. has agreed to the one year renewal at zero increase over the original agreement. The Fleet Management Department recommends approval to renew the current contract with Dion Oil Company, LLC. for the first one-year renewal. Thank you. MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract # Contract with:Dion Oil Company, LLC Effective Date:4/19/08 Expiration Date:4/18/09 Contract Purpose/Description: Supply diesel fuel and unleaded gasoline to Monroe County and Monroe County School Board fueling facilities throughout the Keys. Contract Manager:Roy Sanchez (Name) for BOCC meeting on 3572 Fleet Management (Ext.) (Department) Deadline: CONTRACT COSTS Total Dollar Value of Contract: $1,600,000.00 Current Year Portion: $733.000.00 approx approx Budgeted? Yes® No ❑ Grant: $ County Match: $. Account Codes: ALL DEPARTMENTS PLUS SHERIFF, HIGHWAY PATROL AND OTHER AGENCIES - ADDITIONAL COSTS Estimated Ongoing Costs: $ /yr For: (Not included in dollar value above) (eg. maintenance, utili CONTRACT REVIEW etc. Changes Date Out Date In Needed vi Division Director 114 ID 1Z YesO No[] Z�p� Risk Mana meqL I YesQ N& P a-05 �;� wry O.M.B./Purlasing 661,0`t� YesO NoE� .,::17=�-: � ( County Attorney YesO No®0"L�l�l Comments: OMB Form Reed 9111 /95 MCP *7 RENEWAL AGREEMENT THIS AGREEMENT is made and entered into this 17`I' day of April, 2008 between the COUNTY OF MONROE and DION OIL COMPANY in order to renew the agreement between the parties dated April 18", 2007. In accordance with Paragraph II(B) of the 2007 agreement, the County hereby exercises its option to renew the Agreement for an additional one-year term beginning April 17'', 2008. 2. In all other respects, the agreement between the parties dated April 18"', 2007 remains in full force and effect. IN WITNESS WHEREOF, the parties have hereunto set their hands and seal, the day and year first written above. (SEAL) ATTEST: DANNY L. KOLHAGE, CLERK LIM BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA RA Mayor / Chairman WITNESSES: DION OIL COMPANY B- m s�.�.�_� y MONROE CO UNTY ATTORNEY n APPROrV,�'E Q AS TO FORM: CHRISTINE M. LIMBERT-BARB ASSISTANT COUNTY ATTORNEY Date I IAQ� /Aa CONTRACT DIESEL FUEL & UNLEADED GASOLINE SUPPLIER THIS AGREEMENT, made and entered into this Jy—day of April, 2007 by and between the COUNTY OF MONROE, STATE OF FLORIDA, a political subdivision of the State of Florida hereinafter called "County" and Dion Oil Company, LLC hereinafter called "Vendor". WITNESSETH: That the parties hereto for the consideration hereinafter named, agree to the following: DESCRIPTION: A. The Vendor shall deliver Number Two Diesel fuel, High Sulfur Diesel fuel and 8r-87/88-89f92- 93 Octane Gasoline to locations in the Key West, Marathon, Plantation Key, and Key Largo areas as requested by the ordering Monroe County and School Board departments and on the dates requested by such departments. Fuel shall be delivered the next day if requested by 4:00pm. B. Deliveries will be in quantities of less than One Hundred (100) gallons to Seven Thousand (7,000) gallons (Full Tanks). The Vendor shall have a metered tanker for all deliveries and shall be required to itemize invoices for each delivery under this provision. C. Upon request by the County, Vendor shall provide documentation supporting most recent pump meter certification. D. All deliveries must be witnessed and delivery tickets must be signed and dated by Monroe County personnel. E. The Vendor shall have the capability to pump fuel into aboveground tanks through standard quick detachable couplings. F. The Vendor shall have ability to provide daily deliveries of gasoline and diesel to multiple locations after a hurricane, natural disaster, or other emergency for as long as the need exists. II. TERM OF CONTRACT ° A. This contract shall be for a period of One (1) year commencing upon the day in which it has been executed by both parties. B. The County shall have the option to renew this agreement after the first year, for two (2) additional one (1) year periods. III. HOLD HARMLESS The Vendor covenants and agrees to indemnify and hold harmless Monroe County Board of County Commissioners from any and all claims for bodily injury (including death), personal injury, and property damage (including property owned by Monroe County) and any other losses, damages, and expenses (including attorney's fees) which arise out of, in connection with, or by reason of services provided by the