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Item G2 BOARD OF GOVERNORS FIRE AND AMBULANCE DISTRICT 1 AGENDA ITEM SUMMARY Meeting Date: September 17, 2008 Division: Emergency Services Bulk Item: Yes - No -X- Department: Fire Rescue Staff Contact Person: Camille Dubroff AGENDA ITEM WORDING: Approval of the third Renewal Agreement effective from October 1, 2008 through September 30,2009, with Fire Tech Repair Service, Inc. for maintenance of Fire Rescue vehicles, including semi-annual inspections, preventative- maintenance and unscheduled maintenance resulting from malfunction or failure. ITEM BACKGROUND: On December 21,2005 the Board awarded bid and entered in to an Agreement between the Board of Governors Fire and Ambulance District 1 of MOlU'oe County and Fire Tech Repair Service, Inc. The original agreement provides for annual renewals up to three (3) one-year periods, with approval of the District's governing Board. We are requesting approval to exercise the renewal option for the third and final one-year period, commencing on October 1, 2008 and ending on September 30,2009. PREVIOUS RELEVANT BOG ACTION: On December 21,2005 the board approved an agreement with Fire Tech Repair Service, Inc. for maintenance of Fire Rescue vehicles, including semi-annual inspections, preventative maintenance and unscheduled maintenance resulting from malfunction or failure commencing on October 1,2005 and ending on September 30,2006. On September 20, 2006 the Board approved the first renewal agreement effective from October 1, 2006 through September 30, 2007 for maintenance of Fire Rescue vehicles, including semi-annual inspections, preventative maintenance and unscheduled maintenance resulting from malfunction or failure. On September 19, 2007 the Board approved the second renewal agreement from October 1, 2007 through September 30, 2008, with Fire tech Repair Service Inc. for maintenance of Fire Rescue vehicles, including semi- annual inspections, preventative maintenance and unscheduled maintenance resulting from malfunction or failure. CONTRACT/AGREEMENT CHANGES: Contract will be extended and the new expiration date will be September 30, 2009. - STAFF RECOMMENDATIONS: All conditions of the contract have been met and services provided have been satisfactory. Staff recommends renewing as the contract allows. TOTAL COST: $18,230.00 * BUDGETED: Yes ~ No - *Cost to cover periodic inspections, preventative maintenance and pump testing. In addition, the contract also includes fixed pricing for unscheduled repairs at $73.00/hour and parts at 25% over cost. COST TO COUNTY: See above SOURCE OF FUNDS: 11500-530462 REVENUE PRODUCING: Yes_ No..Jl A~UNTPERMONTH_ Year_ ~ P:b- ~' APPROVED BY: County Arty ::7- OMB/Purchasing _ Risk Managemen ; DOCUMENTATION: Included X Not Required DISPOSITION: AGENDA ITEM # Revised 8/06 MONROE COUNTY BOARD OF GOVERNORS CONTRACT SUMMARY Contract with: Fire Tech Repair Service Contract #_ Inc. Effective Date: 1 % 1/2008 Expiration Date: 09/30/2009 Contract Purpose/Description: Renewal of agreement dated 1/112006 for maintenance of Fire Rescue Vehicles maintenance of Fire/Rescue vehicles, semi-annual-inspections, preventative maintenance and unscheduled maintenance resulting from malfunction or failure. Contract Manager: Camille Dubroff 6010 Emergency Services / Stop 14 (Name) (Ext.) (Department/Stop #) for BOCC meeting on 09/1712008 Agenda Deadline: 09/02/2008 CONTRACT COSTS Total Dollar Value of Contract: $ $18,230.00*Plus Cunent Year repairs at $73/hr and Portion: $ pmis at 25% over cost. Budgeted? Yes[Z] No D Account Codes: 11500-530462-_-_-_ Grant: $ _-_-_-_-_ County Match: $ _-_-_-_-_ - - - - ............... ------- ~ - -- ADDITIONAL COSTS Estimated Ongoing Costs: $~yr For: (Not included in dollar value above) (eg. maintenance, utilities, janitorial, salaries, etc.) CONTRACT REVIEW Changes Date Out Dale In Needed ~ Division Director _ YesD NoD v ~ li2'id{ RiskManagW'e~~ ~/J.l1)1 YesDNoB.. ' . X-3-.}d eJLt.. t; fJ,.AJ e. O.M.B./Purchasing l1"',;U-Ol YesDNo[0 . t~ ~1J '7)-;).& ~Cf6 ~ County Attorney 0- ,q~ Or YesD No[2g ~~ i. tI-aJI '6- IV- 06 Comments: OMB Fonn Revised 2/27/01 Mep #2 RENEWAL AGREEMENT This AGREEMENT dated the day of ,2008, by and between the Board of GovemOfs of Fire and Ambulance District 1 of Monroe County, Florida, hereinafter called the "District" and Fire Tech Repair Service, Inc., whose mailing address is PO Box 1570, Key Largo, FL 33037, hereinafter called the "Contractor". WI rnE S SETH WHEREAS, the parties hereto did enter into an agreement dated January 1, 2006 for maintenance of Fire/Rescue vehicles, semi-annual inspections, preventative maintenance and unscheduled maintenance resulting from malfunction or failure; and WHEREAS, said agreement provided an option to the District to renew ,~~e contract for three additional one year terms; and WHEREAS, the DISTRICT has elected to exercise said third one (1) year renewal option for the continuation of maintenance of Fire/Rescue vehicles, semi-annual inspections, preventative maintenance and unscheduled maintenance resulting from malfunction or failure; now therefore IN CONSIDERATION of the mutual convenants and obligations contained herein, the parties agree as follows: 1. The District elects to renew the contract for an additional year pursuant to paragraph 1 of the agreement entered January 1,2006. 