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Okaloosa County BOCC — September 3, 2013 — RFQ IS-02-14 — reading text
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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: _______________________ SIGNATURE: ____________________
COMPANY: _______________________ NAME: _________________________
(Typed or Printed)
ADDRESS: _______________________
TITLE: _________________________
_______________________
E-MAIL: ________________________
_______________________
PHONE NO.: _______________________
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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.
____________________________ __________________________
Proposer’s Company Name Authorized Signature – Manual
____________________________ __________________________
Physical Address Authorized Signature – Typed
____________________________ __________________________
Mailing Address Title
____________________________ __________________________
Phone Number FAX Number
____________________________ __________________________
Cellular Number After-Hours Number(s)
____________________________
DATE
(REVISED: JANUARY 12, 2001)
15
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: _______________________ SIGNATURE: ____________________
COMPANY: _______________________ NAME: _________________________
(Typed or Printed)
ADDRESS: _______________________
TITLE: _________________________
_______________________
E-MAIL: ________________________
PHONE NO.: ___________________________
16
NOTICE OF AWARD
TO:
PROJECT
DESCRIPTION:
The OWNER has considered the PROPOSAL submitted by you for the above-described WORK
in response to its Advertisement for Qualifications dated __________________ and
Information for Proposers.
You are hereby notified that your PROPOSAL has been accepted for services at the rates
attached hereto.
You are required by the Instructions to Proposers to execute the Agreement and furnish the
required CONTRACTOR’S 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 documents within fifteen (15) calendar
days from the date of this notice, said OWNER will be entitled to consider all your rights arising
out of the OWNER’s acceptance of your PROPOSAL as abandoned and as a forfeiture of your
PROPOSAL. 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 Jack Allen at 850-689-5960.
Dated this ____ day of ____________, 2013.
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 ___________________, 2013.
BY: ___________________________________________________
Title: __________________________________________________
17
NOTICE TO PROCEED
DATE: ________________
TO:
PROJECT: ________________________________________________________
You are hereby notified to commence WORK in accordance with the Agreement dated
_____________________, 2013, 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 _________________, 2013
____________________________________
Signature
By: _________________________________
Type or Print Name
Title: ________________________________
18
CONTRACT
This agreement, executed in Crestview, Florida this _____ day of
___________________________ 2013 between the County of Okaloosa, Florida, the
Owner, hereinafter called the Party of the First Part, and
______________________________ or its successors, executors, administrators and
assigns, hereinafter called the Party of the Second Part.
WITNESSETH:
That for and in consideration of payments, hereinafter mentioned, to be made by the
Party of the First Part, the Party of the Second Part agrees to furnish all equipment, machinery,
tools and labor required to be furnished and delivered and to do and perform all work related
to providing Information Technology Services as per the attached fee schedule in
strict conformity with the provisions of this Contract, the Notice to Contractors, the
Specifications and the Plans approved by the Owner. The said Plans, Specifications, the Notice
to Contractors, and the proposal are hereby made a part of this agreement as fully and to the
same effect as if the same had been set forth at length in the body of this agreement.
In consideration of the foregoing promises, the Party of the First Part agrees to pay to
the Party of the Second Part such unit prices for the work actually done as are set out in the
accompanying proposal in the manner provided in the said Specifications.
The Contractor shall be prepared to begin work to be performed under the contract as
he set forth in his proposal, but will not proceed until he receives official notice to begin.
This contract may be utilized by other Okaloosa County Departments. Said departments
will negotiate Task Orders independently from Public Works.
This contract shall be for a three (3) year period and may be renewed for one (1)
additional three-year period upon written agreement by both parties. This contract may be
cancelled in writing upon 30 days written notice.
REPRESENTATIVES: The authorized representative of the County shall be:
Don Vanderhoek, Director
Okaloosa County Information Systems
1804 Lewis Turner Blvd., Suite 402
Ft. Walton Beach, FL 32547
850-651-7750
E-Mail: dvanderhoek@co.okaloosa.fl.us
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The authorized representative for shall be:
E-Mail:
All notices required by this agreement shall be in writing to the representative listed
above with a courtesy copy to the following:
Jack Allen
Purchasing Services Manager
Okaloosa County Purchasing Department
