Okaloosa County BOCC — May 6, 2014 — Final Invoice backup — reading text

the Contractor engage a subcontractor or sub-subcontractor, the same conditions will apply under this agreement to each subcontractor and sub-subcontractor. Last Revised ~ 08/08/2008 12 REFERENCE: PURCHASING'S ONLINE CONTRACTS PRINTED/ATTACHED BY: BCC FINANCE The Contractor hereby waives all rights of subrogation against Okaloosa County and its consultants and other indemnities of the Contractor under all the foregoing policies of insurance. Umbrella Insurance The Contractor shail have the right to meet the liability insurance requirements with the purchase of an umbrella insurance policy. In all instances, the combination of primary and umbrella liability coverage must equal or exceed the minimum liability insurance limits stated in this agreement. Last Revised — 08/08/2008 13 REFERENCE: PURCHASING'S ONLINE CONTRACTS PRINTED/ATTACHED BY: BCC FINANCE CONFLICT OF INTEREST DISCLOSURE FORM For purposes of determining any possible conflict of interest, all bidders/proposers, must disclose if any Okaloosa Board of County Commissioner, employee(s), elected officials(s), of if any of its agencies Is also an owner, corporate officer, agency, employee, etc., of their business. Indicate either “yes” (a county employee, elected official, or agency is also associated with your business), or “no”. If yes, give person(s) name(s) and position(s) with your business. YES NO... XxX NAME(S) POSITION(S) FIRM NAME: RE Faetns, ELLE BY (PRINTED): WO’ rem Riven bark BY (SIGNATURE): w/t Ze b_ Lez TITLE: Nand gee l Weed £uper ADDRESS: £25 furut St Blkee HW, BEL PHONE NO. 899-25 7- WhIO REFERENCE: PURCHASING'S ONLINE CONTRACTS PRINTED/ATTACHED BY: BCC FINANCE DRUG-FREE WORKPLACE CERTIFICATION THE BELOW SIGNED BIDDER CERTIFIES that it has implemented a drug-free workplace program. In order to have a drug-free workplace program, a business shall: 1. Publish 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. Inform employees about the dangers of drug abuse In the workplace, the business's policy of maintaining a drug-free workplace, any avallable drug counseling, rehabllitation and employee assistance programs, and the penalties that may be imposed upon employees for drug abuse violations. 3. Give each employee engaged in providing the commodities or contractual services that are under quote 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 quote, 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 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. Impose a sanction on, or require the satisfactory participation in, drug abuse assistance or rehabilitation program if such is available in employee's community, by any employee who is 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 this statement, I certify that this firm complies fully with the above requirements. DATE: G- 3-08 SIGNATURE: pb bt. COMPANY: Ko E Farms LLce NAME: 027; / /i€ 4 KipvenbarkK ‘ (Typed or Printed) appress: AS burnt St Blac AL Z621Y tie Mind 4.tt, L TLCEEUOEY, puoneno.: LPS-AS7-4PIO REFERENCE: PURCHASING'S ONLINE CONTRACTS PRINTED/ATTACHED BY: BCC FINANCE LOCAL PREFERENCE DATA SHEET Refer to Special Bid Condition Does the state, county, municipality or political subdivision In which your firm is located offer a preference to their local bidders? (If your firm is located in Okaloosa County, you will check *NO.") If “YES,” list below the extent of such preference. YES. NO. Xx Re E Favs, LUC wll JL Bidder’s Company Name Authorized Signature — Manual William Riven bavK Authorized Signature — Typed REFERENCE: PURCHASING'S ONLINE CONTRACTS PRINTED/ATTACHED BY: BCC FINANCE INDEMNIFICATION & HOLD HARMLESS To the fullest extent permitted by law, CONTRACTOR shall indemnify and hold harmless COUNTY, its officers and employees from liabilities, damages, losses, and costs including but not limited