Vendor or any of its Subcontractor(s) in any tier, occasioned by the negligence or other wrongful act or omission of the Vendor or its Subcontractor(s) in any tier, their employees, or agents. The extent of liability is in no way limited to, reduced, or lessened by the insurance requirements contained elsewhere within this agreement. PP_Re I of 12 d. INSURANCE Prior to execution of this agreement the Vendor shall furnish the County Certificates of Insurance indicating the minimum coverage limitations as stated in the General Insurance Requirements for Suppliers of Goods or Services section of this contract. V. PAYMENT A. Price per gallon shall reflect Port Everglades Florida Terminal (RACK) charges. B. Monroe County may not be charged more than the following prices listed above market (RACK) price from date ordered. Unleaded Gasoline (Any Octane) Diesel W2 and MV15 Dyed) $0.20 Key West $0.23 Key West $0.18 Sugarloaf $0.21 Sugarloaf $0.16 Marathon $0.19 Marathon $0.12 Plantation Key $0.15 Plantation Key $0.10 Key Largo $0.13 Key Largo C. The Vendor shall submit invoice to the County, itemizing the delivery location, the requesting department, the RACK prices, and all taxes, for each delivery to the locations described herein. D. In accordance with the Florida Prompt Payment Act, s. 218.70, Florida Statutes, all invoices will be paid within forty-five days after receipt of a proper invoice. E. Diesel fuels and Gasoline taxes must be itemized on each invoice. VI. INDEPENDENT VENDOR At all times for all purposes under this agreement the Vendor is an independent Contractor and not an employee of the Board of County Commissioners for Monroe County. No statement contained in this agreement shall be construed so as to find the Vendor or any of his/her employees, contractors, servants, or agents to be employees of the Board of County Commissioners for Monroe County. VII. ASSURANCE AGAINST DISCRIMINATION Vendor 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 temrinates without any further action on the part of any party, effective the date of the court order. Vendor and County 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 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 91-616), 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, Qelating to confidentiality of alcohol and drug abuse patent records; 8) True VIII of the Civil Rights Act of 1968 (42 USC §§ 3601 et seq.), as amended, relating to 'atge 2 of 12 nondiscrimination in the sale, rental or financing of housing; 9) The Americans with Disabilities Act of 1990 (42 USC §§ 1201), as amended from time to time, relating to nondiscrimination in employment 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; 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. Vill. ASSIGNMENT Vendor shaft not assign or subcontract this agreement, except in writing and with the prior written approval of the Board of County Commissioners for Monroe County, which approval shall be subject to such conditions and provisions as the County may deem necessary. This agreement shall be incorporated by reference into any assignment or subcontract and any assignee or subcontractor shall comply with all of the provision of this agreement. Unless expressly provided for tterein, such approval shall in no manner or event be deemed to impose any obligation upon the County in addition to the total agreed -upon price of the services/goods of the Vendor. IX. COMPLIANCE WITH LAW In providing all services/goods pursuant to this agreement, the Vendor shall abide by all statutes, ordinances, rules and regulations shall constitute a material breach of this agreement and shall entitle the Comer to terminate this Vendor immediately upon delivery of written notice of termination to the Vendor. X. NOTICE REQUIREMENT Any notice required or permitted under this agreement shall be in writing and hand delivered or mailed, postage prepaid, to the other party by cerrtifified mail, returned receipt requested, to the following: For County: With a cxmv to: Fleet Management Services Suzanne A. Hutton 3583 S. Roosevelt Blvd. Monroe County Attorney Key Wes, FL 33040 P.O. Box 1026 Key West, FL 33041-1026 For Vendor. Dion Oil Company, LLC P.O. Box 1209 Key West, FL 33041 XI. FUNDING AVAILABILITY In the event that finds from Fleet Management Services operating Gasoline and Diesel Accounts are partially reduced or cannot be obtained or cannot be continued at level