2. The effective date ofthis amendment is October 1,2008 and shall extend through September 30,2009, under the same terms and conditions ofthe contract dated January 1,2006. 3. All other terms and conditions of the contract dated January 1,2006 shall remain in full force and effect. Attest: DANNY L. KOLHAGE, CLERK BOARD OF GOVERNORS, FIRE AND AMBULANCE DISTRICT 1 By: By: Deputy Clerk Mayor/Chairman vnTNESS:~~ , Camille Dubroff CYNTHIA L. HAI..:L ASSISTA~T COUNTY ATTORNEY Date .. (S .. ')...00 r RENEWAL AGREEMENT "9:1J ), ~ ~ This AGREEMENT dated the _!_~day of ~J.~ n __. ,2007, by and between the Board of Governors of Fire and Ambulance District 1 of Momoe County, Florida, hereinafter called the "District" and Fire Tech Repair Service, Inc., whose mailing address is PO Box 1570, Key Largo, FL 33037, hereinafter called the "Contractor". WITNESSETH WHEREAS, the parties hereto did enter into an agreement dated January 1, 2006 for maintenance of FirelRescue vehicles, semi-annual inspections, preventative maintenance and lUlscheduled maintenallce resulting from malfunction or failure; and WHEREAS, said agreement provided an option to the District to renew !he contract for three additional one year terms; and WHEREAS. the DISTRICT has elected to exercise said second one (1) year renewal option for the continuation of maintenance of Fire/Rescue vehicles, semi-annual inspections, preventative maintenance and unscheduled maintenance resulting from malfunction or failure; now therefore IN CONSIDERATION of the mutual convenants and obligations contained herein, the parties agree as follows: 1. The District elects to renew the contract for an additional year pursuant to paragraph 1 of the agreement entered January 1, 2006. 2. The effective date of this amendment is October 1, 2007 and shall extend through September 30,2008, under the same terms and conditions of the contract dated January 1, 2006. 3. All other terms and conditions of the contract dated January 1,2006 shall remain in full force and effect. Attest: DANNY L. KOLHAGE, CLERK BOARD OF GOVERNORS, FIRE AND AMBULANCE DISTRICT 1 - By: ,M,a.L.fl(}. ft]xf ~ ByLdL- \.0 l?~pu.t-.y Clerk o't- /9-07 "Mayor/Chairman C~~ 0 L~: .. ( J LL ( , - . . '. c- ..- ". !. x: ~. ^:_) ~-- ". 0- ~ .:':: :: w (.: . -- -........ - .:,...)c:: ;:FIT~3S; '-, f-;: :-.~--'n W :-;::U;:::;. o ~- ~- -'" ,-.. ~.:::: g !. \~ :5 Cl L: l:-...I RENEVV AL AGREEMENT ! '" J. :< This AGREEMENT dated the J?I day of t.}(.'7ZJ6{l!_ ,2006, by and between the Board of Govemors of Fire and Ambulance Disttict 1 of Moru-oe County, Florida, hereinafter called the "'Distilct" and Fire Tech Repair Service, Inc., whose mailing address is PO Box 1570, Key Largo, FL 33037, hereinafter called the "Contractor". WITNESSETH WHEREAS, the parties hereto did enter into an agreement dated January 1, 2006 for maintenance of Pire/Rescue vehicles, semi-annual inspections, preventative maintenance and unscheduled maintenance :esulting from malfunction or failure; and WHEREAS, said agreement provided an option to the Distdct to renew the contract for tIu'ee additional lUe year terms; and .... :..~ ~ 'WHEREAS, the DISTRICT has elected to exercise said first one (1) year renewal option for the ontinuation of maintenance of Fire/Rescue vehicles, semi-annual inspections, preventative maintenance and nscheduled maintenance resulting from malfunction or failure; now therefore IN CONSIDERATION ofthe mutual convenants and obligations contained herein, the parties agree as )l1ows: L The District elects to renew the contract for an additional year pursuant to paragraph 1 oftlle agreement entered January 1,2006. 2, The effective date of this amendment is October 1,2006 and shall extend through September 30,2007, under the same temls and conditions of the contract dated January 1, 2006. 3. All other terms and conditions of the contract dated January 1,2006 shall remain in full force and effect. Attest: g.&~ L. KOLHAGE, CLERK BOARD OF GOVERNORS, #~ (, ~ >~;,~. - , FIRE AND AMBULANCE DISTRICT 1 -~ j~~Y>"'" , ::...~. ,I_~. <' . /1" j;- C:~.~'.. " \ ~u. It 1 ' . \\ ' i'~~ By: L-"---- )1f~ By~t:~~,,':.' . r.~~~ Dep\liy qerk Mayor/Chairman WITNESS: Fir:~~ice, (&~ ) - ~ ~ Authorized Representative MONROE COUNTY ATTORNEY APPROVED AS TO FORM: ~d.d!-_ ~/1 ~<~:-"~cit.<. SUSAN M. GAf GtSlE'f -, 7 Assls.rA~:r COUNTY ATTORNEY . ~IEiQ@') ~?'L.,,",~..k~~...f~:"''';;';' ,. ~ l'!'::.,;,~~"= C<CDNIr1~iC'jf llliIE1rW'lfJE:EI\J TI-KIE JBl{JiPMlill)) (QllF <G([>>WJEffi;I'~<<]J'&~ lFI[1Pl1E A.hID .t:':!1MflBHUL4NClE lJ]JIS'lT'RIIC'Jf 1L ([})IF lWONROE CO[JNlrY~ FLORIDA A.Nli) .-. 1F1rRE TECH REPAlrR SERVICE .lINe. FOR MAlrNmNANCE OF FIRE/RESCUE VEHICLES TIlIs CONTRACT, hereinafter "CONTRACT OR AGREEMENT" made and entered into this f * day nf -1a'l. . , 2006 by and between Board nf Govemors Fire and Ambulance Dislrict 1 of Monroe Connty, Aorida, hereJiiafter referred 10 as "DISTRICT", and Fire Tech Repair Service Inc. , hereinafter referred to as - "'CONTRACTOR". - WITNESSETH: WIiEREAs, the su"""ssful bidder was Fire Tech Repair Service Inc., and; WHEREAS, tbis CONTRACCOR represents tbat it is capable and prepared to provide such services, and; WHEREAs, the DISTRICT intends to enter into an allfeeD1ent for maintenance of FirelRescuc vehicles, semi-annual inspecti""s, preventative maintenance, and -. unscheduled maintenance resulting from malfunction or failure with the CONTRAcroR and; WHEREAS, this contract is an agreement between both parties, NOW, THEREFoRE, in consideration of the promises contained herein, the parties agree as follows: 1. CONTRAcr PERIOD AND RENEWAL - The effective date of Ibis Agreemeut shall be Janu8fJ( 1. 