to reasonable attorney fees, to the extent caused by the negligence, recklessness, or intentional wrongful conduct of the CONTRACTOR and other persons employed or utilized by the CONTRACTOR in the performance of this Agreement. Ry E Farms LLC wb tbd. Bidder’s Company Name Authorized Signature ~ Manual 1077 Bell RA Detenal #95 bo G33 Willian Rs yenbar K Physical Address Authorized Signature ~ Typed 62S Burt St blet/fe 76317 Pan gee Treasurer Mailing Address Title ¥ 50-85 9-198 0 9S0- 851-1080 Phone Number FAX Number 888-2S7T-IB 16 988-2S7-4BI0 Cellular Number After-Hours Number(s) q- 3% -OF DATE (REVISED: JANUARY 12, 2001) REFERENCE: PURCHASING'S ONLINE CONTRACTS PRINTED/ATTACHED BY: BCC FINANCE NOTICE OF AWARD TO: PROJECT DESCRIPTION: The OWNER has considered the BID submitted by you for the above-described WORK in response to its Advertisement for Bids dated and Information for Bidders. You are hereby notified that your BID has been accepted for items in the amounts of $ . You are required by the Instructions to Bidders to execute the Agreement and furnish the required CONTRACTOR'S Performance Bond, Payment Bond, and Certificates of Insurance within fifteen (15) calendar days from the date of this notice to you. If you fail to execute said Agreement and to furnish said bonds within fifteen (15) calendar days from the date of this notice, sald OWNER will be entitled to consider all your rights arising out of the OWNER’s acceptance of your BID as abandoned and as a forfeiture of your BID Bond. The OWNER will be entitled to such other rights as may be granted by law. You are required to return an acknowledged copy of this NOTICE OF AWARD to the OWNER: Okaloosa County Purchasing, 602-C North Pearl St., Crestview, FL 32536, If you have any questions, please call John Christopher at 850-689-5960. Dated this day of , 2008. OWNER ~ OKALOOSA COUNTY BOARD OF COUNTY COMMISSIONERS BY: TITLE Purchasing Director Richard L Brannon ACCEPTANCE OF NOTICE Receipt of the above NOTICE OF AWARD is hereby acknowledged. BY: This the day of , 2008. BY: Title: Last Revised ~ 08/08/2008 23 REFERENCE: PURCHASING'S ONLINE CONTRACTS PRINTED/ATTACHED BY: BCC FINANCE NOTICE TO PROCEED DATE: TO: PROJECT: You are hereby notified to commence WORK in accordance with the Agreement dated , 2008, on or before , and you are to complete the WORK within . The date of completion of all WORK Is therefore You are required to return an acknowledged copy of this NOTICE TO PROCEED to the OWNER; Okaloosa County Purchasing, 602-C North Pearl St, Crestview, FL 32536. OKALOOSA COUNTY BOARD OF COUNTY COMMISSIONERS OWNER BY: Richard L. Brannon TITLE: Purchasing Director ACCEPTANCE OF NOTICE Receipt of the above NOTICE TO PROCEED is hereby acknowledged. Company Name This the day of , 2008 Signature By: Type or Print Name Title: Last Revised — 08/08/2008 24 : REFERENCE: PURCHASING'S ONLINE CONTRACTS PRINTED/ATTACHED BY: BCC FINANCE BID SHEET BID#: WS 71-08 BIDITEM: OKALOOSA COUNTY WATER & SEWER BIOSOLIDS REMOVAL & TRANSPORTATION 1. Price per cubic yard to include all transportation/pickup . and disposal costs $ / 4, 25 2, Price per cubic yard without transportation costs $ 4, 75 ANTI-COLLUSION STATEMENT: The below signed bidder has not divulged to, discussed or compared his bid with other bidders and has not colluded with any other bidder or parties to bid whatever, (Note: No premiums, rebates, or gratuities permitted either with, prior to, or after any delivery of materials. Any such violation will result in the cancellation and/or return of material (as applicable) and the removal from bid list(s). Rak Farms LLC | vile fhe Bidders Company Name Authorized Signature ~ Manual 625 burat St Willian Kivenbar kK Authorized Signature —- Typed BlacK AL 3e314 Mausger [Tieasuvev Address’ Title J 7 S8E-A2S 7- WENO I50-8S7-/080 Phone # Fax # LOVEE 322. Federal ID # or SS # ee