Okaloosa County BOCC — February 18, 2014 — Glaze Communication — reading text

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: Ll-27- 20/3 SIGNATURE: V Zao company: <-/aze Communica¥roa ss NAME: Jocekt vw) Glace (Typed or Printed) appress: /J&64 Cowen Kol TITLE: ces, det al £ BE ze ft. - ES 06, E-MAIL: bung laze —— gulf coasts £22 65 Com PHONE NO.: eso ove. 24S 5_ 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. blaze CSaound tad eas De ; Slervices. a aoe WZ Proposer’s Company Name Authorized Signature — Manual 8 G4 Canina Rol Feet te DN) & faze Physical Address Cx) 2 Reeeze FL Authorized Signature — Typed * 32563 Same President Mailing Address Title 850/96 - 2455 L50- 93 a-9646 Phone Number FAX Number 85d /232- 2¢9¢Y Q50- 26-7455 Cellular/Number After-Hours Number(s) i‘ W-27- 2013 Fellow promph > 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: J)- 27-2073 SIGNATURE: er ‘ company: G/eze Comnun caverns NAME: Bret? W. Cheze (Typed or Printed) appress: /£69 Gwen Ro/ TITLE: Pes pn oe GIF Breeze Ful Ig . * 32563 E-MAIL: @ze € ult coasts PHONE NO.: 5 0-9/6- 7955S Paw BID SHEET Bid #: IS 17-14 BID ITEM: NETWORK CABLING & REPAIR YE SO BID PRICE PER HOUR: $ CATEGORY 5e: ¢ 46,50 CATEGORY 6 OR BETTER: ¢_ 76, 5 O FIBER OPTIC: $ AG, 5 O 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). Cloze Commun i ae fee — Bidder’s Company Name Sey fees “FAs. Authorized Signature — Manual f 1£67 Gwen Ra Beett?} W. 6 lgze Authorized Signature — Typed bult Breeze Fl 354563 Pes inhen t- Address / Title 850- Ub- TYEE F50- 932-96 46 Phone # Fax # 69- B690/L§6 Federal ID # or SS # Pi ACORD — See CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 2/5/2014 REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES certificate holder in lieu of such endorsement(s). IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. if SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the PRODUCER CONTACT Waldorff Insurance & Bonding PHONE Bad. FAX ge0.5B1- 45 Eglin Parkway NE Ste 202 E-MAIL Fort Walton Beach FL 32548 Saas receptionist@waldorffinsurance com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A :Westfield Insurance Company 4112 INSURED GLAZ-01 INSURER B:The FCC! Insurance Company 10178 Glaze Communications Services INSURER C: Inc. ; 1864 Cowen Road INSURER D: Gulf Breeze FL 32563 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 185516160 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSA ADDLISUBRI POLICY EFF | POLICY EXP LTR TYPE OF INSURANCE INSR | WVD POLICY NUMBER MM/DD/YYYY) | (MM/DD/YYYY) LIMITS A GENERAL LIABILITY Y ICWP0937612 2/12/2014 P/12/2015 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED X | COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $100,000 CLAIMS-MADE OCCUR MED EXP (Any one person) $5,000 PERSONAL & ADV INJURY | $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG | $2,000,000 pouicy |X_| FRO: LOC $ [A | AUTOMOBILE LIABILITY CWP0937612 by12/2014 ~~ b/12/2015 e OMBINED SI NGLE LIMIT | ¢1,000,000 x ANY AUTO BODILY INJURY (Per person) | $ ALL OWNED SCHEDULED i ALL OM | 8S HED BODILY INJURY (Per accident) | $ x x __| NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Per accident) $ A X_ | UMBRELLALIAB) = [X | occur CWP0937612 B/12/2014 = B/12/2015 EACH OCCURRENCE $2,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $2,000,000 DED [x | RETENTION $0 $ B | WORKERS COMPENSATION (001 WC14A67995 piizj2o1a = 12/2015 |X | WESTATUL | OTH AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE} $1,000,000 yes, describe und DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT | $1,000,000 A Leased/Rented Equip ICWP0937612 2/12/2014 B/4 2/2015 Limit: $25,000 Ded: $1,000 Installation Floater Limit: $280,000 Ded: $1,000 only when required by written contract. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) It is hereby understood and agreed that the below named Certificate Holder is listed as additional Insured as Pertains to General Liability RE: Jobs per network Cabling & repair contract. CERTIFICATE HOLDER CANCELLATION Okaloosa County 602-C North Pearl Street Crestview FL 32536 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD