Volusia_Hold_Harmless_Agreement.pdf
PDF 140 KB Posted
- Solicitation number
- 26-Q-82KO
- Issued by
- Volusia County, Florida
About this file
This Hold Harmless Agreement is a compliance document for the County of Volusia, Florida, applicable to businesses with fewer than four employees participating in County contracts. The agreement requires the business owner to affirm that the company is exempt from Florida's workers' compensation insurance requirements due to employee count limitations, and mandates that all employees be listed on the agreement with signed waivers and releases prior to commencing work. The document specifies that any new employees must be reported to the County Project Manager or designated representative with required documentation before work authorization. The agreement references a separate Master Contract for the Purchase of Refrigerators for the County of Volusia Summer Food Service Program, which involves the acquisition of thirty-three (33) refrigerators meeting specified capacity and operational requirements. Delivery is scheduled between May 18-22, 2026 for initial sites, with six designated sites requiring delivery between June 1-4, 2026. The RFQ was released on April 15, 2026, with a response deadline of April 30, 2026 at 5:00 pm, and the Master Agreement provides for an initial one-year term with year-to-year renewal options upon mutual written agreement.
The agreement establishes a liability framework in which the business owner and employees waive all workers' compensation claims and liens against Volusia County under Florida Statutes Chapter 440, and agree to indemnify and hold harmless the County against all claims, damages, losses, and legal expenses arising from work performed under the contract. The total quotation for refrigerator procurement cannot exceed $50,000.00, with all pricing required to be all-inclusive of the units, components, freight, delivery, and handling. Vendors must provide manufacturer warranty documentation with a minimum of one year of parts and labor coverage, maintain comprehensive insurance including Workers' Compensation with waiver of subrogation, Commercial General Liability insurance with minimum limits of $1,000,000 per occurrence and $2,000,000 general aggregate, and Motor Vehicle Liability insurance with a combined single limit of $300,000. The County qualifies for an exemption from Manufacturers' Federal Excise Tax and Florida sales tax, payment is remitted within forty-five (45) days of invoice receipt or product acceptance, and title and risk of loss transfer to the County upon receipt, inspection, and acceptance. A three percent (3%) local preference is available for qualified businesses located in Brevard, Lake, Orange, Osceola, Seminole, or Volusia County for at least six months prior to the solicitation closing.
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Text version
HOLD HARMLESS AGREEMENT
I, _______________________________________, (print owner’s name), am the owner of
________________________________________________________ (print company name), an incorporated/unincorporated business operating in the State of Florida. As such, I am bound by all laws of the state of Florida, including but not limited to those regarding the workers’ compensation law.
I hereby affirm that I or [the above-named business] employs fewer than four employees, all of whom are listed below, including myself, and therefore, the business is exempt from the statutory requirement for workers’ compensation insurance for its employees. I certify that I will provide the County of Volusia with the name of each new employee together with all required waivers and releases for each prior to any employee being allowed to work to provide services under the Contract set forth below. If any such employee is allowed to work without a signed waiver and release, such action will be a material breach of this Agreement. All signed waivers and releases shall be furnished before the commencement of any work by an employee or the undersigned to the County Project Manager or designated county representative.
On _________________, 20____, the County of Volusia and I or (the above-named business) entered into a Contract for ___________________________________________ (please insert name of Contract) (hereinafter “Agreement”) which is incorporated by reference herein.
On behalf of myself, my business, and the employees listed below, I and they hereby agree to waive and release any and all workers’ compensation claims or liens under Chapter 440, Florida
Statutes, against the County of Volusia and its agents, officials and employees, arising from any work or services provided under the Agreement whether or not it shall be alleged or determined that the act was caused by intention, or through negligence or omission of the County of Volusia or its agents, officials and employees or subcontractors.
In the event that a workers’ compensation claim or lien is made against the County of
Volusia and/or its agents, officials or employees by myself or my employees or agents as a result of any work or services performed under the Agreement, I agree to indemnify, keep and hold harmless the County of Volusia, Florida, its agents, officials and employees, against all injuries, deaths, losses, damages, claims, liabilities, judgments, costs and expenses, direct, indirect or consequential (including, but not limited to, fees and charges of attorneys and other professionals) arising out of the Agreement with the County of Volusia, whether or not it shall be alleged or determined that the act was caused by intention or through negligence or omission of the County of Volusia or its employees, agents, or subcontractors. I or the above-named business shall pay all charges of attorneys and all costs and other expenses incurred in connection with the indemnity provided herein, and if any judgment shall be rendered against the County of Volusia in any action indemnified hereby, I or the above-named business shall, at my or its own expense, satisfy and discharge the same. The foregoing is not intended nor should it be construed as, a waiver of sovereign immunity of the COUNTY OF VOLUSIA under Section 768.28, Florida Statutes.
Owner: ___________________________ (print name) ___________________________
(signature)
Employee 1: ___________________________ (print name) ___________________________
(signature)
Employee 2: ___________________________ (print name) ___________________________
(signature)
Employee 3: ___________________________ (print name) ___________________________
(signature)
STATE OF _____________________________
COUNTY OF ___________________________
Sworn to and subscribed before me this ____ day of ________________, 20____, by
_____________________________________________________, who is/are personally known to me or who has/have produced ____________________________________ as identification.
NOTARY PUBLIC – STATE OF __________________
Type or print name:
Commission No.: __________________________
(Seal) Commission Expires: __________________________
HOLD HARMLESS AGREEMENT
| Owner: |
| Employee 1: |
| Employee 2: |
| Employee 3: |
| Owner's Name: |
| Company Name: |
| Month - Day: |
| Year: |
| Name of Contract: |
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