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Fort Walton Beach Council agenda — 09-04-12 regular — reading text
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the right to use /not use any Work as deemed appropriate by the Florida
Department of Environmental Protection. No Work will be returned once submitted.
I hereby acknowledge that the Florida Department of Environmental Protection shall bear no responsibility
whatsoever for protecting the Work against third party infringement of my copyright interest or other intellectual
property rights or other rights I may hold in such Work, and in no way shall be responsible for any losses I may
suffer as a result of any such infringement; and I hereby represent and warrant that the Work does not infringe the
rights of any other individual or entity.
I hereby unconditionally release, hold harmless and indemnify Florida Department of Environmental Protection, its
employees, volunteers, and representatives of and from all claims, liabilities and losses arising out of or in
connection with the Florida Department of Environmental Protection' s use of the Work. This release and
indemnification shall be binding upon me, and my heirs, executors, administrators and assigns. I have read and
understand the terms of this release.
Photographer Signature: Date:
Photo Filename( s):
Location of photo shoot:
Name of Person Accepting Photographs:
DEP Agreement No. CM234, Attachment J, Page 1 of 2
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Model Release Form: PhotoNideo /Audio
This photo release form will be used for all State of Florida—Department of Environmental Protection brochures,
websites, displays, articles, magazines, programs, advertisements or events.
Photo Release for Adults
I, being 18 years or older, hereby consent that the videotapes, photographs and/ or motion picture film in which I
appear, and/ or audio recordings made of my voice may be used by the Florida Department of Environmental
Protection, its assigns or successors, in whatever way they desire, including television without compensation.
Furthermore, I hereby consent that such photographs, films, negatives and recordings, and the plates and/ or tapes
from which they are made shall be their property, and they shall have the right to sell, duplicate, reproduce, and
make other lawful uses of such photographs, films, recordings, places and tapes as they may desire, free and clear of
any claim whatever on my part in perpetuity.
IN WITNESS WHEREOF I have hereunto set my hand, in the State of Florida,
this day of , 2
Location-
Signature_
Name ( Print)
Address _
City Zip.
Photo Release for Minors
I being Parent/Guardian of , hereby consent that the videotapes, photographs and/ or
motion picture film for which he/ she posed, and/ or audio recordings made of his/ her voice may be used by the
Florida Department of Environmental Protection, its assigns or successors, in whatever way they desire, including
television without compensation. Furthermore, I hereby consent that such photographs, films, negatives, and
recordings and the plates and/ or tapes or other medium from which they are made shall be their property, and they
shall have the right to sell, duplicate, reproduce and make other uses of such photographs, films, recordings, plates,
and tapes as they may desire free and clear of any claim whatsoever on my part or my child' s part, or by anyone
who may claim by or through my child in perpetuity.
IN WITNESS WHEREOF I have hereunto set my hand, in the State of Florida,
this day of , 2
Signature of parent or guardian
Name of child (print)
Name of parent or guardian (print)
Address
City State Zip,
DEP Agreement No. CM234, Attachment J, Page 2 of 2
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ATTACEMMNT K
Contract Provisions
All contracts awarded by a recipient, including small purchases, shall contain the following provisions as applicable:
1. Equal Employment Opportunity - All contracts shall contain a provision requiring compliance with
Executive Order (E.O.) 11246, " Equal Employment Opportunity," as amended by E.O. 11375, " Amending
Executive Order 11246 Relating to Equal Employment Opportunity," and as supplemented by regulations at
41 CFR part 60, " Office of Federal Contract Compliance Programs, Equal Employment Opportunity,
Department of Labor."
2. Copeland " Anti-Kickback" Act (18 U.S. C. 874 and 40 U.S. C. 276c) - All contracts and subgrants in excess
of $2000 for construction or repair awarded by recipients and subrecipients shall include a provision for
compliance with the Copeland " Anti-Kickback" Act ( 18 U.S. C. 874), as supplemented by Department of
Labor regulations ( 29 CFR part 3, " Contractors and Sub -contractors on Public Building or Public Work
Financed in Whole or in Part by Loans or Grants from the United States "). The Act provides that each
contractor or subrecipient shall be prohibited from inducing, by any means, any person employed in the
construction, completion, or repair of public work, to give up any part of the compensation to which he is
otherwise entitled. The recipient shall report all suspected or reported violations to the Federal awarding
agency.
