Okaloosa County BOCC — April 27, 2013 — reading text

WAS USED: (Indicate location and date of last charge) REMARKS: 65 Packet Pg. 755  8.6.c.b PURCHASING CARD MAINTENANCE FORM DATE: DEPARTMENT: Attachment: Okaloosa County Purchasing Manual-5 (1517 : Revisions to the Purchasing Manual) PHONE $ AMOUNT EMPLOYEE’S NAME NUMBER CARD NUMBER REQUESTED MAINTENANCE REQUESTED (Circle as needed) ADD CARDHOLDER (Fill out above) DELETE/CANCEL ACCOUNT (Account #) RAISE/LOWER LIMIT (Existing amount) OTHER (explain) Authorized By (Department Director) Fax Back To: 689-5037 (Purchasing Department) 66 Packet Pg. 756  8.6.c.b Approved by: ________________________________ Cardholder Signature: ________________________ OKALOOSA COUNTY BOARD OF COUNTY COMMISSIONERS PURCHASING CARD DISPUTE FORM Company Name: Attachment: Okaloosa County Purchasing Manual-5 (1517 : Revisions to the Purchasing Manual) Cardholder Name: Cardholder Account Number: Statement Date Transaction Date Merchant Name/Description Amount Posting Date Reference Number Check the description most appropriate to your dispute. If you have any questions, contact . 1. Alteration of Amount: The amount of the sales draft has been altered from $ to $ . (Please include copy of sales draft) 2. Unauthorized Mail or Phone Order: I certify the charge listed above was not authorized by me or any person authorized by me to use this account. I have not ordered merchandise by phone or mail or received goods and services as represented above. 3. Cardholder Dispute: I did participate in the above transaction; however, I dispute the entire charge, or a portion, in the amount of $_____________because: 4. Credit Not Received: The merchant has issued me a credit slip for the transaction listed above; however, the credit has not been posted to my account. The date on the voucher is between 30 and 90 days old. (Please include a copy of the credit voucher.) 5. Imprinting of Multiple Slips: The above transaction represents multiple billing to my account. I only authorized one charge from this merchant for $ . I am still in possession of my card. 6. Merchandise Not Received: My account has been charged for the above transaction, but I have not received this merchandise. I have contacted the merchant. 7. Merchandise Not Received: My account has been charged for the above transaction, but I have since contacted this merchant and canceled the order. I will refuse delivery should the merchandise still 8. be sent. Merchandise Returned: My account has been charged for the transaction listed above, but the merchandise has been returned. Provide a description of the circumstances. (Please include postal 9. receipt if applicable.) Inadequate Description/Unrecognized Charge: I do not recognize this charge. Please supply a copy of the sales draft for my review. 10. I am no longer disputing this charge. 67 Packet Pg. 757  8.6.c.b OKALOOSA COUNTY PURCHASING CARD AGREEMENT I, , agree to the following regarding my use of the Purchasing Card: (Print Name) 1. I understand that I am being entrusted with a valuable tool and will be financially obligating Okaloosa County and will strive to obtain the best value for the taxpayers of Okaloosa County. Attachment: Okaloosa County Purchasing Manual-5 (1517 : Revisions to the Purchasing Manual) 2. I understand that under no circumstances will I use the Purchasing Card to make personal purchases. Willful intent to use the Purchasing Card for personal use may result in disciplinary actions, including termination of employment. 3. I will follow the established procedures for using the Purchasing Card. Failure to do so may result in the revocation of my use privileges or other disciplinary actions. Additionally, I will follow all County purchasing requirements. 4. I have been given a copy of the Purchasing Card Manual and understand the requirements for using the Purchasing Card. 5. I agree that should I violate the terms of this Agreement and use the Purchasing Card for personal use or gain, I will reimburse the County for all incurred charges and any fees related to the collection of those charges. Employee Name (Print) Employee Signature/Date 68 Packet Pg. 758  8.6.c.b BID ATTACHMENTS The following are requirements that shall be included in all bid specifications (Special Conditions section) for projects that are funded through/by the U.S. Department of Transportation, Federal Transit Administration. Okaloosa County reserves the right to reject any/all bids that are submitted incomplete or without these documents. 