2006 through Selltember 30, 2006. This OOIItract may he renewed annually for one (1) year terms, nolto exceed three (3) 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 Governors Fire and Ambulance District 1. 1 2, CONfI"~4cr TErJ.\1INAnON - Thi. """tract may be termjmted t", ""Y '",,"on by ei!l,., pOliy On 311-day wrille.. ""lice witllout "''''se. If!he CONTRACTOR f.ils !o r"Ifi!! tlw I:effilS of llJis agreeme..~ "" a!taclm!ents, properly Of 00 time, Of olhorwi.. violaio. Ihe P"'visions of !he agleemen! or of .pplicable I.ws 0' ..gel.tioos governing ihe USe of funds, lbe County may lerm.inaie the COntract by Written noti"". The notice shaU specify cause. All finished or unfinished supplies _._ Or services shall, .i the option of lbe County, become property of the Connty. The County silalJ pay the CONTRACTOR fair and equitable oompen8;liion ful expenses incurred prior to (ermin.lion of Ibe agr""men~ less any llmount Or damages caus.d by lbe CONTRACTOR's breach. If the dOlOagem are more thon <lOIilpensation payable, Ihe CONTRACTOR will remain liable after lenmination and the COUi.Rty shall pursue collection for damages. ," 3. SUBJ:Ecr MAlTER OF CONTRAcr - This contract is ror scheduled semi - aanual inspec!iolls and preven/oIive maintenance of fire rescue vehicles, annuol - pump tests and ror unscbeduled maintenance and repair resulting from equipment failure or malfunction. 4. RATES -The hourly rate shalJ he $73.00 per man-hour with no traveltime or mileage cbarge. Semi Amnuol inspections and annual pump lests are at quoted flat rates and excluded from houdy rate. 5. OVERTIME AND HOLIDAYS - Rales per man-hour ror emergency repairs called outside nOrmal busin"slmurs and federal hOlidays shail be One .nd one holt times the normal rate. ~ 6. SEMI-ANNuAL INSPECTIONS - Durimg lite year CONTRACTOR sball perfunn twn inspections on vehicl.. described in "Attaclnnenl A" (!.eve I I and Level II Preventative Maintenance Service) at an annual total cost of: Rescue~type vehicles, without pump $ 360.00 -~ Pumpers $ 490.00 Aerials $ 640.00 Exception shall be if a vehicle hos been used 1,000 bours Prior to yearly preventative maintenance service, Level I and n Preventative Maintenance Service shall be performed and charged the above rate. Level I: 250 Hours or 6 months (whichever comes fir~ Pnll vehicle inspection as per attached semi-annual Inspection schedUle plus: - Engine oil and filter change - Fuel filter change (every 6 months) - Air filter inspection and replacement if necessary - Chassis lubrication 2 ~ (t)&i:!J';:P31l'(] (1f(!)niV~1"tD1) Jill]]p[;;]lleF Sh1afi: h!bJI'k~~J!(J1m - L!!lliJl'ica€~iQ!]] of aU V8JHVe; C(iiXRKfOB H1ffiEW)g68 c_ CReam 011 reri.JIlacf': autr COl11t1lpre8~(JJf stFmmer - CReam engin.e crankcase breather - Illspocoo" of gellerato, and ""m"" of lubricOlllt system, full system, ""d air filter according to its individuai hours of Ol"'rotJo" (not to .""""<1 6 months) --. Level DI.: 1000 Hours or ORte xear (which ever comes rust) Full service pell'lfonned in level I plus: - Replacement of coolant hoses~ filter and coolant as needed ~ Replacement of all. drive belts as needed - Replacement of pump transmission oill and filter . Replacement of engine transmission fluid and filter -.~~ - ~ B Replacement of rear rode lube oil as needed _ - Inspection of front wheel bearing a Replacement and repacking as needed - Inspection and cleaning of relief valve strainer - Replacement of secondary fuel filters on both engine and generator The number of vehicles may fluctuate from time to time due to new purchases or removal of vehicles from inventory. The mspections shall be preformed at the respective fire stations. 7. WORK SCHEDULE - Regu/arly SCheduled semi-annual inspections and preventative maintenance shall be conducted at such intervals as are approved by the DISTRICT. 8. PUMp TESTS - CONTRAcroR shan perfonn an annual pump test at a flat rate COst of $250.00 each for aU vehicles requiring such test. In order to facilitate the Passing of the pump test, minor repairs and adjustments shan be made as needed; -~ price inclUdes clean-up after salt water use. The CONTRAcroR shall provide doc:umentation of performance to Monroe County. The dOCllmenta/ion must be in the form of an electronic version report that is emailed to the Captain of Support Services. The fonn must either be in Microsoft Word or Excel. 9. PARTS, FWIDS AND LUBRICANTs - All parts, f1nids, aud lubricants used for maintaining and repairing vehicles shan be SUPplied by CONTRAcrOR and biUed to the DISTRlcr at cost plus 25%. For jlarts $400.00 and over, a COpy of origilla/ Parts supplier invoices shall be attached to the biD. CONTRAcrOR wiU be required to keep aU original parts supplier inVOices available at request by County for spot checking and auditing purposes. :3 l{OI I8NGjIJ\1jE OIL A[~JJ HLIJE:R CHlLI\fGE ""~ complote drive i,.;" l"bric.iJon Ill1ld ony 01110.. J1l.io1, anfl;o.. ru"" clllll1lgo., s!;lll1 "" l"'IT(lr,>'ed .. ''''''''''''''.nded by the Iil.em:m1f8!CKlJEeli' . H. SEMI-ANlIlUM, INSPECTION SCHED1UUl - COllfIRACTOR shalll"'rfo1ID liJ. following inspection and preventative maiIDlenance twice per year OlD all vebicles: ._.