sufficient to allow for the purchase of services/goods specified herein, this agreement may then be terminated immediately at the option of the county by written notice of termination delivered in person or by mail to the Vendor. The County shall only be obligated to pay for any goods delivered by the Vendor until the Vendor has received written notice of termination due to hick of funds. XiI. PROFESSIONAL RESPONSIBILITY The Vendor warrants that it is authorized by law to engage in the performance of the activities encompassed by the project herein described, subject to the terms and conditions set forth in the Notice of calling for Bids. The provider shall at all times exercise independent, professional judgment and shall assume professional responsibility for the services to be provided. Continued funding by the County is contingent upon retention of appropriate local, state, and/or federal certification and/or licensure of vendor. P,w_ e 3 of 12 Xtll. PUBLIC ENTITY CRIME STATEMENT A person or affiliate who has been placed on the convicted vendor list following a conviction for a public entity crime may not submit a bid on a contract to provide any goods or services to a public entity, may not submit a bid on a contract with a public entity for the construction or repair of a public building or public work, may not submit bids on leases of real property to public entity, and may not be awarded or perform work as a contractor, supplier, subcontractor, or consultant under a contract with any public entity, and may not transact business with any public entity in excess of the threshold amount provided in Section 287.017, for CATEGORY TWO ($3000.00) for a period of 36 months from the date of being placed on the convicted vendor list. XIV. TERMINATION If the Vendor fails to fulfill the terms of this agreement, or attachments, property or on time, otherwise violates the provisions of the agreement, the County may ten nate the contract by written notice. The notice shall specify cause. The County shall pay the vendor the contract price for goods delivered but not paid for on the date of termination, less any amount of damages caused by the Vendor's breach. if those damages are more than the amount due the Vendor then the Vendor remains liable to the County for the excess amount. XV. APPLICABLE LAWS AND VENUE This contract is governed by the laws of the State of Florida. Venue for any litigation arising under this contact mroe County, Florida. �r the parties hereto have executed this agreement the day and year first above written, (Seal) BOARD OF COUNTY COMMISSIONERS Attest: DANNY I.` KOLHAGE, CLERK MONROE COUNTY, FLORIDA Y AWE-OV6111 BY 7 (Corporate Seal) Attest: Witness ib IeSS Page 4 of 12 By: Mayor/Chairman MONROE COUNTY ATTORNEY AFtVROVERAS TO FARM: GYNTHIA L. AL'L ASSISTANT COUNTY ATTORNEY Date 4 ' �� ' V'. _ RISK MANAGEMENT POLICY AND PROCEDURES CONTRACT ADMINISTRATION MANUAL General Insurance Requirements for Other Contractors and Subcontractors As a pre -requisite of the work governed, or the goods supplied under this contract (including the pre -staging of personnel and material), the Contractor shall obtain, at his/her own expense, insurance as specified in any attached schedules, which are made part of this contract. The Contractor will ensure that the insurance obtained will extend protection to all Subcontractors engaged by the Contractor. As an alternative, the Contractor may require all Subcontractors to obtain insurance consistent with the attached schedules. The Contractor will not be permitted to commence work governed by this contract (including pre -staging of personnel and material) until satisfactory evidence of the required insurance has been fiunished to the County as specified below. Delays in the commencement of work, resulting from the failure of the Contractor to provide satisfactory evidence of the required insurance, shall not extend deadlines specified in this contract and any penalties and failure to perform assessments shall be imposed as if the work commenced on the specified date and time, except for the Contractor's fiilure to provide satisfactory evidence. The Contractor shall maintain the required insurance throughout the entire term of this contract and any extensions specified in the attached schedules. Failure to comply with this provision may result in the immediate suspension of all work until the required insurance has been