Item C22 C22
BOARD OF COUNTY COMMISSIONERS
COUNTY of MONROE i Mayor Holly Merrill Raschein,District 5
The Florida Keys Mayor Pro Tern James K.Scholl,District 3
Craig Cates,District 1
Michelle Lincoln,District 2
' David Rice,District 4
Board of County Commissioners Meeting
August 21, 2024
Agenda Item Number: C22
2023-2650
BULK ITEM: Yes DEPARTMENT: Parks and Beaches
TIME APPROXIMATE: STAFF CONTACT: Erika Nodal
N/A
AGENDA ITEM WORDING: Approval of a Memorandum of Understanding with Friends of Upper
Keys Monroe County Parks and Beaches, Inc, for the purpose of creating a mutually beneficial and
clear operational understanding. The Friends mission is to raise funding and public awareness in the
community to support the services and programs of the Monroe County Parks and Beaches. As a non-
profit, 501(c)(3) organization, however, it is a legally distinct entity and is not a part of the Monroe
County Parks and Beaches Department.
ITEM BACKGROUND:
Approval of a Memorandum of Understanding with Friends of Upper Keys Monroe County Parks and
Beaches, Inc for the purpose of creating a mutually beneficial and clear operational understanding. The
Friends mission is to raise funding and public awareness in the community to support the services and
programs of the Monroe County Parks and Beaches. As a non-profit, 501(c)(3) organization, however,
it is a legally distinct entity and is not a part of the County or Monroe County Parks and Beaches
Department.
PREVIOUS RELEVANT BOCC ACTION:
N/A
INSURANCE REQUIRED:
No
CONTRACT/AGREEMENT CHANGES:
N/A
STAFF RECOMMENDATION: Approval.
DOCUMENTATION:
Pc&B MOU Fi al.pdf
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FINANCIAL IMPACT:
Effective Date:
Upon approval by BOCC Expiration Date: N/A
Total Dollar Value of Contract: N/A
Total Cost to County: N/A
Current Year Portion: N/A
Budgeted:
Source of Funds:
CPI:
Indirect Costs: staff time, utilities and operation costs Estimated Ongoing Costs Not Included in above
dollar amounts: N/A
Revenue Producing: No If yes, amount: N/A
Grant: N/A
County Match: N/A
Insurance Required: N/A
Additional Details: N/A
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MEMORANDUM OF UNDERSTANDING
between
FRIENDS OF UPPER KEYS MONROE COUNTY PARKS & BEACHES, INC.
and
MONROE COUNTY
THIS MEMORANDUM OF UNDERSTANDING, (hereafter "AGREEMENT") is
entered into on 1 , 2024 by and between the Friends of Upper Keys Monroe
County Parks &Beaches, Inc. (hereafter"Friends"), a Florida not-for-profit 501(c)(3) corporation
whose address is 99696 Overseas Highway, Key Largo, FL 33037 and Monroe County (hereafter
"County"), a political subdivision of the State of Florida whose address is 1100 Simonton Street,
Key West, FL 33040.
WHEREAS,the County owns and operates Parks and Beaches throughout Monroe County
(hereafter "Parks and Beaches") including locations in the Upper Keys, specifically Plantation
Key, Tavernier, and Key Largo; and
WHEREAS,the Friends mission is to raise money and public awareness in the community
to support the services and programs of the Monroe County Parks and Beaches Department; and
WHEREAS, the parties desire to enter into this agreement in which they shall work
together to accomplish the goals and objectives set forth.
NOW, THEREFORE,be it resolved by the parties as follows:
A. RESPONSIBILITIES AND OBLIGATIONS OF THE PARTIES
1. County:
1.1. The County agrees to include the Friends in the long-term planning process to ensure
that the Friends are aware of the goals and direction of County with respect to the
Parks and Beaches.
1.2. The County agrees to share with the Friends the Parks and Beaches Department goals
and objectives at the beginning of each fiscal year and discuss with Friends how their
resources and support might help forward these goals and objectives.
1.3. The County agrees to supply the Friends with a"wish list" each year approved by the
County Administrator or designee that indicates the anticipated needs for Friends
support.
2. Friends:
2.1. Friends is a qualified 501(c)(3) charitable organization registered in the State of
Florida and by the Internal Revenue Service (IRS) (EIN 99-2669265). As such, the
Friends must file an IRS Form 990 annually, a publicly accessible document. The
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Friends agree that all monies raised will be spent exclusively for Parks and Beaches
programs, services, and other County Parks and Beaches department defined needs
with the exception of reasonable operational expenses. Operational Expenses may
include reasonable marketing fees and costs, insurance, accounting fees and costs,
office supplies and fees for required filings. If the Friends organization anticipates
higher than normal expenditures in a particular year, it will notify the County in
writing and in advance.