~ (a) Cooling system, including fan belts, radialor supports, hoses, and cl.mps, and auxiliary cooler;. . (b) Exbanst System, incJuding hanger, clamps, muffler, and pipes; (e) CJlutch, induding freeplay, linkage, and fluid levels; (d) Manual Tramsmissioll1, including seals, linkage, and lube level; (e) Automatic Transmission, including fluid! level, seals, modulator adjustment, and linkage; " (t) Drive Train, including V-joints, center support, and companion flangeS; - (g) Rear Axle and springs, includiug oil links, spring hangers, center bolts, and - U~bolts (h) Front End, including steering box, linkage, lringpius and bushings, spring hangers, and U -bolts; (i) Mechanical Brakes, mcluding adjustment and fluid levels; CD Air Brakes, including dram, adjustment, wear, 2nd air leaks; (k) Tires, including condition and wear; (1) Electrical System, including running lights, emergency lights, battery cables, turn lights, 4-way .!lasher, beadlights, stop lightS, and switches; (m) Fuel System, including hoses and fittings, filters and brackets, and tank straps; (n) Booster Tank, including leaks and supports; (0) Prime Pump, including electrical wires, coupling, switch, and valve discharge; (P) Plumhing and Gales, including leaks, brackets, bleed Valves, control arms and knobs, and linkage; (q) Main Pump, inclUding vacuum tes~ pressure les~ paclring, clappers, and mounting; (r) Pump TranSmission, including fluid levels, seals, shift motors, and manual override; (s) Aerial Ladder, including power takeoff, drive shaft and coupling, P. T.O. activating device and outrigger COntrols; (t) Aerial Operation, including engine RPM., hydraulic pressure, operation of all controls, warning devices, hoses and fittings, rung COvers, ladder locks, and ring gear; (u) Aerial Platform, including lubrication, platform leveling, electrical system, turntable and platfonn controls, COmmunications, and water tube. The above inspections shall include, at no additional labor charge, the changing of all spplicable filters and fluids used by the unit being inspected. Air filters shall be Changed on first inspection and then yearly thereafter. Filters and fluids shall be 4. tmed! at 0iJ1St pllis 25%, as pre~nkmsH)F described JlJrl Secdcm 9 of tJhli8 AGREEMENT. Upon comp~etioh1 of afwpectioll ;2 -computerized report vviU be forwarded to the Captain. of Support Services indicating dl!.e status Df the items inspected. TIllS wm be done for every vehicle when Preventative maintenance is performed Dn the vehicle. This repmt must be ~maiied to the Captain Qf Support Sexvices at lubert- peter@monroecounty-fl.gov. The form mu.st either be in Microsoft VVord or --- Excel. h 12. WEEKLY MAINTENANCE SCHEDULE - CONTRACTOR shall provide to the DISTRICT a preventative maintenance schedule that can be perfDrmed weekly by the individual Volunteer Fire Departments! personnel. 13. M..lUNTENANCE WG - CONTRACTOR shall maintain an inspection amd maintenance chart on each vehicle containing at least the following information; - ~ (a) Date QfperfQnnance, (d) Parts used, (b) Apparatus serviced, (e) Name Qf service person(s), (c) Service performed, (f) Total downtime of vehicle A CQPY Qf this chart shall be supplied to the Fire Rescue Office within 30 days olf the service. 14. COMMUNICAnON ~ CONTRACTOR shall maintain a telephone or paging device such that prompt nQtification of request for service is PQssible twenty-four (24) hours a day. 15. RESPONSE TO SERVICE REQUEST ~ CONTRAcrOR shall maintain itself in a state Qf readiness during nQrmal working hours, 8:00 am - 5:00pm Monday thru Friday, and shall respond tQ the IQcation where emergency repairs are needed within 12 hQurs of receiving a request. For repairs required after normal wQrking hours, CONTRACTOR shall respond to the locatiQn where emergency repairs are - needed within 24 hQurs of receiving a request. 16. CERTIFICATION - CONTRACTOR shall prQvide evidence satisfactQry to the DISTRICT that its personnel who pedorm maintenance wQrk: are certified in pump mechanics, general mechanics and repair. 17. QUAliFICATIONS OF MAINTENANCE PERSONNEL _ All persQnnel perfQnning maintenance, repairs, adjustments and related work on MQnroe County equipment shall be a certified fue apparatus mechanic Qr Qtherwise certified fQr the wQrk tQ be performed. Personnel perfQrming work who are nQt certified Qr experienced in such work shall be directly supervised (in person) by an individual with such certificatiQn. 5 )U3/r KN])m\1[I"TJUFKCAT~ON " COl\rrJ[U-'1CrO~ sh81nn JUmdem]jIJi(l' 8!Il]d hoM ~rae DlS'JrJlUClr 8@d] MOJi]Kile Ci!Ji\!.lllffi~Y hm1i1ill.!les8l fm @Eny m.eg]ngem.ce ()Jj]]I. ntfl pEr[~ Of fa~dty (liX' J1mRJlJ!'Oper woiilrnmcmgfanp, few an wC~fk peITOrmI1K;d! 1!]IT1der tllis cont['@.ct, mdudmg aU costs of oonHectioKil, reasomabHe attorney fees, daim costs, alilrl a~ per ';Attad.1ment B;'. AU pJl"Opef~Y Of equrrpmeJl1t ~~mg dill'ectly M?1imtl.ili:ted or repaire~ by CON1ffiAC'I'OR shaRi be considered in its care, custody, an.d contml while such work is in progress and until physical control of such property OE' equipment is restored to the DISTRICT. -.