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Okaloosa County BOCC — April 5, 2016 — 2016 Solid Waste Procurement - FINAL — reading text

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[Note: Pursuant to 31 U.S.C. § 1352(c)(1)-(2)(A), any person who makes a prohibited expenditure or fails to file or amend a required certification or disclosure form shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such expenditure or failure.] The Contractor, ___________________, certifies or affirms the truthfulness and accuracy of each statement of its certification and disclosure, if any. In addition, the Contractor understands and agrees that the provisions of 31 U.S.C. A 3801, et seq., apply to this certification and disclosure, if any. __________________________ Signature of Contractor's Authorized Official __________________________ Name and Title of Contractor's Authorized Official __________________________ Date RFP Page - 33 OKALOOSA COUNTY Okaloosa County Solid Waste & Recyclables Collection, Transfer, and Processing/Disposal RFP# XXXXXX RANKING SHEET Qualifications Respondent Name Technical Proposal (0-35)  Project Organization  Collection Services  Transfer Station Operations  Solid Waste Processing & Disposal Qualifications and References (0-15)  Company Qualifications  Personnel Qualifications  Collection Service Performance  Transfer Station Operations  Solid Waste & Disposal  Performance History  Financial Capability  Previous Experience in Okaloosa County Financial Proposal (0-45) Waste Diversion Proposal (0-5) Total (100 point scale) COMMITTEE MEMBER (Print): Date: SIGNATURE RFP Page - 34 OKALOOSA COUNTY Okaloosa County Solid Waste & Recyclables Collection, Transfer, and Processing/Disposal RFP# XXXXXX Form A – Collection Service References Proposer shall complete and submit this form in conjunction with any other relevant material. COLLECTION SERVICE – REFERENCE #1 Municipality/County: Contact (Name/Title): Contact Address: Contact Phone: ( ) Contact Email: Term of Current Contract: Start Date: End Date: Residential Collection Service Provided: Services Type of Frequency of Collection Number of Automated Provided Type of Service Service (U/S) Collection? 1x per 2x per (check all (U =Universal; Units Serviced Other that apply) S =Subscription) (check if yes) week week □ Solid Waste □ □ Recycling □ □ Yard Waste □ □ Bulk Waste n/a Commercial Collection Service Provided: Number of commercial Municipal Solid Waste (MSW) customers: Roll-off compactor/open top container service provided: □ YES □ NO Commercial recycling collection provided: □ YES □ NO Technology: Is service verification via RFID included in the services provided? □ YES □ NO Is asset management included in the service provided? □ YES □ NO Other relevant information: RFP Page - 35 OKALOOSA COUNTY Okaloosa County Solid Waste & Recyclables Collection, Transfer, and Processing/Disposal RFP# XXXXXX COLLECTION SERVICE – REFERENCE #2 Municipality/County: Contact (Name/Title): Contact Address: Contact Phone: ( ) Contact Email: Term of Current Contract: Start Date: End Date: Residential Collection Service Provided: Services Type of Frequency of Collection Automated Provided Service (U/S) Number of Type of Service Collection? 1x per 2x per (check all (U =Universal; Units Serviced Other (check if yes) week week that apply) S =Subscription) □ Solid Waste □ □ Recycling □ □ Yard Waste □ □ Bulk Waste n/a Commercial Collection Service Provided: Number of commercial Municipal Solid Waste (MSW) customers: Roll-off compactor/open top container service provided: □ YES □ NO Commercial recycling collection provided: □ YES □ NO Technology: Is service verification via RFID included in the services provided? □ YES □ NO Is asset management included in the service provided? □ YES □ NO Other relevant information: RFP Page - 36 OKALOOSA COUNTY Okaloosa County Solid Waste & Recyclables Collection, Transfer, and Processing/Disposal RFP# XXXXXX COLLECTION SERVICE – REFERENCE #3 Municipality/County: Contact (Name/Title): Contact Address: Contact Phone: ( ) Contact Email: Term of Current Contract: Start Date: End Date: Residential Collection Service Provided: Services Type of Frequency of Collection Automated Provided Service (U/S) Number of Type of Service Collection? 1x per 2x per (check all (U =Universal; Units Serviced Other (check if yes) week week that apply) S =Subscription) □ Solid Waste □ □ Recycling □ □ Yard Waste □ □ Bulk Waste n/a Commercial Collection Service Provided: Number of commercial Municipal Solid Waste (MSW) customers: Roll-off compactor/open top container service provided: □ YES □ NO Commercial recycling collection provided: □ YES □ NO Technology: Is service verification via RFID included in the services provided? □ YES □ NO Is asset management included in the service provided? □ YES □ NO Other relevant information: RFP Page - 37 OKALOOSA COUNTY Okaloosa County Solid Waste & Recyclables Collection, Transfer, and Processing/Disposal RFP# XXXXXX COLLECTION SERVICE – REFERENCE #4 Municipality/County: Contact (Name/Title): Contact Address: Contact Phone: ( ) Contact Email: Term of Current Contract: Start Date: End Date: Residential Collection Service Provided: Services Type of Frequency of Collection Automated Provided Service (U/S) Number of Type of Service Collection? 1x per 2x per (check all (U =Universal; Units Serviced Other (check if yes) week week that apply) S =Subscription) □ Solid Waste □ □ Recycling □ □ Yard Waste □ □ Bulk Waste n/a Commercial Collection Service Provided: Number of commercial Municipal Solid Waste (MSW) customers: Roll-off compactor/open top container service provided: □ YES □ NO Commercial recycling collection provided: □ YES □ NO Technology: Is service verification via RFID included in the services provided? □ YES □ NO Is asset management included in the service provided? □ YES □ NO Other relevant information: RFP Page - 38 OKALOOSA COUNTY Okaloosa County Solid Waste & Recyclables Collection, Transfer, and Processing/Disposal RFP# XXXXXX Form B – Transfer Station Operations References Proposer shall complete and submit this form in conjunction with any other relevant material. TRANSFER STATION OPERATIONS – REFERENCE #1 Municipality/County: Contact (Name/Title): Contact Address: Contact Phone: ( ) Contact Email: Term of Current Contract: Start Date: End Date: Types of Materials Handled: Average Daily Throughput (Tons per day): Transfer Station Operation Activities Provided: TRANSFER STATION OPERATIONS – REFERENCE #2 Municipality/County: Contact (Name/Title): Contact Address: Contact Phone: ( ) Contact Email: Term of Current Contract: Start Date: End Date: Types of Materials Handled: Average Daily Throughput (Tons per day): Transfer Station Operation

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