Required Certifications.pdf

Required Certifications

All sections must be initialed, and the last page signed by an authorized representative of the submitting company.

initial

Anti-Human Trafficking Affidavit A. Contractor understands and affirms that Section 787.06(13), Florida Statutes, prohibits the City from executing, renewing, or extending a contract to entities that use coercion for labor or services, with such terms defined as follows:

Contractor hereby attests, under penalty of perjury, that Contractor does not use coercion for labor or services as defined in Section 787.06(2), Florida Statutes.

a. “Coercion” means: (1) using or threatening to use physical force against any person; (2)restraining, isolating, or confining or threatening to restrain, isolate, or confine any person without lawful authority and against her or his will; (3) using lending or other credit methods to establish a debt by any person when labor or services are pledged as a security for the debt, if the value of the labor or services as reasonably assessed is not applied toward the liquidation of the debt, the length and nature of the labor or services are not respectively limited and defined; (4) destroying, concealing, removing, confiscating, withholding, or possessing any actual or purported passport, visa, or other immigration document, or any other actual or purported government identification document, of any person; (5) causing or threatening to cause financial harm to any person; (6) enticing or luring any person by fraud or deceit; or (7)providing a controlled substance as outlined in Schedule I or Schedule II of Section 893.03,Florida Statutes, to any person for the purpose of exploitation of that person.

b. “Labor” means work of economic or financial value.

c. “Services” means any act committed at the behest of, under the supervision of, or for the benefit of another. The term includes, but is not limited to, forced marriage, servitude, or the removal of organs.

B. Contractor hereby attests, under penalty of perjury, that Contractor does not use coercion for labor or services as defined in Section 787.06(2), Florida Statutes.

Debarment and Suspension A. Contractor certifies that the Contractor and any person associated with the

Contractor in the capacity of owner, partner, director, officer, principal, investigator, project director, manager, auditor, or position involving the administration of public funds:

a. is not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from government transactions by any federal, state, or local governmental entity;

b. has not within a three-year period preceding this certification been convicted of or had a civil judgment rendered against it for:

commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a federal, state, or local government transaction or public contract; violation of federal or state antitrust statutes; or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property;

c. is not presently indicted for or otherwise criminally or civilly charged by a federal, state, or local governmental entity with commission of any of the offenses enumerated this certification; or

d. has not within a three-year period preceding this certification had one or more federal, state, or local government public transactions terminated for cause or default.

B. By executing this Agreement and each and every renewal hereof (if renewal is separately provided for herein), pursuant to section 287.135, Florida Statutes, Contractor certifies, represents, and warrants that:

a. it is not on the Scrutinized Companies with Activities in Sudan List,

b. it is not on the Scrutinized Companies with Activities in the Iran

Petroleum Energy Sector List,

c. it is not on the Scrutinized Companies with Activities in Iran Terrorism

Sectors List,

d. that it does not have Business operations or is engaged in business in

Cuba or Syria, and

e. that it is not engaged or engaging in a Boycott of Israel, and that all such certifications were true at the time it submitted its bid or proposal for this Agreement, as of the Effective Date of this Agreement, and as of the effective date of any renewal of this Agreement.

C. The Contractor certifies that it shall not knowingly enter into any transaction with any subcontractor, material supplier, or vendor about which any of the foregoing paragraphs are not true.

D. Notwithstanding anything contained in this Agreement to the contrary, the City of Largo may terminate this Agreement immediately for cause if:

a. Contractor is found to have submitted a false certification regarding (a)

– (d) above in accordance with section 287.135(5), Florida Statutes,

b. Contractor is found to have been placed on the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List, or is or has been engaged in Business operations in Cuba or Syria or a Boycott of Israel, or

c. Contractor is found to have been placed on a list created pursuant to section 215.473, Florida Statutes, relating to scrutinized active business operations in Iran.

Such termination shall be in addition to any and all remedies available to the City of Largo at law or in equity. The terms “Boycott of Israel” and “Business operations” used in this section are defined as in Section 287.135, Florida Statutes.

The Lists referred to in this section are those Lists in and maintained pursuant to section 287.135, Florida Statutes.

Foreign Countries of Concern The Contractor certifies that the Company is not:

A. Owned or controlled by the government of the People’s Republic of China, the

Russian Federation, the Islamic Republic of Iran, the Democratic People’s Republic of Korea, the Republic of Cuba, the Venezuelan regime of Nicolás Maduro, or the Syrian Arab Republic (collectively and individually, a Foreign Country of Concern), including any agency of or any other entity of significant control of such Foreign Country of Concern. Where ‘controlled by’ means having possession of the power to direct or cause the direction of the management or policies of a company, whether through ownership of securities, by contract, or otherwise; or a person or entity that directly or indirectly has the right to vote 25 percent or more of the voting interests of the company or that is entitled to 25 percent or more of its profits is presumed to control the foreign entity; or

B. A partnership, association, corporation, organization, or other combination of persons organized under the laws of or having its principal place of business in a Foreign Country of Concern, or a subsidiary of such entity.

