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Okaloosa County BOCC — May 17, 2016 — Okaloosa HA Contract 2016-17 — reading text
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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.
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Codes of Conduct
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 Monday to Friday 8:00 AM - 5:00 PM.
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.
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Attachment G
Certification Regarding
Debarment, Suspension, Ineligibility
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:____________________________ __________________________________
Signature Recipient’s Name
________________________________ __________________________________
Name and Title DEM Contract Number
________________________________ __________________________________
Street Address Project Number
________________________________
City, State, Zip
________________________________
Date
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Attachment H
Statement of Assurances
The Recipient hereby assures and certifies compliance with all Federal statutes, regulations, policies,
guidelines and requirements, including OMB Circulars No. A-21, A-110, A-122, A-128, A-87; E.O. 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 local unit of government whose principal employment is in connection with an activity financed in
whole or in part by Federal grants. (5 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.
5. 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.
6. 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.
7. It will provide an Equal Employment Opportunity Program if required to maintain one, where the
application is for $500,000 or more.
8. 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.
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Attachment I
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 Facility} (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 Facility Page)
Facility Maximum Occupancy {a minimum of one is required for unmanned facilities} (ID and Regs Codes Tab on facility Page)
Select correct check boxes for facilities subject or not subject to section 112r or section 302 (ID and Regs Codes Tab on facility Page)
Hazard Identification (CAMEOfm 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}, Physical State and Quantity Tab)
Maximum amount in Largest Container or Interconnected Containers (Chemical in Inventory Page{s}, Physical State and Quantity
Tab) {This figure will be used as the release amount to determine the vulnerable zone in the Scenario}
Type/Design, Pressure and Temperature of Container(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}, Physical State and Quantity Tab)
Vulnerability Analysis (CAMEOfm Scenario Page) (for each Extremely Hazardous Substance on site)
Enter maximum amount in largest container or interconnected containers in the Amount Released field (Scenario Description tab)
{Must match the Chemical in Inventory Page, Physical State and Quantity Tab, maximum amount in largest container figure}
Enter the concentration percentage in the Concentration field (Scenario Description tab)
Enter Release Duration (10 minutes for gases, solids in solution or powders; no entry for liquids is required) (Scenario Description tab)
Determine the natural Physical State of the chemical at room temp (specified in CAMEO Chemicals) and enter into the Physical State
field (Scenario Description tab)
Weather Information - Use the weather default settings or enter average wind speed (don’t enter a value in the Wind From field) and
Urban or Forest is recommended in the Ground Roughness field. (Scenario Description tab)
Risk Assessment - Rate the Risk, Consequences and Overall Risk of a release occurring {based upon release history & maintenance etc.}
(Scenario Description tab)
Extent of Vulnerable Zone {CAMEO automatically calculates Threat Zone Radius when Edit button and Estimate Threat Zone Radius
buttons are used} (Scenario Description tab)
Enter estimate of Total Exposed Population (Notes Tab on Scenario Page{s})
Enter Critical Facilities {name of critical facility(s) and max occupancy for each; if none, state No Critical Facilities} (Notes Tab on Scenario Page{s})
See scope of work for alternatives.
On-Site Visits (for each Facility and within the Contract Period)
Site Visit Certification Form (Attached to Site Plan Tab on Facility Page) (file name must contain at minimum the SERC number if
applicable and SV – if SERC number is not available facility name and SV. If it’s a telephone call for the sulfuric acid exception the name
of the facility rep spoken to and date of call must be noted on the form. Additional info allowed but not required.)
Site Plan (Attached to Site Plan Tab on Facility Page) {file name must contain at minimum the SERC number if applicable and SP – if
SERC number is not available the facility name and SP – additional info allowed but not required.}
Sufficient Detail to Identify:
Location of Major Building(s)
Name and Location of Extremely Hazardous Substance(s) (if extremely hazardous materials are co-located, noting EHS is acceptable)
Name and Location of Street(s) {At minimum street facility where facility is located and the nearest intersection or cross street.}
Identify Pertinent Access and Egress Points
Note Additional Features Pertinent to Hazardous Materials and Medical Response
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Attachment J
FLORIDA STATE EMERGENCY RESPONSE COMMISSION FOR HAZARDOUS
MATERIALS
HAZARDS ANALYSIS SITE VISIT CERTIFICATION FORM
Facility Name (Please print)
Street Address, City & Zip Code (Please print)
_________________________ __________________
County (Please print) SERC ID #
Name of Facility Representative (Please print)
Facility Representative Signature Site Visit Date
Site Visit Performed by (Please print)
Signature Site Visit Date
The individuals signing above certify that a hazards analysis site visit was
