Okaloosa County BOCC — April 5, 2016 — Palm Beach Bid 15-063-LC — reading text

NAME: (Enter the entire legal name of the bidding entity) DATE: PRINT NAME: PRINT TITLE: * SIGNATURE: _____________________________ ADDRESS: ______________________________________________________________________________________ CITY / STATE: ___________________________________________________ ZIP CODE: _____________________ TELEPHONE # ( ) E-MAIL: TOLL FREE # ( ) FAX #: ( ) APPLICABLE LICENSE(S) NUMBER # ______________________________________ TYPE: ______________________________________ FEDERAL ID # ____________________________________________________________________________________  Page 13 CERTIFICATION OF BUSINESS LOCATION BID #15-063/LC In accordance with the Palm Beach County Local Preference Ordinance, as amended, a preference may be given to: (1) bidders having a permanent place of business in Palm Beach County (“County”) or (2) bidders having a permanent place of business in the Glades that are able to provide the goods and/or services to be utilized within the Glades. To receive a local preference, bidders must have a permanent place of business within the County or the Glades, as applicable, prior to the County’s issuance of the solicitation. A Business Tax Receipt which is issued by the Palm Beach County Tax Collector, authorizes the bidder to provide the goods/services being solicited by the County, and will be used to verify that the bidder had a permanent place of business prior to the issuance of the solicitation. The bidder must submit this Certification of Business Location (“Certification”) along with the required Business Tax Receipt at the time of bid or quote submission. The Business Tax Receipt and this Certification are the sole determinant of local preference eligibility. Errors in the completion of this Certification or failure to submit this completed Certification will cause the bidder to not receive a local preference. In instances where the bidder is exempt by law from the requirement of obtaining a Business Tax Receipt, the bidder must: (a) provide a citation to the specific statutory exemption; and (b) provide other documentation which clearly establishes that the bidder had a permanent place of business within the County or the Glades prior to the date of issuance of the solicitation. The County hereby retains the right to contact said bidders for additional information related to this requirement after the bid/quote due date. I. Bidder is a: _________ Local Business: A local business has a permanent place of business in Palm Beach County. (Please indicate): ________ Headquarters located in Palm Beach County ________ Permanent office or other site located in Palm Beach County from which a vendor will produce a substantial portion of the goods or services. _________ Glades Business: A Glades business has a permanent place of business in the Glades. (Please indicate): ________ Headquarters located in the Glades ________ Permanent office or other site located in the Glades from which a vendor will produce a substantial portion of the goods or services. II. The attached copy of bidder’s County Business Tax Receipt verifies bidder’s permanent place of business. THIS CERTIFICATION is submitted by , as (Name of Individual) , of (Title/Position) (Firm Name of Bidder) who hereby certifies that the information stated above is true and correct and that the County Business Tax Receipt is a true and correct copy of the original. Further, it is hereby acknowledged that any misrepresentation by the bidder on this Certification will be considered an unethical business practice and be grounds for sanctions against future County business with the bidder. ________________________________ ____________ (Signature) (Date)  Page 14 DRUG-FREE WORKPLACE CERTIFICATION BID #15-063/LC IDENTICAL TIE BIDS/PROPOSALS - In accordance with Section 287.087, F.S., a preference shall be given to vendors submitting with their bids/proposals the following certification that they have implemented a drug-free workplace program which meets the requirements of Section 287.087; provided, however, that any preference given pursuant to Section 287.087, shall be made in conformity with the requirements pursuant to the Palm Beach County Code, Chapter 2, Article III, Sections 2-80.21 thru 2-80.34. In the event tie bids are received from vendors who have not submitted with their bids/proposals a completed Drug-Free Workplace Certification form, the award will be made in accordance with Palm Beach County's purchasing procedures pertaining to tie bids. This Drug-Free Workplace Certification form must be executed and returned with the attached bid/proposal, and received on or before the published bid submission time to be considered. The failure to execute and/or return this certification shall not cause any bid/proposal to be deemed non-responsive. Whenever two (2) or more bids/proposals which are equal with respect to price, quality, and service are received by Palm Beach County for the procurement of commodities or contractual services, a bid/proposal received from a business that certifies that it has implemented a drug-free workplace program shall be given preference in the award process. 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 bid a copy of the statement specified in number (1). (4) In the statement specified in number (1), notify the employees that, as a condition of working on the commodities or contractual services that are under bid, 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, Florida Statutes, 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 a drug abuse assistance or rehabilitation program if such is available in the employee's community, by any employee who is so convicted. (6) Make a good faith effort to continue to maintain a drug-free workplace through implementation Section 287.087, Florida Statutes. THIS CERTIFICATION is submitted by _______________________________________________________________ the (Individual's Name) _______________________________________________ of ________________________________________________ (Title/Position with Company/Vendor) (Name of Company/Vendor) who does hereby certify that said Company/Vendor has implemented a drug-free workplace program which meets the requirements of Section 287.087, Florida Statutes, which are identified in numbers (1) through (6) above. ________________________________ _______________ Signature Date  Page 15 NON-DISCRIMINATION POLICY BID #15-063/LC Pursuant to Palm Beach County Resolution R-2014-1421, as may be amended, it is the policy of the Board of County Commissioners of Palm Beach County that Palm Beach County shall not conduct business with nor appropriate any funds for any organization that practices discrimination on the basis of race, color, national origin, religion, ancestry, sex, age, familial status, marital status, sexual orientation, gender identity and expression, disability, or genetic information. All bidders doing business with Palm Beach County are required to submit a copy of its non-discrimination policy which shall be consistent with the policy of Palm Beach County stated above, prior to entering into any contract with Palm Beach County. In the event a bidder does not have a written non-discrimination policy or one that conforms to Palm Beach County’s policy, such bidder shall be required to check the applicable statement and sign below affirming it will conform to Palm Beach County’s policy. Check one: (__) Bidder hereby acknowledges that it does not have a written non-discrimination policy or one that conforms to Palm Beach County’s policy and Bidder hereby acknowledges and affirms by signing below that it will conform to Palm Beach County’s non-discrimination policy as provided in Palm Beach County’s Resolution R-2014-1421, as may be amended. OR (__) Bidder hereby attaches its non-discrimination policy which is consistent with the policy of Palm Beach County. OR (__) Bidder hereby attaches its non-discrimination policy which does not conform to the policy of Palm Beach County; however, Bidder hereby acknowledges and affirms by signing below that it will conform to Palm Beach County’s non-discrimination policy as provided in Palm Beach County’s Resolution R-2014-1421, as may be amended. NOTE: Bidder’s failure to either: (i) have a written or non-written