Okaloosa County BOCC — December 2, 2014 — MANSFIELD OIL CONTRACT — reading text

(Typed or Printed) TITLE: Director of Government Pricing Gainesville, GA 30501 E-MAIL: Mocbids@mansfieldoil.com PHONENO,, (800) 255-6699 21 RFB 03-15 Okaloosa County Purchasing CONFLICT OF INTEREST DISCLOSURE FORM For purposes of determining any possible conflict of interest, all respondents/proposers, must disclose if any Okaloosa Board of County Commissioner, employee(s), elected officials(s), or 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 x NAME(S) POSITION(S) FIRM NAME: Mansfield Oil Company BY (PRINTED): Dalvid Zarfoss BY (SIGNATURE): TITLE: Director o¥ Government Pricing ADDRESS: 1025 Airport Parkway SW Gainesville, GA 30501 PHONE NO. (800) 255-6699 E-MAIL mocbids@mansfieldoil.com DATE October 27, 2014 22 RFB 03-15 Okaloosa County Purchasing FEDERAL E-VERIFY COMPLIANCE CERTIFICATION In accordance with Okaloosa County Policy and Executive Order Number 11-116 from the office of the Governor if 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 respondent during the contract term, and shall expressly require any subcontractors performing work or providing services pursuant to the contact to likewise utilize the U.S. Department of Homeland Securities E-Verify system to verify the employment eligibility of all new employees hired by the subcontractor during the contract term; and shall provide documentation 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. pate; __ October 27, 2014 SIGNATURE: company: Mansfield Oil Company name: David Zarfoss Appress; 1025 Airport Parkway SW TITLE: Director of Government Pricing Gainesville, GA 30501 E-MAIL: Mocbids@mansfieldoil.com PHONE NO.: (800) 255-6699 23 RFB 03-15 Okaloosa County Purchasing NO CONTACT CLAUSE The 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 respondents/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 Manager or an appointed representative. It shall be the Purchasing Manager decision whether to consider this information in the decision process. Any violation of this policy 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 representing Mansfield Oil Company Signature Company Name On this 27th day of October , 2014 hereby agree to abide by the County’s “No Contact Clause” and understand violation of this policy shall result in disqualification of my proposal/submittal. 24 RFB 03-15 Okaloosa County Purchasing ***NOT APPLICABLE*** RECYCLED CONTENT FORM RECYCLED CONTENT INFORMATION 1. Is the material in the above: Virgin. or Recycled (Check the applicable blank). If recycled, what percentage %. Product Description: 2. Is your product packaged and/or shipped in material containing recycled content? Yes No. Specify: 3. Is your product recyclable after it has reached its intended end use? Yes. No. Specify: The above is not applicable if there is only a personal service involved with no product involvement. Name of Respondent: Mansfield Oil Company E-Mail: mocbids@mansfieldoil.com 25 RFB 03-15 Okaloosa County Purchasing 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 INDEMNIFICATION AND HOLD HARMLESS Agreement. RFB 03-15 Mansfield Oil Company Bidder’s Company Name 1025 Airport Parkway SW Gainesville, GA 30501 Physical Address 1025 Airport Parkway SW Gainesville, GA 30501 Mailing Address (800) 255-6699 Phone Number Cellular Number 26 Authorized/Signature — Manual David Zarfoss Authorized Signature — Typed Director of Government Pricing Title (678) 450-2242 FAX Number (800) 255-6699 After-Hours Number(s) October 27, 2014 Date Okaloosa County Purchasing 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 Mansfield Oil Company Bidder’s Company Name David Zarfoss Authorized Signature — Typed 27 RFB 03-15 Okaloosa County Purchasing COMPANY DATA Physical Address & Phone #: 1025 Airport Parkway SW Gainesville, GA 30501 (800) 255-6699 Proposer’s Company Name: Mansfield Oil Company of Gainesville, Inc Physical Address: 1025 