2.2. The Friends agree to publicly support the Parks and Beaches and the County's
policies regarding same.
2.3. The Friends agree to include a member from the Parks and Beaches Department as a
non-voting presence at all Friends' board meetings and to allow room on the agenda
for a County report.
2.4. The Friends agree that they will not engage in the creation or hosting of programming
or events without the written agreement and prior approval of the County.
2.5. The Friends agree that the County has the final say in accepting or declining any and
all gifts made to the County. County Administrator shall have the authority to
individually approve any and all gifts valued at $100,000.00 or less. County shall
accept or decline in writing.
2.6. The Friends agree that the County has final say in accepting or declining any
expenditure of funds on behalf of or for the benefit of the County. County
Administrator shall have the authority to individually approve any such expenditure
valued at$100,000.00 or less. County shall accept or decline in writing.
2.7. The Friends agree to engage in advocacy efforts on behalf of the Parks and Beaches
Department under the guidance of the County and Parks and Beaches Director.
2.8. The Friends agree that if they cease to actively fundraise for, and/or promote,
County's Parks and Beaches, they will disband, allowing for a new Friends group to
be established in the future. Upon dissolution the residual assets of the organization
will be turned over to the to the County for placement into its Special Revenue Fund.
The funds will continue to be restricted for parks or recreation as contemplated by
this Agreement.
2.9. Board of County Commissioners agrees to allow Friends to utilize the County seal as
long as the County Administrator reviews and preapproves in writing any of Friends'
membership brochures and promotional materials which use the County's name,
likeness and/or seal(s).
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2.10. Friends agrees to execute any and all forms required by the County as attached in
Exhibit A to this Agreement.
B. INDEMNIFICATION AND LIABILITIES
1. Friends shall be solely responsible to parties with whom it shall deal with in
carrying out the terms of this agreement and shall save the County harmless against all claims of
whatever nature arising out of or related to this agreement. For purposes of this agreement,Friends
acknowledges that Friends is not an employee or agent of the County, but is an independent
501(c)(3)non-profit corporation.
2. Friends recognizes that Friends, its staff, agents,volunteers, etc.,volunteers are not
employees or agents of the County in any form and that Friends maintains their own system of
management and personnel policies.
3. Nothing herein is intended to serve as a waiver of sovereign immunity by any party
or recipient to whom sovereign immunity applies. Nothing herein shall be construed as consent
by a County agency or subdivision of Monroe County to be sued by third parties in any matter
arising out of this or any other contract.
4. Friends agrees to indemnify, defend, and hold free and harmless, the County and
each of its commissioners,members, agents, servants, employees, officers, and directors,from and
against any and all actions, claims, liabilities, assertions of liability, losses, costs, and expenses
including,but not limited to, attorney fees,reasonable investigative and discovery costs, and court
costs, which in any manner may arise or be alleged to have arisen, or resulted, or alleged to have
resulted, from the presence and activities, or any nature or otherwise of Friends, its agents,
servants, or employees relating to this Agreement, including but not limited to, claim or claims for
bodily injury or death of persons, and for loss of or damage to property, including claims or loss
by the County or its agents, servants, and employees the County and the County's elected and
appointed officers and employees harmless from and against (i) any claims, actions or causes or
action, (ii) any litigation, administrative proceedings, appellate proceedings, or other proceedings
relating to any type of injury(including death), loss, damage,fire,penalty or business interruption,
and (iii) any costs or expenses that may be asserted against, initiated with respect to, or sustained
by, any indemnified parry by reason of, or in connection with, this Agreement. Insofar as the
claims, actions, causes of action, litigation, proceedings, costs or expenses relate to events or
circumstances that occur during the term of this Agreement,this section will survive the expiration
of the term of this Agreement or any earlier termination of this Agreement.
