Okaloosa County BOCC — November 18, 2014 — REVISED Okaloosa HA Agreement 2014-15 — reading text

Dale Brazel 15331]1564 Percy L Coleman Road Okaloosa Chlorine Fort Walton Beach, 32548 850-978-0020 08/10/2014 25 Shalimar, 32579 850-978-0020 ATTACHMENT C - OKALOOSA COUNTY SECTION 302 FACILITY LIST 2014-2015 0 | ; ; kaloosa County-Northgate Water Well ; Dale Brazel 10241 Jonquil Avenue Okaloosa _ Chlorine 950-978-0020 Fort Walton Beach, 32547 Okaloosa County-Oddfellow Water Tank . Dale Brazel 34026] Oddfellow Road Okaloosa Chlorine 850-978-0020 Fort Walton Beach, 32547 Okaloosa County-Office Water Well . . : Dale Brazel 10235] First Avenue and Eglin Street Okaloosa Chlorine 850-978-0020 Fort Walton Beach, 32547 Okaloosa County-Okaloosa Island Booster Station . . . . Dale Brazel 30392/110 West Amberjack Drive Okaloosa Chlorine 250-978-0020 Fort Walton Beach, 32547 : Okaloosa County-Russell Stephenson WWTP 10249]3182 West US Highway 98 Okaloosa Chlorine oeneet ying Mary Esther, 32569 Okaloosa County-Shalimar Water Well Dale Brazel * 10234|Seventh Street Okaloosa Chlorine a 08/10/2014 26 Attachment D FINANCIAL INVOICE FORM FOR HAZARDOUS MATERIALS HAZARDS ANALYSIS UPDATE RECIPIENT: Okaloosa County AGREEMENT# 15-CP-11-01-56-XXX FEID#: 59-6000765 DUNS#: AMOUNT AMOUNT APPROVED REQUESTED BY THE BY THE RECIPIENT DIVISION 1. First Payment (45% of contract amount) $ $ (50% Hazards Analyses completed/submitted) 2. Second Payment (45% of contract amount) $ $ (50% Hazards Analyses completed/submitted) 3. Final Payment (10% of contract amount) $ $. (Approval, distribution & notification) TOTAL AMOUNT $ $ (To be completed by the Division) | certify that to the best of my knowledge and belief the billed costs are in accordance with the terms of the Agreement. Signature of Authorized Official/Title Date TOTAL AMOUNT TO BE PAID AS OF THIS INVOICE $ (To be completed by the Division) 27 Attachment E JUSTIFICATION OF ADVANCE PAYMENT RECIPIENT: If you are requesting an advance, indicate same by checking the box below. [ ] ADVANCE REQUESTED Advance payment of $ is requested. Balance of payments will be made on a reimbursement basis. These funds are needed to pay staff, award benefits to clients, duplicate forms and purchase start-up supplies and equipment. We would not be able to operate the program without this advance, If you are requesting an advance, complete the following chart and line item justification below. ESTIMATED EXPENSES . BUDGET CATEGORY/LINE ITEMS 20__-20___ Anticipated Expenditures for First Three Months of (list applicable line items) Contract For example ADMINISTRATIVE COSTS (Include Secondary Administration.) For example PROGRAM EXPENSES TOTAL EXPENSES LINE ITEM JUSTIFICATION (For each line item, provide a detailed justification explaining the need for the cash advance. The justification must include supporting documentation that clearly shows the advance will be expended within the first ninety (90) days of the contract term. Support documentation should include quotes for purchases, delivery timelines, salary and expense projections, etc. to provide the Division reasonable and necessary support that the advance will be expended within the first ninety (90) days of the contract term. Any advance funds not expended within the first ninety (90) days of the contract term shall be returned to the Division Cashier, 2555 Shumard Oak Boulevard, Tallahassee, Florida 32399, within thirty (30) days of receipt, along with any interest earned on the advance) 28 Attachment F Warranties and Representations Financial Management Reciptent’s financial management system must include the following: (1) Accurate, current and complete disclosure of the financial results of this project or program (2) Records that identify the source and use of funds for all activities. These records shall contain information pertaining to grant awards, authorizations, obligations, unobligated balances, assets, outlays, income and interest. (3) Effective control over and accountability for all funds, property and other assets. Recipient shall safeguard all assets and assure that they are used solely for authorized purposes. (4) Comparison of expenditures with budget amounts for each Request For Payment. Whenever appropriate, financial information should be related to performance and unit cost data. {5) Written procedures to determine whether costs are allowed and reasonable under the provisions of the applicable OMB cost principles and the terms and conditions of this Agreement. (6) Cost accounting records that are supported by backup documentation. Competition All procurement transactions shall be done in a manner to provide open and free competition. The Recipient shall be alert to conflicts of interest as well as noncompetitive practices among contractors that may restrict or eliminate competition or otherwise restrain trade. In order to ensure excellent contractor performance and eliminate unfair competitive advantage, contractors that develop or draft specifications, requirements, statements of work, invitations for bids and/or requests for proposals shall be excluded from competing for such procurements. Awards shall be made to the bidder or offeror whose bid or offer is responsive to the solicitation and is most advantageous to the Recipient, considering the price, quality and other factors. Solicitations shall clearly set forth all requirements that the bidder or offeror must fulfill in order for the bid or offer to be evaluated by the Recipient. Any and all bids or offers may be rejected when it is in the Recipient's interest to do so. Codes of Conduct. 