reinstated or replaced. Delays in the completion of work resulting from the failure of the Contractor to maintain the required insurance shall not extend deadlines specified m this contract and any penalties and failure to perform assessments shall be imposed as if the work had not been suspended, except for the Contractor's failure to maintain the required insurance. The Contractor shall provide, to the County, as satisfactory evidence of the required insurance, either: • Certificate of Insurance or • A Certified copy of the actual insurance policy. The County, at its sole option, has the right to request a certified copy of any or all insurance policies required by this contract. All insurance policies must specify that they are not subject to cancellation, non -renewal, material change, or reduction in coverage unless a minimum of thirty (30) days prior notification is given to the County by the insurer. The acceptance and/or approval of the Contractor's insurance shall not be construed as relieving the Contractor from any liability or obligation assumed under this contract or imposed by law. The Monroe County Board of County Commissioners, its employees and officials will be included as "Additional Insured" on all policies, except for Workers' Compensation Any deviations from these General Insurance Requirements must be requested in writing on the County prepared form entitled "Request for Waiver of Insurance Requirements" and approved by Monroe County Risk Management. Page 5 of 1 GENERAL LIABILITY INSURANCE REQUIREMENTS FOR CONTRACT DIESEL FUEL & UNLEADED GASOLINE SUPPLIER BETWEEN MONROE COUNTY, FLORIDA AND Dion Oil Company, LLC 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: $1,000,000 Combined Single Limit (CSL) If split limits are provided, the minimum limits acceptable shall be: $ 500,000 per Person $ 1,000,000 per Occurrence $ 100,000 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. GL3 0agge 6 of 12 WORKERS' COMPENSATION INSURANCE REQUIREMENTS FOR CONTRACT DIESEL FUEL & UNLEADED GASOLINE SUPPLIER BETWEEN MONROE COUNTY, FLORIDA AND Dion Oil Company, LLC Prior to the commencement of work governed by this contract, the Contractor shall obtain Workers' Compensation. Insurance with limits sufficient to respond to the applicable state statutes. In addition, the Contractor shall obtain Employers' Liability Insurance with limits of not less than: $500,000 Bodily Injury by Accident $500,000 Bodily Injury by Disease, policy limits $500,000 Bodily Injury by Disease, each employee Coverage shall be maintained throughout the entire term of the contract. Coverage shall be provided by a company or companies authorized to transact business in the state of Florida. 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 fiend, a Certificate of Insurance will be required. In addition, the Contractor may be required to submit updated financial statements from the find upon request from the County. Pige 7 of 12 VEHICLE LIABILITY INSURANCE REQUIREMENTS FOR CONTRACT DIESEL FUEL & UNLEADED GASOLINE SUPPLIER BETWEEN MONROE COUNTY, FLORA AND Dion Oil Company, LLC Recognizing that the work governed by this contract requires the use of vehicles, the Contractor, prior to the commencement of work, shall obtain Vehicle Liability Insurance. Coverage shall be maintained throughout the life of the contract and include, as a minimum, liability coverage for. O Owned, Non -Owned, and Hired Vehicles The minimum limits acceptable shall be: $1,000,000 Combined Single Limit (CSL) If split limits are provided, the minimum limits acceptable shall be: $ 500,000 per Person $1,000,000 per Occurrence $ 100,000 Property Damage The Monroe County Board of County Commissioners shall be named as Additional Insured on all policies issued to satisfy the above requirements. VAW Pae 3 of 12 HAZARDOUS CARGO TRANSPORTERS Id4,Bl1UTY INSURANCE REQUIREMENTS FOR CONTRACT DIESEL FUEL & UNLEADED GASOLINE SUPPLIER BETWEEN 1MONROE COUNTY, FLORIDA AND Dion Oil Company Prior to the commencement of work governed by this contract, the Contractor shall purchase Pollution Liability Insurance which extends to the hauling of toxic and hazardous material by motorized vehicles. In compliance with the Motor Carrier Act, the policy should be endorsed with an MCS-90 Endorsement, demonstrating financial responsibility for spills and clean-up. Any pollution exclusion limiting coverage under this policy shall be removed. ` The minimum limits acceptable shall be: $1,000,000 per Occurrence VLP3 LOBBYING AND CONFLICT OF INTEREST CLAUSE ETHICS CLAUSE SWORN STATEMENT UNDER ORDINANCE NO.010-1990 MONROE COUNTY, FLORIDA (Company Officer/Partnerlindividual) warrants ,that herd 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. 