C. ACCOUNTING/INSPECTION OF BOOKS/ANNUAL AUDIT/PUBLIC
RECORDS
1. Friends agrees to allow the County to review any and all financial records upon
request. Friends shall maintain all books,records, and documents directly pertinent to performance
under this Agreement in accordance with generally accepted accounting principles consistently
applied. All records shall be retained for a period of seven (7) years from the termination or
expiration of this agreement or in accordance with the State of Florida retention schedules
(https:Hdos.fl.�zov/1ibrary-archives/records-mana�zement/�zeneral-records-schedules/), whichever
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is greater. Records shall include, but not be limited to, accounting records (hard copy, as well as
computer readable data if it can be made available; original estimates; estimating work sheets;
correspondence; change order files (including documentation covering negotiated settlements);
backcharge logs and supporting documentation; general ledger entries detailing cash and trade
discounts earned, insurance rebates and dividends, and any other supporting evidence deemed
necessary by County or the Monroe County Office of the Clerk of Court and Comptroller
(hereinafter referred to as "County Clerk") to substantiate charges related to this agreement, and
all other agreements, sources of information and matters that may in County's or the County
Clerk's reasonable judgment have any bearing on or pertain to any matters, rights, duties or
obligations under or covered by any contract document (all foregoing hereinafter referred to as
"Records") shall be open to inspection and subject to audit and/or reproduction by County's
representative and/or agents.
2. Friends shall provide a copy of its annual IRS Form 990 and/or other required
filings within seven (7) business days of filing with the Internal Revenue Service. The County
Clerk possesses the independent authority to conduct an audit of Records, assets, and activities
relating to this Project.
3. Friends must comply with Florida public records laws, including but not limited to
Chapter 119, Florida Statutes and Section 24, Article I of the Constitution of Florida. The County
and Friends shall allow and permit reasonable access to, and inspection of, all documents,records,
papers, letters or other "public record" materials in its possession or under its control subject to
the provisions of Chapter 119, Florida Statutes and made or received by the County and Friends
in conjunction with this contract and related to contract performance. The County shall have the
right to unilaterally cancel this contract upon violation of this provision by Friends. Failure of the
Friends to abide by the terms of this provision shall be deemed a material breach of this contract
and the County may enforce the terms of this provision in the form of a court proceeding and shall,
as a prevailing parry, be entitled to reimbursement of all attorney's fees and costs associated with
that proceeding.
Friends is encouraged to consult with its advisors about Florida Public Records Law in order to
comply with this provision. Pursuant to Section 119.0701, Florida Statutes and the terms and
conditions of this contract, Friends is required to:
(1) Keep and maintain public records that would be required by the County to perform the
service.
(2) Upon request from the County's custodian of records, provide the County with a copy of
the requested records or allow the records to be inspected or copied within a reasonable
time at a cost that does not exceed the cost provided in this chapter or as otherwise provided
by law.
(3) Ensure that public records that are exempt or confidential and exempt from public records
disclosure requirements are not disclosed except as authorized by law for the duration of
the contract term and following completion of the contract if the contractor does not
transfer the records to the County.
(4) Upon completion of the contract, transfer, at no cost, to the County all public records in
possession of the Contractor or keep and maintain public records that would be required
by the County to perform the service. If the Contractor transfers all public records to the
County upon completion of the contract, the Contractor shall destroy any duplicate public
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records that are exempt or confidential and exempt from public records disclosure
requirements. If the Contractor keeps and maintains public records upon completion of the
contract,the Contractor shall meet all applicable requirements for retaining public records.
All records stored electronically must be provided to the County, upon request from the
County's custodian of records, in a format that is compatible with the information
technology systems of the County.
(5) A request to inspect or copy public records relating to a County contract must be made
directly to the County,but if the County does not possess the requested records,the County
shall immediately notify the Contractor of the request, and the Contractor must provide the
records to the County or allow the records to be inspected or copied within a reasonable
time.
A contractor or vendor who fails to provide the public records to the County or pursuant to a valid
public records request within a reasonable time may be subject to penalties under Section 119.10,
Florida Statutes. Friends shall not transfer custody, release, alter, destroy or otherwise dispose of
any public records unless otherwise provided in this provision or as otherwise provided by law.
IF THE FRIENDS HAS QUESTIONS REGARDING THE APPLICATION
OF CHAPTER 119, FLORIDA STATUTES, TO FRIENDS' DUTY TO
PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT,
CONTACT THE CUSTODIAN OF PUBLIC RECORDS, BRIAN BRADLEY
AT PHONE# 305-292-3470 BRADLEY-BRIAN@MONROECOUNTY-
FL.GOV, MONROE COUNTY ATTORNEYS OFFICE, 1111 12TH
STREET, SUITE 408, KEY WEST, FL 33040.
4. The provisions of this section survive the termination of or expiration of this
Agreement.
D. AMENDMENT OR CANCELLATION OF THIS MEMORANDUM
This Agreement may be amended or modified at any time in writing by mutual consent of both
Parties.