Insurance Requirements The Contractor agrees to obtain and maintain the following:

TYPE MINIMUM LIMIT

REQUIRED

DESCRIPTION

General Liability – Commercial

$2,000,000.00 General Aggregate

General Liability – Occurrence Form

$1,000,000.00 Product/Completed Operation Aggregate

$1,000,000.00 Personal and Advertising Injury

$1,000,000.00 Each Occurrence Auto Liability – Owned, Hired, and Non-Owned

$1,000,000.00 Combined Single Limit per Occurrence

Worker’s Comp and Employers Liability

$100,000.00 Each Incident

$500,000.00 $100,000.00

A. The Certificate of Insurance must show “The City of Largo, its elected officials and employees” as an additional insured. The Certificate shall bear the requisite endorsements providing that the City is an additional insured and providing for waiver of subrogation by the Proposer/Subcontractor when applicable.

B. Contractor shall provide immediate notice of any Contractor or Subcontractor initiated cancellation, non-renewal or adverse change to the policies required to be obtained or maintained pursuant to this solicitation. Contractor shall immediately forward to the City any notice it receives of cancellation, non-renewal or adverse change to any policy that is initiated by a policy provider(s).

C. Certificates must identify proposal title and proposal number.

D. Subcontractors must carry the same insurance limits.

E. Insurance carrier must be A rated.

F. The City reserves the right to request any additional information it deems necessary, and at a frequency it deems necessary, to confirm the requisite insurance remains in effect, at the required levels, for the duration of any contractual agreement entered into.

Public Records Pursuant to section 119.0701, Florida Statutes, for any tasks performed by Proposer on behalf of the City, Proposer shall: (a) keep and maintain all public records, as that term is defined in chapter 119, Florida Statutes (“Public Records”), required by the City to perform the work contemplated by this Agreement; (b) upon request from the City’s custodian of public records, provide the City with a copy of the requested Public Records or allow the Public Records to be inspected or copied within a reasonable time at a cost that does not exceed the costs provided in chapter 119, Florida Statutes, or as otherwise provided by law; (c) ensure that Public Records that are exempt or confidential and exempt from Public Records disclosure requirements are not disclosed except as authorized by law for the duration of the term of this Agreement and following completion or termination of this Agreement, if Proposer does not transfer the records to the City in accordance with (d) below;

and (d) upon completion or termination of this Agreement, (i) if the City, in its sole and absolute discretion, requests that all Public Records in possession of Proposer be transferred to the City, Proposer shall transfer, at no cost, to the City, all Public Records in possession of Proposer within thirty (30) days of such request or (ii) if no such request is made by the City, Proposer shall keep and maintain the Public Records required by the City to perform the work contemplated by this Agreement.

If Proposer transfers all Public Records to the City pursuant to (d)(i) above, Proposer shall destroy any duplicate Public Records that are exempt or confidential and exempt from Public Records disclosure requirements within thirty (30) days of transferring the Public Records to the City and provide the City with written confirmation that such records have been destroyed within thirty (30) days of transferring the Public Records. If Proposer keeps and maintains Public Records pursuant to (d)(ii) above, Proposer shall meet all applicable requirements for retaining Public Records. All Public Records stored electronically must be provided to the City, upon request from the City’s custodian of public records, in a format that is compatible with the information technology of the City. If Proposer does not comply with a Public Records request or does not comply with a Public Records request within a reasonable amount of time, the City may pursue any and all remedies available in law or equity including, but not limited to, specific performance. The provisions of this section only apply to those tasks in which Proposer is acting on behalf of the City.

IF THE PROPOSER HAS QUESTIONS REGARDING THE

APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO

THE PROPOSER’S DUTY TO PROVIDE PUBLIC RECORDS

RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN

OF PUBLIC RECORDS AT: Telephone number: (727) 587- 6710 ext. 7003 E-mail address: dbruner@largo.com

Mailing address: City of Largo, Attn: City Clerk, P.O. Box 296, Largo, Florida 33779-0296

I, the undersigned, hereby represent that I make the above attestation based upon personal knowledge; am over the age of 18 years and otherwise competent to make the above attestation;

and am authorized to legally bind and make the above attestation on behalf of the submitting corporation. Under penalties of perjury, I declare that I have read the forgoing document and that the facts stated in it are true.

Signature: _________________________ Date: _________________________

Print Name: ________________________ callto:%28727%29%20587-6710 callto:%28727%29%20587-6710