1. Buy America 2. Bus Testing Attachment: Okaloosa County Purchasing Manual-5 (1517 : Revisions to the Purchasing Manual) 3. Lobbying 4. Clean Air 5. Civil Rights 6. Bid Protests 7. Government Debarment and Suspension 8. Fraud 9. The Purchasing Director has the authority and responsibility to ensure Federal requirements are met regarding all procurements of goods and services utilizing FTA Funds. That person will also have the ability to stop any procurement activity if it conflicts with Federal procurement practices. 10. The Okaloosa County Coordinated Transportation Office shall ensure that all required portions of the Uniform Administrative Requirements for Grants & Cooperative Agreements (49CFR-Part 18 & Circular 4220 are complied with. 11. The Purchasing Department & Okaloosa Coordinated Transit will maintain current copies of the above documents and familiarize themselves with the requirements. 12. Okaloosa Coordinated Transit shall maintain a written record of all purchases utilizing FTA funds showing the purpose of the expenditure. 69 Packet Pg. 759  8.6.c.b FEDERAL TRANSIT ADMINISTRATION REQUIREMENTS UNDER 49 CFR, PARTS 18 AND 19, AND CIRCULAR 4220 BUY AMERICA - The contractor agrees to comply with 49 U.S.C. 5323(j) and 49 CFR Part 661 which provide that Federal funds may not be obligated unless steel, iron, and manufactured products used in FTA-funded projects are produced in the United States, unless a waiver has been granted by FTA or the product is subject to a general waiver. General waivers are listed in 49 CFR 661.7 and include final assembly in the United States for 15 passenger vans and 15 passenger wagons Attachment: Okaloosa County Purchasing Manual-5 (1517 : Revisions to the Purchasing Manual) produced by Chrysler Corporation, microcomputer equipment, software, and small purchases (currently less than $100,000) made with capital, operating, or planning funds. Separate requirements for rolling stock are set out at 5323(j)(2)(C) and 49 CFR 661.11. Rolling stock not subject to a general waiver must be manufactured in the United States and have a 60 percent domestic content. A bidder or offeror must submit to the FTA recipient (Okaloosa County) the appropriate Buy America certification (below) with all bids on FTA-funded contracts, except those subject to a general waiver. Bids or offers that are not accompanied by a completed Buy America certification must be rejected as non-responsive. This requirement does not apply to lower tier subcontractors. Certification requirement for procurement of steel, iron, or manufactured products. Certificate of Compliance with 49 U.S.C. 5323(j)(1) The bidder or offeror certifies that it will meet the requirements of 49 U.S.C. 5323(j)(1) and the applicable regulations in 49 CFR Part 661. Date Signature Company Name Title Certificate of Non-Compliance with 49 U.S.C. 5323(j)(1) The bidder or offeror hereby certifies that it cannot comply with the requirements of 49 U.S.C. 5323(j)(1), but it may qualify for an exemption pursuant to 49 U.S.C. 5323(j)(2)(B) or (j)(2)(D) and the regulations in 49 CFR 661.7. Date Signature Company Name Title Certification requirement for procurement of buses, other rolling stock and associated equipment 70 Packet Pg. 760  8.6.c.b Certificate of Compliance with 49 U.S.C. 5323(j)(2)(C) The bidder or offeror certifies that it will comply with the requirements of 49 U.S.C. 5323(j)(2)(C) and the regulations at 49 CFR Part 661. Date Signature Attachment: Okaloosa County Purchasing Manual-5 (1517 : Revisions to the Purchasing Manual) Company Name Title Certificate of Non-Compliance with 49 U.S.C. 5323(j)(2)(C) The bidder or offeror hereby certifies that it cannot comply with the requirements of 49 U.S.C. 5323(j)(2)(C), but may qualify for an exception pursuant to 49 U.S.C. 5323(j)(2)(B) or (j)(2)(D) and the regulations of 49 CFR 661.7. Date Signature Company Name