This Agreement may be cancelled by either parry without cause with 90 days advanced written
notice. Should either parry wish to cancel this Agreement for cause, where cause for cancellation
may include, but is not limited to, lose or suspension of 501(c)(3) non-profit corporation status
and/or a material and significant breach of any of the provisions contained herein,this Agreement
may be terminated immediately upon delivery of written notice to the other parry. Upon receipt of
said written notice from the County, no further responsibilities will be performed by Friends in
accordance with this Agreement unless specifically authorized by the County Administrator in
writing and Friends shall be disbanded in accordance with this Agreement.
E. MEDIATION DISPUTE RESOLUTION
Should any dispute arise through any aspect of this relationship under this Agreement including,
but not limited to, any matters, disputes or claims,the parties shall confer in good faith to promptly
resolve any dispute. If the issue or issues are still not resolved to the satisfaction of the parties,
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then any parry shall have the right to seek such relief or remedy as may be provided by this
Agreement or by Florida law. This Agreement is not subject to arbitration.
F. NOTICE
Any notice or communication required or permitted under this Agreement shall be sufficiently
given if delivered in person or by certified mail, return receipt requested, to the following:
If to County:
County Administrator With copy to:
1100 Simonton Street County Attorney
Key West, FL 33040 P.O. Box 1026
Key West, FL 33041-1026
If to Friends:
Friends of Upper Keys Monroe County
Parks & Beaches, Inc.
Attn: Car* Sanders
99696 Overseas Highway
Key Largo, FL 33037
G. GOVERNING LAW AND VENUE
This Agreement shall be governed by and construed in accordance with the laws of the State of
Florida. Friends and County agree that venue for any dispute arising under this Agreement shall
be exclusively in the appropriate court, or before the appropriate administrative body, in Monroe
County, Florida.
H. SEVERABILITY CLAUSE AND CONSTRUCTION
In the event that any provision of this Agreement shall be deemed to be severable or invalid, and
if any term, condition, phrase or portion of this Agreement shall be determined to be unlawful or
otherwise unenforceable, the remainder of this Agreement shall remain in full force and effect, so
long as the clause severed does not affect the intent of the parties. If a court should find that any
provision of this Agreement to be invalid or unenforceable, but that by limiting said provision it
would become valid and enforceable,then said provision shall be deemed to be written, construed
and enforced as so limited. This Agreement has been carefully reviewed by each of the parties.
Therefore, this Agreement is not to be construed against any parry on the basis of authorship.
I. ASSIGNMENT
Friends may not assign or transfer the responsibilities or agreement made herein without prior
written consent of the County, which approval may be unreasonably withheld. All the obligations
of this Agreement will extend to and bind the legal representatives, successors and assigns of the
Parties.
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J. AUTHORITY
Each individual executing this Agreement on behalf of a Party hereto hereby represents and
warrants that lie or she is, on the date lie or she executes this Agreement, duty authorized by all
necessary and appropriate action to execute this Agreement on behalf of such Party and does so
with full legal authority.
K. ENTIRE UNDERSTANDING
'Fhis Agreement constitute,,, the entire understanding of the Parties whether written or oral.
L. COUNTERPARTS
'Phis Agreement may be executed in any number Of Counterparts, each of which will be deemed to
be an original, but all of which when taken together will constitute the Agreement. If any signature
is delivered by email delivery of a .pdl" format data file, Such signature will create a valid and
binding obligation of the party executing (or on whose behalf Such signature is executed) with the
same force and effect as if the ".pdf' signature was an original signature. If Friends transmits an
electronic signature, Friends agrees to provide the inked original to the County, at the County's
request.
IN WITNESS WHEREOF, the parties have caused this Agreement to be executed this
day of 2024.
(SEAL)
ATTEST: KEVIN MADOK, CLERK BOARD OF COUNTY COMMISSIONERS
OFMONROE COUNTY, FLORIDA
By: By:
As Deputy Clerk Mayor
APPROVED AS TO FORM&LEGAL SUFFICIENCY
Monr _ aunty Attorney's Office
Ass�'iZairweiiies Archer
tart County Attorney
FRIENDS OF UPPER KEYS MONROE
COUNTY PARKS & BEACHES, INC., a
Florida not for profit corporation
By:
Cari Sanders, President
Name and Title
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COUNTY FORMS AFFIDAVIT
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of per Ury.dew and say ofthe cit of" it according irr It�ttiv ern my oarth,arid urrdea penalty
that: y
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I� >fit corporation TFRIE'NDS OF'1 am t �t ���q� ...-,..,,,.,. of the 501(c)(3) non-pr<� oration p
UPITR k:F;YS 'MONROE' COUNTY PARKS & BI',ACHF.S. INC., ("FRIF,NDS--), the non-profit entering into an
Agreement with the County and that I executed the said Agreement with full authority to do so.