- 19. LOCATION OF WORK -This contract is for mamtenance offlre fescue vehicles located at the foHlowing sites: A, Stock: Island JP, Monroe County Fire Academy (Marathon) B. Big Coppitt G. Conch Key C Sugadoaf H. LaytOIfl D. Cudjoe JL Tavernier - - Eo Big Pine 20. ]INSURANCE - During the term of this contract~ the CONTRACTOR must keep in force and effect the insurance required by Attachments e". Attachments C" are attached and incorporated into this contract. 2:t ADDITIONAL REQUIRED STATEMENTSNER1FICATIONS/AFFIDA VITS. Attached hereto lin. "Attachment D" are Public Entity Crime Statement~ Non.- Collusion Affidavit, Ethics Clause, and Drug-Free Workplace Ponn , 22, PAYMENTS - Payments for semi-annual inspection, preventative maintenance , and pump tests shall be made by the DISTRICT within 30 days of the completion of the rendered services on each vehicle and proper invoicing by the CONTRACTOR. All unscheduled maintenance and repair r~sulting from equipment failure or malfunction requiring service shall be billed by the CONTRACTOR at the applicable rates as specified in Section four, five and six of tbis AGREEMENT. The CONTRACTOR upon notification by the DISTRICT of -~ an equipment failure or malfunction requiring unscheduled maintenance shall, in a timely manner investigate the problem and provide to the DISTRICT an estimate of the cost for repair and vehicle downtime. The CONTRACTOR upon receiving authorization to proceed from the DISTRICT shall effectuate such repair; upon completion of same the CONTRACTOR shall notify the DISTRICT of the out come and actual cost. The DISTRICT shall issue a separate purchase order for each occurrence of unscheduled maintenance and repair. 23. Monroe County's performance and obligation to pay under this contract is contingent upon an annual appropriation by the Board of County Commissioners. 24. Venue for any litigation arising under this contract must be in a court of competent jurisdiction in Monroe County, Florida. 6 Xl\! 'tVrfN1ESS 'WlftERIEOF, each pan"ty hereto .ha.g caused thils contract ~o 1iJe: execm!ed! by Jits QU]y authorized n"ipres';:Ki\l:ative. BOARD OF GOVERNORS FJIRE A1\ID AJM[lBlUlA.l\JCJE DlfS'fRICT 1 ,", ,;;(~~~~:;", "frOE COuru ~}4~ !~j:;J,;:: '~~~:'Jj;! .; -. -. ,l!~~~Chairman . . - - ~ - ~~:><t.::::t5~~~:. "~~-~: >:/' '<~:~. .~~~t~l:J~ailnY L Kolhage, Clerk 'C7~~.c. - Clerk #~/"o!~s - WITNESS: Fire Tech Repair Service Inc. ~ (~) Authorized Representative ---- g - :x CI .." 0 - 1> CIJ"Io r- z """1 :::002: f"S"D f"\'1 or-z all 0 rr1~-< I -r'f ("'). r- 0 on' en ;.0 C::-;:J:;: :?~ ::0 c. !i: ;::u -I ~ G1 -< <? ~.~ ft ~:,:::: n '\.C 0 -rl ~ .. :;.u r- 1"'1 N '=' )> "'""" 7 !-t'} t I I . , Il~ . I i , -'" A.:..itfr8w;Bllmm~IITla: A IMI@illlft@!fJ C@l1\1ID1tI:y Fihrce ApP&!lIt'2JtuR~ Dii8l~llilCft ]. LocatR@Ii! Vehicle Description Stock Island 1990 JE~One Pumper -- 1994 .southern Coach TankerflI1mrnpelr Big CoppiU 1983/89 Ford Rehab Unit 1990 E~Orue Pumper 1999 Southern Coach Pumper 1978 LFRNC Pumper Sugadoaf 1993 Boardman Triple Comb Pumper - - 1986 Chevrolet Rescue Pumper 1981/1998 Saulsbury 3000 Gallon Tanker/ Pumper Cudjoe 2003 Pierce Pumper Big Pine Key 1989 Young Pumper 1981/1998 Saulsbury 3000 Gallon Tamter/ Pumper 1996 Dodge 3500 Brush Truck 1985 AMGC 6 x 6 Brush Truck Marathon Airport 1997 E~One Ford 450 ARFF Monroe County Fire Academy 1985 AMGC 6 x 6 Brush Truck (Marathon) 1978 LFRNC Pumper 1978 LFRNc Pumper - Conch Key 1989 Young Pumper 1981/1998 Saulsbury 3000 Gallon Tanker/Pumper Layton 1992 E~One Rescue 1990 E-One Pumper Tavernier 1992 Saulsbury Hose Reel Truck 1988 Spartan Rescue/Pumper 1988/2004 E-One Aerial Platfonn 2001 Pierce Pumper 1992Ford Rehab Unit ! t.K~{i I!til5~ii.l" ..~~ [vII(Q)NIJ?l@1!t <CCD.llUN1rWg W!L(Q)~IDlA !RillSK ~A<<;IMEm fOlLRCW AND PROCEDUUS CON1rRACT ADMINISTRA nON MANuAL -- KIilHlil(iSml!llm~:1iti.@liB aod 8@M. &arm.Hea row Othelf Cll'lllll\traet@n allild Sns!Dc@Jl!ltnet@!ffil TM Contractor CCV@wmtl'J and apees to inde~ amd hold harmless Monroe COlWty Board! of Coumy Co~ hill.,," and all claims 10r bodily iqjury (iDo~ death). _na! "yUfy, and property <Iamogo (~ pro~ Owned by Moome eo...,. and lII\V otbloi' 10...... --:;..; dam8geo, and el<peDscll (incIudmg attorliJIlYs &es) which am.. oUl 0 In COIlIIcctlo" with, or by - reason of services provided by tbe Contractor or any of its Subcontractor(s) in any tier, occasioned by the nePJence, errors, Of other wrongful act or omission of The Contractor or its SubcoDtmctors in any tier, their employees, or agems. In the event the completiom oftbe project (to iaclwte the work of others) is delayed or suspended! as a. result of the CoBltmctorBs &ilure to Iollrebase Off maintain b required imurance, the Contractor shall iH1demnity the County m my and all ~ expenses resulting &000 such delay. -.. The first ten doUan ($I()'OO) ofremWlemtion paid to the Contractor is for the indelnll'lfficatwm provided. fur above. 1m, extent of liability is in no way limited to, reduced. or lessened by the insunmce requirements contained elsewhere within this agreement. . - ~ - yeS AdminislraLion rnstruai(Jn Attachment B #4709.' ,~ ; li ~}.