3. Davis -Bacon Act, as amended ( 40 U.S. C. 276a to a -7) - When required by Federal program legislation, all
construction contracts awarded by the recipients and subrecipients of more than $2000 shall include a
provision for compliance with the Davis -Bacon Act (40 U.S. C. 276a to a -7) and as supplemented by
Department of Labor regulations (29 CFR part 5, " Labor Standards Provisions Applicable to Contracts
Governing Federally Financed and Assisted Construction "). Under this Act, contractors shall be required to
pay wages to laborers and mechanics at a rate not less than the minimum wages specified in a wage
determination made by the Secretary of Labor. In addition, contractors shall be required to pay wages not less
than once a week. The recipient shall place a copy of the current prevailing wage determination issued by the
Department of Labor in each solicitation and the award of a contract shall be conditioned upon the acceptance
of the wage determination. The recipient shall report all suspected or reported violations to the Federal
awarding agency.
4. Contract Work Hours and Safety Standards Act (40 U.S.C. 327 -333) - Where applicable, all contracts
awarded by recipients in excess of $2000 for construction contracts and in excess of $2500 for other contracts
that involve the employment of mechanics or laborers shall include a provision for compliance with Sections
102 and 107 of the Contract Work Hours and Safety Standards Act (40 U.S. C. 327 -333), as supplemented by
Department of Labor regulations ( 29 CFR part 5). Under Section 102 of the Act, each contractor shall be
required to compute the wages of every mechanic and laborer on the basis of a standard work week of 40
hours. Work in excess of the standard work week is permissible provided that the worker is compensated at a
rate of not less than 1 '/ a times the basic rate of pay for all hours worked in excess of 40 hours in the work
week. Section 107 of the Act is applicable to construction work and provides that no laborer or mechanic shall
be required to work in surroundings or under working conditions which are unsanitary, hazardous or
dangerous. These requirements do not apply to the purchases of supplies or materials or articles ordinarily
available on the open market, or contracts for transportation or transmission of intelligence.
5. Rights to Inventions Made Under a Contract or Agreement - Contracts or agreements for the performance
of experimental, developmental, or research work shall provide for the rights of the Federal Government and
the recipient in any resulting invention in accordance with 37 CFR part 401, " Rights to Inventions Made by
Nonprofit Organizations and Small Business Firms Under Government Grants, Contracts and Cooperative
Agreements," and any implementing regulations issued by the awarding agency.
6. Clean Air Act (42 U.S.C. 7401 et seq.) and the Federal Water Pollution Control Act, as amended (33
U.S. C. 1251 et seq.) - Contracts and subgrants of amounts in excess of $100, 000 shall contain a provision that
requires the recipient to agree to comply with all applicable standards, orders or regulations issued pursuant to
the Clean Air Act (42 U.S. C. 7401 et seq.) and the Federal Water Pollution Control Act as amended ( 33
U.S. C. 1251 et seq.). Violations shall be reported to the Federal awarding agency and the Regional Office of
the Environmental Protection Agency (EPA).
DEP Agreement No. CM234, Attachment Ir, Page 1 of 4
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Byrd Anti-Lobbying Amendment (31 U.S.C. 1352) - Contractors who apply or bid for an award of
100,000 or more shall file the required certification. Each tier certifies to the tier above that it will not and
has not used Federal appropriated funds to pay any person or organization for influencing or attempting to
influence an officer or employee of any agency, a member of Congress, officer or employee of Congress, or
an employee of a member of Congress in connection with obtaining any Federal contract, grant or any other
award covered by 31 U.S. C. 1352. Each tier shall also disclose any lobbying with non -Federal funds that takes
place in connection with obtaining any Federal award. Such disclosures are forwarded from tier to tier up to
the recipient.
Governmentwide Debarment and Suspension ( NonProcurement) —Recipients shall comply with the
provisions of Subpart C of 2 CFR Part 1326, " Governmentwide Debarment and Suspension
Nonprocurement)," published in the Federal Register on December 21, 2006, 71 FR 76573, which generally
prohibit entities that have been debarred, suspended, or voluntarily excluded from participating in Federal
nonprocurement transactions either through primary or lower tier covered transactions.
9. Section 508 of the Federal Water Pollution Control Act, as amended ( 33 U.S.C. 1368) and Section
1424(e) of the Safe Drinking Water Act (42 U.S. C. 300h -3( e)) - Contracts and subgrants of amounts in
excess of $100,000 shall contain a provision that requires the recipient to agree to comply with all applicable
standards, orders or regulations issued pursuant to Section 508 of the Federal Water Pollution Control Act, as
amended (33 U.S. C. 1368) and Section 1424( e) of the Safe Drinking Water Act (42 U.S. C. 300h- 3( e)).
Violations shall be reported to the Federal awarding agency and the Regional Office of the Environmental
Protection Agency (EPA).
10. Compliance with all Federal statutes relating to nondiscrimination - These include but are not limited to:
a) Title VI of the Civil Rights Act of 1964 (P.L. 88 -352), which prohibits discrimination on the basis of sex;
b) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. 795), which prohibits discrimination
on the basis of handicaps; ( c) the Americans with Disabilities Act of 1990 (42 USC 12101 et. seq.) prohibiting