Public Entity Crime Statement
A person or affiliate who has been placed oil the convicted vendor list ftrllowing a conviction fur public entity crime may
not submit a bid, proposal,or reply on contracts to provide any goods,or services to a public entity, may not submit a bid.
proposal,or reply on a contract with a public entity for the construction or repair of a public building or laublic work,may
not submit bids,proposals,or replies on leases ofreal property to public entity,may not be awarded or perform work as a
contractor,supplier,subcontractor,or consultant under a contract with awry public entity,and may not transact business with
any public,entity in excess of tire threshold a.nrount provided in Section 287.017 of the Florida Statutes, for CA F"GORY
TWO for a period o1 36 months from the date ot'being placed oil the convicted vendor list.
The FRIF'NDS certifies and agrees that neither FRIIF,NDS nor any Affiliate has been placed on the convicted vendor list
within the last 36 months.
Ethics Clause
By signing this Affidavit. I-RIFuN17S warrants that he/it has riot employed, retained or otherwise had act on his/her behalf'
any Inrrner C'crunty officer or employee in violation of Section 2 of Ordinance No. 010-1990 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 frown the Agreement or
purchase price,or otherwise recover.the full arnourrt ol'any fee,commission. percentage, gift,or consideration paid to the
former County officer or employee..
Vendor Certification Regarding Scrutinized Companies Lists
FRIFNI:)S agrees and certifies compliance with the l'ollowing:
Section 287.135, Florida Statutes prohibits a company from bidding on, submitting a proposal for.or entering into
or renewing a contract fur goods or services of any amount it. at the time ofcontracting or renewal,the compan}r
is on the Scrutinized Companies that Boycott Israel List, created pursuant to Section 215.4725, ]:-Florida Statutes,
or is engaged in a Boycott of Israel. Section 287.135.Florida Statutes,also prohibits a company frorn bidding on,
submitting a proposal for,or entering into or renewing a contract fur goods or services of'$1,000,000 or more,that
are oil either the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities
in the Iran 'terrorism Sectors List which were created pw°stiant to s. 215.473. Florida Statutes, or is engaged in
business operations in Cuba or Syria.
As the person authorized to sign on behalf of FRIT',NDS, I hereby certify that the company identified above as
'TFRI1?NI)S- is not listed oil the Scrutinized Companies that Boycott Israel List or engaged in a boycott of Israel
and for Projects of`fi1,000.000 or more is not listed on either the Scrutinized Companies with Activities in Sudan
List, the Scrutinized Companies with Activities in the Iran Terrorism Sectors list, or engaged in business
operations in Cuba or Syria.
I understand that pursuant to Section 287.135.Florida Stab-JAes,the submission of'a frls;e certification may;subject
company to civil penalties. attorney's fees, and/or costs. I further understand that any contract with the County
may be terminated immediately, at the option of tlrc County, ifthe company is IOUnd to have submitted a flalse
certification or has been placed on the Scrutinized C'omrpanies that Boycott Israel List or engaged in a boycott of
Israel or placed oil the SCrUtirli7.ed Companies with Activities in Sudan List or the Scrutinized C,onrpanies with
Activities in the Iran"Terrorism Sectors list or been engaged in business operations in Cuba or Syria.
Vendor has reviewed Section 287.135,Florida Statutes,and in accordance with such provision of Florida law, is eligible to
bid arr,Submit a proposal for.or enter into or renew a contract with Monroe County fior goods or services.