010-19W or any County officer or employee in violation of Section 3 of Ordinance No. 010-1990. For breach or violation of this provision the County may, in its discretion, terminate this Agreement without liability and may also, in its discretion, deduct from the Agreement or purchase price, or otherwise recover, the full amount of any fee, commission, percentage, gift, or consideration paid to the former County officer or employee". ILI (Signature) Date: STATE OF: COUNTY OF: CL) L7A7V) Subscribed and swom to (or affirmed) before me on _ ��— 1 S- 2- '�J b] (date) by ��kZ 8, rMQ 1 1 io�y��CZ (name of affiant). 44e/She is personally known to me eW*9-pfeduGe& Page 10 of 12 a� NOTARY PUBLIC My commission expires: MWARD R. BQZA CQWAS 10050d911 i cEVKe.- aFebriny 11, 2010 0 NON -COLLUSION AFFIDAVIT L> > 'ate 6 - 6'4c,, k the city of my oath, and under penal of u de according to law on penalty perj ry, pose and say that: I am of the firm of -I� 16A-) /X q � making the Bid for the services/work/project described in the Request for Bids for: executed the said Bid with full authority to do so: and that I 2. The prices in this bid/Bid have been arrived at independently without collusion, consultation, communication or agreement for the purpose of restricting competition, as to any matter relating to such prices with any other bidder or with any competitor. 3: Unless otherwise required by law, the prices and percentage of return which have been quoted in this bid/Bid have not been knowingly disclosed by the responder and will not knowingly be disclosed by the responder prior to bid/Bid opening, directly or indirectly, to any other bidder/responder or to any competitor. 4. No attempt has been made or will be made by the bidder/responder to induce any other person, partnership or corporation to submit, or not to submit, a bid/Bid for the purpose of restricting competition. 5. The statements contained in this affidavit are true and correct, and made with full knowledge that Monroe County relies upon the truth of the statements contained in this affidavit in awarding contracts for the project/services/work. �l STATE OF: /-1� � -�%� x✓ C/��-1���-.1�1��� (Date) �,i�9-�.c ars- r�s✓a'rC.,E, g.�. , %>/I,,�.� U!L G.f3r�(_%�fi��,� L-�C, j�ve�i 1�,4 COUNTY OF. MOA- JJ,V— PERSONALLY APPEARED BEFORE ME, the undersigned authority' ri -1-6 - who, after first being sworn by me, (name of individual signing) affixed his/her signature in the space provided above on this /3� day of " W ,, 20AJ r � NOTARY PUBLIC My Commission ROM .#Ui4S:y WC0aA1- 1l00504917 ' Page 11 of 12 LkdMWftM 1 DRUG -FREE WORKPLACE: FORM The undersigned Contractor/bidder/responder in accordance with Florida Statute 287.087 hereby certifies that: (Name of Business) 1. Publishes a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the workplace and specifying the actions that will be taken against employees for violations of such prohibition. 2. Informs employees about the dangers of drug abuse in the workplace, the business'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), notify the employees that, as a condition of working on the commodities or contractual services that are under bid, the employee will abide by the terms of the statement and will notify the employer of any conviction of, or plea of guilty or nolo contendere to, any violation of Chapter 893 (Florida Statutes) or of any controlled substance law of the United States or any state, for a violation occurring in the workplace no later than five (5) days after such conviction. 5. Imposes a sanction on, or requires 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, 1 certify that this firm complies fully with the above requirements. id�r's_Si, ,n tune Date 611- STATE OF: f "i , OA eab A, COUNTY OF. _Yrc bA*_) WE' PERSONALLY APPEARED BEFORE ME, the undersigned authority,�j�Zc�1h11Q � h�5 who, after first being swom by me, (name of individual signing) affixed his/her signature in the space provided above on this r S day of M ck Y c 20_D 1. _ —j 100 NOTARY PUBLIC i My Commission Expires: ®yy,�q.W . Iw �f # 00 5C391: ems: Fd*oy i1, 201d Page 12 of 12 +firewxx�Fyh�„,, �_