~;j 8,r3IjU~fr3 IffiJl~J1;f: lMIJLRJA~ ]Ef%1lEf'\f'lI' 1F(D!LlI<CW ~JD) J?JRcnXCm;}IDOJlIDE~ (1):Q)Nlrr~i~C'F Jdi)fi1fm~m5\1rJltA\ 1Tl[ON MANlJAIL G@:H1J@lNi!S Jlllll$!Whlll~e Req !!ll6lfemeJlllt'$ - f@lf Ot!Jn@1i' C@l!iltn€t@n mlllJd SWb€fllllltE'll(\;t@n --- As a pre-ooquisite oft!liil work g01lelMll, or the 8QOd$ =Iied under this coJJtr8ct (irlobl;"ll the pre-staging of ~ aDlIl material), the Cont.actor obtain, at hiaIIrer own ~ insurance ~ in any a_bed scIIeduIes, 1Nhicb are made part of this coli1r&:t. n,., Coillmlotor - tIlat t!liil m...r_ obtained will ~ J>fOtec!jan to alii S"""OIlimoIors ""88I/I1i<I by t!liil CoiD!ractor. As....~. the Cooimcto. ma,v te4uire alii S~r. to obtain ~ oom!stem with the attached scheduJq~ _ -:.,.:. - - The C01llmctor will",,! be peuoitted to colilllleJoce WOrk 1IO-..ed by this CODIract (includinll pre- sta&ins of""""""", and ~:ril satis&ctory eoideJiee of the ooquired iIIsurance has been furiiisiie4 to the CcnnIly os spec' below. ~ in the colllll1Olll:ement of work, ""'"::If Will tbe fiIiIure of the CoDtnctor to J"'>\Iide satisliRGtmy ovicIeuce of the ooquired insnraoce. ""I oxtend deadIiues specified in thiS co1llmct aud lII\lf ~ and liIiIure to Jl<lI'fi>nn__. sbaII be ~..... as iftbo _rlt co~ on tile specified date and time, """opt Ibr tbo Comracto s:&iIure to provide satismctory evidence. The C01llmctor sbaII ma;,wg" the ooquired inanrance tIuo~ the entiIe femt oftlUs _ aud ~ specified in the attacbed ~ F ... to comp(v witIa this pro1lision DIlI\Y result "I the inDDediat., SUSpensIon ofaD Work 1DJtiI the ooql!ir!:4 ~ ..... been ~ or replaced. ~ in the completion of work ~m the liIiIute of the CODlractor to maintain the '!'luiml insurmcc shall ""t e1ltend apec/&d in this conlract and lII\lf penalties aud fiIiIute to ~rm --...m.. sbaIl be ~sed os if the WOrk bad ""t been suspend~ except tOr . Contractor's &ilure to maintain the required insurance. - The Contractor sbaII provide, to !be COIlllty. as satis&ctmy evidence of the ooquired inaumnce, either: u . Certificate of Insurance or e A Certified copy of the actual ~ policy. The Collllty. at its sole optioll; ..... the right to request a certified copy of any or all insurance policies req~ by this contract. AU ~licies must specifjr !bat they "'" ""t subject to ClbIceIIation, non-renewal, material change, 0.. ction in coverage unless a minimutn 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 oot be construed as relieving the Contractor from any liability Or obligation ".1IIIled lUlder this contract or imposed by law. Administration lnstr'Uction Attachment C' il4709.5 1 of 7 8 ~;-~~J [2eD~~!J:D "!I'l]t& I~Jrr'1J)m't!J!& (;<!1)[Il@~Y BQJ)&i1i'dl of CQ))mJl1i.y C(l}\1ffimr1i.8~<<i))IT:8ll.s) fr~B €;?rn~n:QlY@~8 2!Ji.R@ <Qila3iQ;';~ '~i1r[j!IlIb~ Q~~R\ill'~(;d: @s ,oA@Qlfi~:i(\))~ ITJj'~@rllm 6]J]ffi &nll1l Ei:D1lill,~11@8p &J~@jpJ[ 1RQ)!f %V@llJk~J[ffio C(!JnDmp~JimKi[@lllio Almy oo~~wm lfrOlill ~ra~~g Gs;E1'1~ll'Mill KmmF8Um~@' Req-wre;:lOJW!1~Zl m\OOt b@ 1l'€;)ltJl~&~edl W w-&furn~ ~lQl ~h@ C"""'-y prop-olllIDm ~ "Jm.'iJ"'&~ ff,w 'lJ'lf!ll"'e~ @ffhlo"""llD<e@ R..<II"ilr."@llDlto" ""'<I ~jlll''''''oo by M!GM'@@ C@ooty ~Jk MSllll\~lg~~J.Ol~o ._- . .. - ~ Attachment C 2 of 7 AJministration ltIslruction #4709.5 ~ ;r:'~'~:~h E~jf!d~r~r;.. KlICDr1W~(D)Et Cq))GJFJJTW\l ]FrL(QlfHillii1JA iRill~OC [\1ITM\iJA<(;iMfJEr~ IP@lLK<CYf !U~]] Ir~@CIl!;IDJ~~ C([jlN~C1l ADMllNIS1l1ltA'lEON MLAJ.\nUAIL W AlfVER €O' 1IN~URANCE REQUIREMENTS .-.- . There will be time$ whe@ it will be necesmuy, OlL' in the best interest of the County, to deviat~ from tire mmdard ~e requirements specified within this manuaL Recognizfug this potell1t~ ood acting on the advice of th,g Coumy Attomey, the Board of County Commissionm has gnmted authorization to Risk Mamhgement to waive and modifY various ~ce provisions. Specifically excluded nom this authorization is the right to waive: -::...;. ~ 0 The COUDllty as bebllllBamed as _a Additiolllal Illlsured _ If a letter from. the Insurance Company (not the Agen.t) is presented, stating that they are unable or unVl!illing to IWime the COWlty as an Mditionmll Insured, Risk Management bas been granted the authomy to waive this provision. and liD The Iodemrmiftead@1Ili and Bold Bmnrmless provisions Waivin, ofinsma1'\t"!e orovisions could. e)(pOse the Connty to economic loss. For this reason, every attempt should be made to obtain the standard insurance requirements. If a waiver Of a modification is desired, a Request for Waiver of III!lanace R.equirememts form should be completed and. submitted for consideration with the proposal.. After consideration by Risk Management and if approved, the fonn will be re~ to the County Attorney who will submit the Waiver with the other contract documents for execution by the Clerk of the Courts. Should Risk Management depy the Waiver Request~ the other party may file an appeal with the County Administrator or the Board of County Commissioners, who retains the final decisi()lf]1. making a.uthority. Administration lnsrruCl:ion Attachment C #4709.5 3 of 7 19;jl;j E:ili~nM! a:; lli:f:J1ElFU.01 ILIL~1lli..li'1f'V IIT'1$iIJlWJti\YCCIl1: nndQl1lm1~KMI1EW1T'3) W\QJ JRl CON'lI'l{>>Jt.C1r = lHHE'nVEEN MONROE COUNTY~ FLORIDA AND -- y Prior to the commencement of work governed by this contraICt9 the ConmwtOE' shalJl obtain Genem1 Liab~ Ins_. eo-age shall be ~ throughout too lire of the coll!ract ami irJ.clude~ 8$ a minimum: e Premises Operations Products and Completed Operatiom - I!l - e Blanket Contractual Liability E> Personal I$ry Liability Ell Expanded Definition of Property Damage The minimum limits acceptable shall be; $300~OOO Combined Single Limit (CSL) If split limits are provided, the minimum limits acceptable shall be: $100,000 per Person $300,000 ~ Occurrence S 50,.000 petty Damage An Occurrence Fonn policy is preftorred. If coverage is provided on a Claims Made policy, its provisions should include coverage fur claims filed on or after the e1Il:ctiye date of this contract. In addition, the~d fur which claims may be reported should extend fur a minimum of twelve (I2) months fo owing th,e acceptance of work by the County. . The Monroe County Board of County ComnUssio""lll sbaD be mmcd .. Additional Insured on aU policies issued to satisfy the above requirements. GLI Admi llistration Instruction Attachment C #4709.5 4 of 7 R ~'1~(il l1@nhi~B \/1EJBIITCCILlE JLJlfl~JI1LIT1I'l{ lJI0~1JJ1illJlJ\I em: ~(Jl([JITJRSlEI\liITI1N1rf] WQJ)~ <C<<:DN'ITJJlh<CT ~ BETVVEEN MONROE COUNTY9 FLORIDA - AND -- R€lcognizing thm€ thg work gov6~d by this contract requires ilie use of vehicles, the Cc:m.tmctor, prior to the commencement of WOi'~ shall obtmin Vehicle Liability IDSWCmce. Coverage shall be maintained throughout the life of the contract and inelude~ 00 a minim.~ liability Cov~age foIl': 0 Owne4, NonmO~ and Hired Vehicles -:..... - The ilninimum limits acceptable shall be: $100,000 Combined Single Limit (CSL) If split limits are provided, the minimum limits acceptable sba.ll be: $ 50,000 pel!' Person $1 00,000 ~r Occurrence $ 25,000 roperty Damage The Monroe County Board of County COmmissioners shall be named as Additional Insured on all policies issued to satisfy the above l'equirements. . VLl Administration Instruction Attachment C #4'109.5 5 of 7 i .~>).~,~ ~id~hd~E.~: 'W(Q)lPl1I:&JEh~3g CC(jJ)]MIWn1f,j'@\&1TI[r[j)l\l IIPJt)TIJ~CClE IPJn:~ID~tMr~I'\Jll~ Wi[!) 1ill, (:(j]W1rJR!.AC'JI' ]ffiE1'WlEE1~ MONROE COUN1I1f9 nOmTIJ]A - AND --- PriQf to the C(\l~l!'U:emmt (Qlf work governed by this tOll1tyact~ tire Contlmctof sh.d obmm Workelfs' Compensation I!IlSU1rmce with limits sufficient to !respond to Florida StatUlte 440. IlDl &ddilio~ too Contractor sball obtain Employers' Liability 1!mmm(bj~ with !limits of oot les$ tmm: $100,000 Bodily Injury by Accident -.....l. $500,000 Bodily In~ury by Disease, ~1icy limits - $100,000 Bodily Injury by Disease, each employee Coverage shall be maintained throughout the entire term of the contract. Cov~e shall be provided by fA company or companies authorized to transact business in the state 0 Florida. If the Contractor bas been approved by the Florida's Department ofLaoori> as an authorized ~lf.. insurer, the CoWIty shaU Il'eco~ and honor the Contractors status. The Contractor may be required to submit a Letter 0 Authorization issued by the Department of Labor and a Certmcat@ 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. . we! Attachmnet C Administration Instruction 6 of 7 #4709.5 f i " t B'?~:, EJB~(:~JU R1IT@[z]{glQ)rn; ~@OJk~1f\) Wlt@iilllIDL-Q ~~tID@@€ !W@TF 'WWMJfu~@lJ' @ff IlI!iJ@~mlIit~ ~~U1lf!M!!l\ll@!iI!1~ I' i. '"'1- !bot !be i._~ ...........n., .. .~l&.I .. lb. C....IJf. s.~....'" on......... Requi_...", D(g waiv~ tw lillll@d1illi.gd aail ftHD@ ~H~@wiB'n1 ~anUri4r' Coo.~r. Fif2.6.. - T tI!c!'i R.$pJf/ IlL. S ~0Ct: :::t:/i}f-. Ca@ftl!;!! ~ll': r;s12..e.- APP;f~ru<c .IJ?J9//llrd:;elflI'VCf:- Addll'~ofCG@~ao~ ~o_ ao:'" I ho " ~ _.~ 1<~'1 L." ~" I t<L ~()3"). - - Piuaoe: ':?aJ:. 79~" J7'9' / .:?t.tr... S1..2.. - <<;$PS'R . SeopeafWoll'k: _;<1:( A/7l!JVAAlC€... "-'" F' J}ee., fU.,e<-t If v It /IleuS. ~ ' ~ 1br WmiVf,lr. . _": -:::.I! PO "''''P(o;,,(~ - 'VtJ!ZK IS ~/lF~b .11?, ~ P"Uclos Waiver =Mly ow4J~s. Am:, .!:'1.AI~~M.S ~ f.Jo/4<'.t1?~/V'5 ~PJUU.ShT/bA/ will apply 00: Si8ll01u".feo._ - ~ ------- = Appmved it ~ Not.A.pproVed Risk Manl!lgement rn ~j , . p~ " n R :6.:YO-; - Date . COUlBty Admiojsb'ator appeal: Approved: - Net Approved: - - Date: Board ofCounly Commissioners appeal: Approved: Not Approved: - .\.fe~rirt8 Date: r\dministlatian lnst.ructian Attachment C ;14101).' 7 of 7 IF'TD!J1rLLlI~:: TItr~f1TTI'ln:r q:;JIDJrr%~ 8nrA 'lITJ',lNflIu~M;'1T (' t "'~n' t -" I\"ru", r~ ~~ - M." , '~A=..Il~ W . e. nn. .~ e. n.""JJii "J'i1 )Y5-lJ8Dilill i[~? &lfiLl]ill'!@ Uilill@1 !.l!!2illl!J@@Iill fiJi;@~,gm tUill! ~g Gnill!m!@tie'4ll Vltil!.i3.\!llWJ' ul!l]ll !l@U @WUiJ. ~ ~WllQ,'l\Il@illlllmJ Ifllw ((;: omuliiiy """'. -, OM!! lliIl~ " IOOO! "" m ~ .. ~ "", ~ M 00lM""" .. "jli1!Iiolie ...~lIJ" '""'tV lill@:~ ~mrnii~ @ lhMl @ill @, OO~~ wmiRll:n &! W-lI.H@' @i!J!fii1ty fM HOO OO~moo l!)\r ~ (ME' ~ nmbUlk; bmi~ @'J' )j5)tdfJ:DJIk; Wi'@~ liIID&y Wl@~ ~1lll_nfr bneis @!iii R~~ @f refill pmp~ to ,ubH~ M\bi~p lWiy OO~ be ~wme@l @11' peri'o.rm w~llk &E &J, OOilll~ltol!'p nppOOrp m~~!l'o ~ oonmllimt -der i! oon~ \llflith .Y plllJbBi~ ~fi1tity~ mmd may not ~fiIDt inmmeu wi~ mily punblic ftllt!ity m €mQfliS @ffhe threshold Im@wt pi'@'lflldelil[ fuID ~$fi 281.