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Note: The I..,ist are available at the following Department of Management Services Site:
17tt2 vwy�w.dills illy_ftow_idi_cc>m/bLisiness (Tt Eaiion5st,,Ae ly�}r 17�sin< '��i7cic)> intotin�uimi r"ii.jcted �usle led discrimi
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rla_tory_cc:�lnpWints vendoi lists
Foreign Countries of Concern
The Contracting with Entities of Foreign Countries ofConcern Prohibited Affidavit Form("Form") is required by Section
287.138,Florida Statutes,which is deemed as being expressly incorporated into this Form.The Affidavit must be completed
by a person authorized to make this attestation oil behalf ofthe Bidderl,Proposer fir the purpose of submitting a bid,proposal,
quote,or other response,or otherwise entering into a contract with the County.If being awarded the Contract,or otherwise
entering into the C.'ontract, would grant Contractor access to an individual's personal identifying information, pursuant to
section 287.138, Florida Statutes, the undersigned, on behalf of Contractor, hereby certifies, represents, and warrants that
Contractor is not affiliated with a foreign Country of concern,as such countries are identified in section 287.138(1), Florida
Statutes. 'The undersigned additionally certifies, represents. and warrants that: (A) Contractor is not owned by a foreign
country of concern, (L)the government of a foreign country of concern does not have a controlling interest in ('ontractor;
and(C.)Contractor is not organized under the Laws of nor has its principal place of business in a foreign country of concern.
Common Carrier
If Contractor is a common carrier, as defined by Section 908.111,Florida Statutes,then Contractor hereby certifies that it is
not willfully providing and will not willfully provide any service during the Contract term in furtherance of transporting a
person into this state knowing that the person is all Unauthorized Alien, except to facilitate the detention, removal, or
departure of the person from this state or the United States.
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 SAID PROJECT.
UNDER PENALTIES OF PERJURY, I HEREBY CERTIFY AND DECLARE THAT I HAVE READ AND
UNDERSTAND THE FOREGOING AFFIDAVIT. PURSUANT TO THE AUTHORITY GRANTED TO
THE UNDERSIGNED BY FRIENDS, THE UNDERSIGNED HEREBY ACKNOWLEDGES, AFFIRMS,
AND MAKES THE ABOVE SWORN CERTIFICATIONS ON BEHALF OF FRIENDS OF UPPER KEYS
MONROE COUNTY PARKS & BEACHES,INC.
" M. .
Signature oft � �
` �r ��� )r �. _....._. . _........ (Date)
_._....pTitle �
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STATE OF /C ,r ( .__......_.____...__...._...........
COUNTY OF
foregoing Pi ( } y e by means of['j, iysrcaI presence or
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online rn}otarizati n thisw sworn to fot Intl subscribeZ(b before raa I` 1€� � t -- � C1 t
"gs
_ - ---------- _.._.. -----------
,� .:'".. DEB S.R ERTS Signature of Notary Publac State of Florida
= C0mK*$j rn RH 121327
Expim day 17,2025
Name of Notary
My commission expires: fi`"tr_` f_!.t --
Personally Known -----� OIL Produced Identification
Type of Identification Produced
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AFFIDAVIT ATTESTING TO NONCOERCIVE CONDUCT
FOR LABOR OR SERVICES
Entity/VendorNarne:
..................
.............. ............. .......................................... ....................�61.v V
Vendor FEIN:
Vendor's Autho i-i z e d Rep re se ntati:rvve: )(A �Al)�
(Name and'title)
Address V
r kit
.... ............... State:
1
Phone Nutn)er: `X4 2
Email Address:
-----------------
As a nongovernmental entity executing, renewing, or extending a contract with a government entity, Vendor is
required to provide an affidavit under penalty of perjury attesting that Vendor does not use coercion for labor or
services in accordance with Section 787.06, Florida Statutes.
As defined in Section 787.06(2)(a),coercion means:
I. Using or threating to use physical force against any person;
2. Restraining,isolating,or confining or threating to restrain, isolate,or confine any person without lawful
authority and against her or his will;
3. Using lending or other credit methods to establish a debt by any person when labor or services are
pledged as a security for the debt, if the value of the labor or services as reasonably assessed is not
applied toward the liquidation of the debt, the length and nature of the labor or service are not
respectively limited and defined;
4. Destroying, concealing, removing, confiscating, withholding, or possessing any actual or purported
passport, visa, or other immigration document, or any other actual or purported government
identification document,of any person,
5. Causing or threating to cause financial harm to any person;
6. Enticing or luring any person by fraud or deceit; or
7. Providing a controlled substance as outlined in Schedule I or Schedule 11 of Section 893.03 to any person
for the purpose of exploitation of that person.
As a person authorized to sign on behalf of Vendor, I certify under penalties of perjury that Vendor does not use
coercion for labor or services in accordance with Section 787.06. Additionally, Vendor has reviewed Section 787.06,
Florida Statutes, and agrees to abid by same.
Certified By: o who is authorized to sign on
behalf of the above referenced company.
Authorized Signature:
Y
Print Name:._,,,
Title:
---—------------------------------- ------------------------------------------------
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