Airport Parkway SW Gainesville, GA 30501 Contact Person (Typed-Printed): David Zarfoss Phone #: (800) 255-6699 Cell #: Federal ID or SS #: 58-1091383 Proposer’s License #: No, 53586 Fax #: (678) 450-2242 Emergency #’s After Hours, Weekends & Holidays: (800) 255-6699 28 RFB 03-15 Okaloosa County Purchasing ADDENDUM ACKNOWLEDGEMENT Acknowledgment is hereby made of the following addenda (identified by number) received since issuance of solicitation: ADDENDUM NO. DATE NOTE: Prior to submitting the response to this solicitation, it is the responsibility of the respondent to confirm if any addenda have been issued. If such addenda have been issued, acknowledge receipt by noting number(s) and date(s) above. 29 RFB 03-15 Okaloosa County Purchasing Mansfield Oil Co. irport Pa 1025 Ajrp ‘A 30501 rkway BID SHEET . P — Gainesville, G FIXED FIXED MARKUPOR | MARKUPOR DISCOUNT/GAL | DISCOUNT/GAL BID ESTIMATED | +0 opis DAILY | TO OPIS DAILY ITEM ANNUAL NO FUEL TYPE GALLONS RACK RACK PENSACOLA | PENSACOLA TRANSPORT | TANK WAGON DELIVERY DELIVERY REGULAR UNLEADED 1 | GASOLINE,10% 442,800 $-0.0274 ETHANOL No Bid 87 OCTANE DYED DIESEL FUEL 2 | GRADE #2 504,000 $+0.0110 No Bid ULTRA LOW SULFUR Obl MINIMUM ORDER ~ TRANSPORT DELIVERY: 6,000 Gallons MINIMUM ORDER — TANK WAGON DELIVERY: 500 Gallons MAY ORDERS BE SPLIT BETWEEN LOCATIONS FOR TRANSPORT ORDERS? YES NO WHAT IS THE MAXIMUM NUMBER OF SITES THAT CAN BE SPLIT FOR TRANSPORT ORDERS? __ 4 IS THERE A CHARGE FOR SPLIT TRANSPORT ORDERS BETWEEN LOCATIONS? X_YES NO. WHAT IS THE CHARGE PER SPLIT BEYOND ONE SITE? $45.00 IS THERE A CHARGE FOR SPLIT TRANSPORT ORDERS TO THE SAME LOCATION? (ORDER DYED DIESEL & GASOLINE FOR THE SAME LOCATION TO MEET THE MINIMUM ORDER) YES X_NO. WHAT IS THE CHARGE FOR A SPLIT ORDER TO THE SAME LOCATION? RESPONDENT EMERGENCY CONTACT NAME & PHONE NUMBER: Alexi Russell, 678-207-4751 (800) 255-6699 TOLL FREE NUMBER FOR ORDERING: RFB 03-15 30 Okaloosa County Purchasing Employer Wizard erify Page | of | . . wishromie hae Br Laws cage Employmant Eligibility Verltioation ais Mihetheed AMZ Set OM. 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On Qu ef Chenetyea: TRUBS IserScarch aspx Acthirneeeti Aapnirieaatot Genera Ler Frew Nate, Mahon Alwine Weatied His no HAO OBEN Jee OTe ZIG PM ‘Saabs sf Pasuvrore Caan? 8 unent i Pcccad Page | of fast Lege 1048 BM oy sgtig Lag Out Legge an Angessibitty Dowminad yiswern 2014 Local Service, Nationwiie. Mansfield Oil Company Emergency Plan 2014 I. Assumptions Given that this plan is for natural disasters, and the scope of its affect is impossible to predict, Mansfield must make certain assumptions and caveats to any relief plan put into action. Mansfield will make every possible effort to maintain service levels at locations after a hurricane has passed, while working with regulatory authorities and under any executive order that has been issued. For planning purposes, the following assumptions must be made: e Fuel is readily available from terminals suppliers that we would normally use to pull fuel. Mansfield is authorized to pull at nearly every major terminal off of every major supplier. If providers have to travel non-standard distances to procure fuel, capabilities to fueling locations will be reduced. « FEMA and state disaster agencies have not taken control of a Mansfield provider’s capacity. e Providers are able to reposition drivers and equipment in a timely manner in the aftermath of the natural disaster. Given the increased demand for supply before and after hurricanes, capacity is extremely finite. If any of the above assumptions are not met, capacity to fulfill customer needs will further be diminished, With this in mind, Mansfield will do everything possible to make sure that locations are fueled, If, Procedure Currently, Mansfield uses a number of resources to monitor the progress of tropical storms throughout the season. As Mansfield monitors storm activity the following statuses will be