29 The Recipient shall maintain written standards of conduct governing the performance of its employees engaged in the award and administration of contracts. No employee, officer, or agent shall participate in the selection, award, or administration of a contract supported by public grant funds if a real or apparent conflict of interest would be involved. Such a conflict would arise when the employee, officer, or agent, any member of his or her immediate family, his or her partner, or an organization which employs or Is about to employ any of the parties indicated, has a financial or other interest in the firm selected for an award. The officers, employees, and agents of the Recipient shall neither solicit nor accept gratuities, favors, or anything of monetary value from contractors or parties to subcontracts. The standards of conduct shall provide for disciplinary actions to be applied for violations of the standards by officers, employees, or agents of the Recipient. Business Hours The Recipient shall have its offices open for business, with the entrance door open to the public, and at least one employee on site, from 8:00 AM — 5:00 PM Monday - Friday Licensing and Permitting All subcontractors or employees hired by the Recipient shall have all current licenses and permits required for all of the particular work for which they are hired by the Recipient. 30 Attachment G ws Certification Regarding _, Debarment, Suspension, Ineligibilit And Voluntary Exclusion Subcontractor Covered Transactions (1) The prospective subcontractor of the Recipient, , certifies, by submission of this document, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. (2) Where the Recipient's subcontractor is unable to certify to the above statement, the prospective subcontractor shall attach an explanation to this form. SUBCONTRACTOR: By: Okaloosa County . Signature / Recipient's Name 15-CP-11-01-56-01-XXX Name and Title DEM Contract Number Street Address Project Number City, State, Zip Date 31 Attachment H Statement of Assurances The Recipient hereby assures and certifies compliance with all Federal statutes, regulations, policies, guldetines-and requirements, including OMB Circulars No. A-21, A-110, A-122, A-128, A-87; E.0. 12372 and Uniform Administrative Requirements for Grants and Cooperative Agreements 28 CFR, Part 66, Common rule, that govern the application, acceptance and use of Federal funds for this federally-assisted project. Also the Applicant assures and certifies that: 1. It will comply with provisions of Federal law which limit certain political activities of employees of a State or lacal unit of government whose principal employment is in connection with an activity financed in whole or in part by Federal grants, (6 USC 1501,et. seq.) 2. It will comply with the minimum wage and maximum hour's provisions of the Federal Fair Labor Standards Act. 3. It will establish safeguards to prohibit employees from using their positions for a purpose that is or gives the appearance of being motivated by a desire for private gain for themselves or others, particularly those with whom they have family, business, or other ties. 4. It will give the sponsoring agency or the Comptroller General, through any authorized representative, access to and the right to examine all records, books, papers, or documents related to the grant. 6. it will ensure that the facilities under its ownership, lease or supervision which shall be utilized in the accomplishment of the project are not listed on the Environmental Protection Agency's (EPA) list of Violating Facilities and that it will notify the Federal grantor agency of the receipt of any communication from the Director of the EPA Office of Federal Activities indicating that a facility to be used in the project is under consideration for listing by the EPA. 7. In the event a Federal or State court or Federal or State administrative agency makes a finding of discrimination after a due process hearing on the Grounds of race, color, religion, national origin, sex, or disability against a recipient of funds, the recipient will forward a copy of the finding to the Office for Civil Rights, Office of Justice Programs. 8. It will provide an Equal Employment Opportunity Program if required to maintain one, where the application is for $500,000 or more. 9. DRUG-FREE WORKPLACE (GRANTEES OTHER THAN INDIVIDUALS) As required by the Drug-Free Workplace Act of 1988, and implemented at 28 CFR Part 67, Subpart F, for grantees, as defined at 28 CFR Part 67 Sections 67.615 and 67.620. 32 Attachment! Hazard Analysis Contract Checklist and CAMEOfm Guide Facility Information (CAMEOfm Facility Page) Facility Name {per Attachment C} ( Facility Page) Facility Physical Address (Facility Page) Latitude and Longitude in Decimal Degrees {ex, 30.197, -84,3621} (Map Data Tab on Facility Page) Facility Phone Number (Facility Phones Tab on Facility Page) Facility Emergency Coordinator Name, Title and 24-hour Emergency Phone Number (Contact Tab on Facility Page) Transportation Route(s) {From County Line to the Facllity} (Notes Tab on Facility Page} Evacuation Route(s) to exit the Vulnerable Zone (Notes Tab on Facility Page) Historical Accident Record {If none, please note} (Notes Tab on Facllity Page) Facility Maximum Occupancy {a minimum of.one Is required for unmanned facilities} (ID Codes Tab on facility Page} Hazard identification (CAMEOsm Chemical in Inventory-Page) (for each Extremely Hazardous Substance on'site) Proper Chemical Name(s) (Chemical in Inventory Page{s}) Chemical Abstract Service (CAS} Number {Chemical in Inventory Page{s}) Physical State in Storage {ex. mixture, pure, liquid, gas} {Chemical in Inventory Page(s}, Physical State and Quantity Tab} Maximum Quantity On-site In Pounds (Chemical in Inventory Page{s}, Physica! State and Quantity Tab) Amount in Largest Container or Interconnected Containers (Chemical in Inventory Page{s}, Physical State and Quantity Tab) Type/Design, Pressure and Temperature of Contalner(s) (cylinder, battery, ambient etc} (Chemical in Inventory Page{s}, Location Tab) Nature of the Hazard {ex. acute, chronic, fire, pressure, etc.} Chemical in Inventory Page(s},