Okaloosa County BOCC — February 18, 2014 — Datech — reading text

located in Okaloosa County, you will check “YES’-reciprocal only.) YES NO XXXX If yes, you must identify how you confirmed this information or who you spoke with within your area of business location below: Datech “ON ~~ Bidder’s Company Name Authorized Signature — Manual Daniel Truax Printed Name 11/25/13 Date BOARD POLICY ON “NO CONTACT CLAUSE” The Okaloosa County Board of County Commissioners have established a solicitation silence policy (No Contact Clause) that prohibits oral and written communication regarding all formal solicitations for goods and services (formal bids, Request for Proposals, Requests for Qualifications) issued by the Board through the County Purchasing Department. The period commences when the procurement document is received and terminates when the Board of County Commissioners approves an award. When the solicitation silence period is in effect, no oral or written communication is allowed regarding the solicitation between prospective bidders/proposers and members of the Board of County Commissioners, the County Administrator or members of the Board Approved Review Committee. All questions or requests for information regarding the solicitation must be directed to the designated Purchasing Representative listed in the solicitation. Any information thought to affect the committee or staff recommendation submitted after bids are due should be directed to the Purchasing Director or his appointed representative. It shall be the Purchasing Director's decision whether to consider this information in the decision process. Any attempt by a vendor/proposer to influence a member or members of the aforementioned shall be grounds to disqualify the proposer from consideration during the selection process. All proposers must agree to comply with this policy by signing the following statement and including it with their submittal. I SN : representing Datech ~ Signature Company Name Hereby agree to abide by the County’s “No Contact Clause” and understand violation of this policy shall result in disqualification of my submittal. 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 XXXX NAME(S) POSITION(S) FIRM NAME: Datech BY (PRINTED): Daniel Truax BY (SIGNATURE): eN Qe TITLE: President ADDRESS: PO Box 871 Gulf Breeze, FL 32562 PHONE NO. 850-432-8324 E-MAIL Dan@4datech.com DATE 11/25/13 DRUG-FREE WORKPLACE CERTIFICATION THE BELOW SIGNED PROPOSER 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 available drug counseling, rehabilitation 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: 11/25/13 SIGNATURE: ins Se OOOO COMPANY: Datech NAME: Daniel Truax (Typed or Printed) ADDRESS: PO Box 871 TITLE: President Gulf Breeze, FL 32562 E-MAIL: Dan@4datech.com PHONE NO.: 850-432-8324 INDEMNIFICATION AND 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. Datech ~~ a Proposer’s Company Name Authorized Signature — Manuai 27 Galvez Ct Pensacola Beach, FL 32561 Daniel Truax Physical Address Authorized Signature — Typed PO Box 871 Gulf Breeze, FL 32562 President Mailing Address Title 850-432-8324 Phone Number FAX Number 850-748-1259 850-432-8324 Cellular Number After-Hours Number(s) 11/25/13 DATE (REVISED: JANUARY 12, 2001) FEDERAL E-VERIFY COMPLIANCE CERTIFICATION In accordance with Okaloosa County Policy and Executive Order Number 11-116 from the office of the Governor of the State of Florida, Proposer hereby certifies that the U.S. Department of Homeland Security’s E-Verify system will be used to verify the employment eligibility of all new employees hired by the contractor during the contract term, and shall expressly require any subcontractors performing work or providing services pursuant to the contract to likewise utilize the U.S. Department of Homeland Security's E-Verify system to verify the employment eligibility of all new employees hired by the subcontractor during the contract term; and shall provide documentation of such verification to the COUNTY upon request. As the person authorized to sign this statement, I certify that this company complies/will comply fully with the above requirements. DATE: 11/25/13 SIGNATURE: > <—_————— COMPANY: Datech NAME: _ Daniel Truax (Typed or Printed) ADDRESS: PO Box 871 TITLE: _ President Gulf Breeze, FL 32562 E-MAIL: _ Dan@4datech.com PHONE NO,; __ 850-432-8324 BID SHEET Bid #: IS 17-14 BID ITEM: NETWORK CABLING & REPAIR BID PRICE PER HOUR: _ $80.00 per technician CATEGORY 5e: $ 80.00 per technician CATEGORY 6 OR BETTER: $ 80.00 per technician FIBER OPTIC: ¢___ 80.00 per technician 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). Datech WO eA Bidder’s Company Name Authorized Signature — Manual PO Box 871 Daniel Truax Authorized Signature — Typed Gulf Breeze, FL. 32562 President Address Title 850-432-8324 Phone # Fax # 20-0070869 Federal ID # or SS #