Okaloosa County BOCC — May 17, 2016 — Okaloosa HA Contract 2016-17 — reading text

Dale Brazel 10240 Hawkins Road Okaloosa Chlorine 850-978-0020 Fort Walton Beach, 32547 Okaloosa County-Kennedy Lakes Water Well Dale Brazel 30393 97 West Navajo Trace Okaloosa Chlorine 850-978-0020 Crestview, 32536 Okaloosa County-Live Oak Water Well Dale Brazel 10245 Live Oak Road Okaloosa Chlorine 850-978-0020 Crestview, 32536 Okaloosa County-Longwood Water Well Dale Brazel 10236 Sunset Lane and Sharilyn Drive Okaloosa Chlorine 850-978-0020 Shalimar, 32579 Okaloosa County-Lowery Water Well Dale Brazel 20758 Lowery Drive and Commanche Avenue Okaloosa Chlorine 850-978-0020 Fort Walton Beach, 32547 Okaloosa County-Newcastle Water Well Dale Brazel 10238 Newcastle Drive and Ross Road Okaloosa 850-978-0020 Fort Walton Beach, 32547 Okaloosa County-North Beal Extension Site Dale Brazel 15331 1564 Percy L Coleman Road Okaloosa Chlorine 850-978-0020 Fort Walton Beach, 32548 27 03/23/2016  ATTACHMENT C - OKALOOSA COUNTY SECTION 302 FACILITY LIST 2016-2017 Okaloosa County-Northgate Water Well Dale Brazel 10241 Jonquil Avenue Okaloosa Chlorine 850-978-0020 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 850-978-0020 Fort Walton Beach, 32547 Okaloosa County-Russell Stephenson WWTP Darren Alford 10249 3182 West US Highway 98 Okaloosa Chlorine 850-651-7179 Mary Esther, 32569 Okaloosa County-Seashore Village Water Well 4 Dale Brazel 9353 US Highway 98 and Woodland Park Circle Okaloosa Chlorine 850-978-0020 Mary Esther, 32569 Okaloosa County-Shalimar Water Well Dale Brazel 10234 Seventh Street Okaloosa Chlorine 850-978-0020 Shalimar, 32579 USAF - Eglin Area IV Bruce Stippich 22226 700 Range Road Okaloosa Chlorine 850-885-2601 Eglin AFB, 32542 28 03/23/2016  Attachment D FINANCIAL INVOICE FORM FOR HAZARDOUS MATERIALS HAZARDS ANALYSIS UPDATE _________________________________________________________________ RECIPIENT: Okaloosa County AGREEMENT# 17-CP-11-01-56-01-XXX AMOUNT AMOUNT APPROVED REQUESTED BY THE BY THE RECIPIENT DIVISION 1. First Payment (45% of contract amount) $ $ (50% Hazards Analyses submitted and approved) 2. Second Payment (45% of contract amount) $ $ (50% Hazards Analyses submitted and approved) 3. Final Payment(10% of contract amount) $ $ (approval, distribution & notification) TOTAL AMOUNT $ $ (To be completed by the Division) I 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) 29  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) ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ 30  Attachment F Warranties and Representations Financial Management Recipient’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