@R1/p f(!1lCA'fOOORV TW01 (@if a pm~ @fJ' IlIfIllOOll~ inm d!l.e ~ @f~ JP~ '@fill ft~ OOlmvi~red 'lfeiRdOll' llimt. Cl By SBgWnj ooD@w II $cbawRedge Rimrc H awe Ifeiild aM mullemtm1d the aOOVf:aJreferem.cedl stat@Jmllelllt STATED!' TL<..~t!dJ.&. pe JL~ J{f4f7~t:~..) (Siaruture ofBi , ~C. COUNTY OF ;110 " J'/"J~ 11- r --eJ <;- Date PERSONALLY APPEARED BEFORE ME, the undersigned eufuorityo _f20 n c: rl G u I-~L -e 'i. ...u, -lim beiug __ by..... (fiame of ilI1dividuml IripmB) 3fih~ his/her mipamre in the space provided above OD this 1--1 t h day of () 0 V e: r'r)\!3 -e r -8 20 0..s - . a /7 /J7 0?/ kt-:> ~"'" My commission el<pires: N JUly PUBLIC t/ JEAHNHE M. COOK ~'I'IJiIIc. ~ ofFlodda -., 1I,2DG7 CammfII;Ian" D01107CD BcndICIIIVNaIanaI AllIn. Attachment D 1 of 4 f:~(l)i~~(C;'.dJ)IlJl"j~~llil]!0 ~\1FW ]l1})Jt. Wll.'T ",-, '/ ! =~ { E.=--/~.odl G~..r'O;;~~~==~___ =~~-~~,~ "-- =-" @(f ~@ @lllW ~ of ~&v~::'tUtEe- ~~ . - ~it:@f@Wag t@ Hffi~lr onn lTIffiJf @81ltrm~ _ M~f1' ~1W@1f~?p ~\OO@!illlil@ ~y ~ .lb !~" ,,p Ii'b-r.-<<t. ~PS"'~'?e~"~~DM~~fu, ~~~~~~f@ie~~ . _ _ ~)~dI1.g g. dF )'ftrMr~-('(\ k;T1' ~- ~.~4-;/19-irt/il::' Vl">h,-dtsct. RuQ-r~(>; -~l,l~fJv;t:, 2) n.. pica in I!Us bitII haw !10m -..... lit ~y vril!rcut ooIhJoi.... -ulla2i.... ~..._.....~"'~~"" iI>_-"""'IiDs 10>_ -",... prilCei with my~~~widi -,~ - 3) UnIon othawi&e ""'IUrimd bjr law, die prica which have '- quoIiod in lido bid have IllOI ....... knowinaIY diackJoed bjr iIIo bicIcIor lIIIIIII vrilllIOIllDowiualJr be ............ bjr .. bi4cIo. priOJr fill> lIid @~ ~y Of' ~YP to my o61er bidder Oli'to Iny competitor; ad! 4) No............. """"'..... "" will be ........ bjr tlieloiddo.r eo iDduco _.....-..... ~ or ............111> lI1I1Joalt" .... _,., lHBlnnit. ..lIid ... die pIDpOse "'~ ~ S) n.. ...........1lI_1ailIIIIIII in I!Us allIdavit.... _lIIIIIII """'""" lIIIIIII..... wiIh fidI ~ tIIIat M_ Cuooay.... .... Olio: ....1Ii "'iIIo.--.. -iIDIDed In lido alIidavit io ..-. contmcts fur u!d ~ect . ~ -: ,-Y---t;<k../Taf>-.) STATEOF fiorl~ (Sipatum 0 Bi COUNTY OF }1z O71ro"t... 11-7'-r'J~ Date PBllSONALL Y APPBARBD BBFORB ME, the undenigo.ed authority, r-T -t- J-t:. who. after fiat beinc S'MJmm by me, (D&me ofiodividual l.iipio,) dhed hi&Jber si~ in tlpace provided above H .. ~+h n _ day'" . Q \Je.d .20 15 S " ~ n /J??U/M,? (;, " My--.... ezpiRla: OTA.RY PUBUC -17--~-__ ..vAN_ II.; COOK OMB ~ Mep FORM #1 Ncbv ",-. .. GfFlolfda 2tI07 ~fJDD1101OI 1ozIded. NaIoIIlI1~-. Attachm.ent D 2 of 4 !Sv:;fIWill1f;J' 8\'ITA'ITLfR@l?,Ii'J'IT ill]'iJ1IDlEuT:.; @EfJflDillNRJKjCC~LZ :!i::J'Q)o ll@)o,l1q,~"S@ k0IT@lNh~@l2; OOIDj!~TIFYfD TIJ11@TIUlIDliA gH1~Cill <Clk.4JlV$ill .f1.oiA ~r"- c. 6<.> f' {IE"? _ _O$io IMllOOiJi! _ _ ""'I'io;w<>lll., ~ @!!' i!lltlll~ l!uM!t ~ 00 11lWftt!il ~!lmMf my fliMlMler ~ty @!ficer 00 empRoyee in mlmoo @f Sfddo@ 2 @f~ N@~ !6J=,H9M ~ mmy ~ @ffi~ @If empw~ MIl vi@~ €it .__.. f. ~ 3 @fOMnM~ N@~ lo..ll990. 1100 b~ @ii'm@hMi@!m oftbU ~ioiR. ~ Jm&yp Bml i~ ~@m.;; ~iiil1uUe ~ eon~ without limbilliy ad mmy., m _ _~~ '" ",ct &om the OOI!~ @If ~~ pnlOOg or @th~ mooverp ~ ftill.~o_ @f.y fecp eommiiq~ ~o ~ ~ ~~oo paid to the ftwmer Coumy ofikeJr Of' empJo~. -0' ;:(~ ~~----ft(-r./T,;rr.) Due: / 1- Y'" -0 ~ STAtEOF Ft.e>rtcOA,. , COUNTY OF f/?I c!>n ra e PERSoNALLY AP'J!ARm) BEFORE ME, the 1IDdenigoed autbodtyt .. ~D (l Cr. 13 II r- 1-... 'j.. who, alWfint beiog _ by iDe, ~ IdoIhor sDpa!Um <name ofindividull'lipina) in the space provided above 0I11hia 1-1 -th day Olf 20 os: My ccmmiuion api:ral: .EANNINE M. COCItC e:g---"- OMB - MCP FORM 114 · .. :e.' . ~DOJClnl.~7~ ~II __ IIandId NaIcIrIIGII. . AB\ Attachment D 3 of 4 llDW)U}(fY- rj'F!)H17 '\~"U(r'j)F0j7!}!)H ,0\(["19' l'3J([l1F'IT0'il uu .i d..J:=.J.....1. ~....::.._;~~.!..;:U IV ~ ~\.:..:.:..i:~ ~L:. .~ ,f~..J. _~~.-....'\ , , ~ ~ ~ ~ ~~.""=..L...--- .~=.-..-~ _ .- -,= 1tl1@ 1lll!Jt~@r~~ '!f~li' full ~ w.ril@a Wllm_ Sw.~ &;$1.@iO' ~fuJy ~lii1!11ffioo ~: ;::;/~ ---reef..- [~pA-tlr ~F\I/C~ -- {-14- (Nam@ ofButrineu) "-..- 1. hhlish Ii ~ ~ &mpl@~ thma the mkwfu1l mmn~D dWin'buti~ ~i9 ~-... m' 'Wlle ef 6A ~ ~ u prohibited. . wodp~ tmd ~~ the ~~~ ~ win be ~~ cmpi@~ _ <W€lllmmu ofsmd>> pmhibitiw. 2D Iof4rnn ~yeeI ~ ~ ~ @f -. ~ iml die w~ . ~igs 1Nik'.w @f R1l1If.\~.1 & ~ ~ S)" ~ 6.'i!iI ~",~ ad ~ ~ IiftllIfWlMB and die peaaI- thatmaJ be impoM upmB emp~ tmr fig ~ vio~" - -- :I. Give each employee coppd m. ~ d:te otmIlmOOitiu or ~ ~ tbu am ~ bid - ti copy or the statement speci8ed in subsection (l). , 4. In dHlmtatemem ~ m ~ (Jl). W!tify die employea thmt, U & ~ ofwcd:DS 00. €he ~ Oi'~Q~ ~ dW Ie"'~ the ~ wiD ~ bydHil temu of. ~.. wiD ~ the emp~ of., convietiom 0( (V pia of piIt.y Oil' DOlo ~ ~ amy ~ of~ m (PIeri"~) Ql'ofmycmD:olWlU~ law oIebe Ulmited~ oray state. fOIl' a violati.mm ~ in the workplace 00 later thm fivCl (5) da)'lll after lmCh a:onvietioo. S. ~ a ~ OB" << ~ eb= -ti~ ~ in 1I .. mbue Uli.~ Of reMbilimtiom pmpm if lmI!:h is ~Ie hi die ~91i1 eom..i....js,y. _ my emp~ wOO is m ~cW. '" 6. Make a good faith eftOrt to comimIe to maintain a dmg.fiee workplace thmugh implemeJ1tatiolll of this sectiOIl. Am * ~ R~ m RP ., ~ I cerdifg dud dais &m complies ftIUy wida tM mbove ~. ~~~~~r_/~~~) . Bidders Sipatm'e , 11- Y' -as- Date OMS - Mer FORM 1#5 Attachment D 4 of 4 .'