R00-178RESOLUTION NO. R 00-/2',~
A RESOLUTION OF THE CITY COMMISSION OF THE
CITY OF BOYNTON BEACH, FLORIDA, AUTHORIZING
AND DIRECTING THE MAYOR AND CITY CLERK TO
ACCEPT AND EXECUTE THE STATE OF FLORIDA,
DEPARTMENT OF HEALTH GRANT, IN THE AMOUNT
OF $248,000.00, PROVIDING FOR REIMBURSEMENT IN
SAID AMOUNT TO THE UTILITY GENERAL RESERVE
ACCOUNT FOR THE FLUORIDATION EQUIPMENT TO
BE INSTALLED AT THE EAST AND WEST WATER
TREATMENT PLANTS; AUTHORIZING THE MAYOR TO
EXECUTE ALL OTHER NECESSARY DOCUMENTATION
PROVIDED BY THE STATE TO EFFECT RECEIVING
SAID GRANT FUNDS; AND PROVIDING AN EFFECTIVE
DATE.
WHEREAS, the City of Boynton Beach Utility Department applied for and
has been awarded a grant from the State of Florida, Department of Health in the
amount of $248,000.00, which will provide for reimbursement to the Utility General
Reserve account for fluoridation equipment to be installed at the east and west
water treatment plants, and;
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COMMISSION OF
THE CITY OF BOYNTON BEACH, FLORIDA, THAT:
Section 1. The City Commission of the City of Boynton Beach hereby
authorizes and directs the Mayor and City Clerk to accept and execute the grant in
the amount of $248,000.00, which will provide for reimbursement to the Utility
General Reserve account for fluoridation equipment to be installed at the east and
west water treatment plants. A copy of the agreement and other documentation is
attached hereto as composite Exhibit "A."
Section 2. This Resolution shall become effective immediately upon
passage.
PASSED AND ADOPTED this /~' day of December 2000.
Vice Mayor .----.. ~ // '~'-~_ ~.
uommlssloner
Commissioner
Commissioner
ATTEST:
Cit.CCleCk - -
Jeb Bush
Governor
HEAl THI
Robert G. Brooks, M.D.
Secretary
Bob Kenyon
Utilities Director
City of Boynton Beach
100 F:. Boynton Beach Boulevard
Boynton Beach, FL 33425
Dear Mr. Kenyon:
November 29, 2000
Enclosed are the following documents: a memo of negotiation, a certification regarding
debarment and two original contracts regarding payment for the fluoridation equipment for the
city of Boynton Beach. The memo of negotiation needs to be signed and dated by you. The
certification regarding debarment needs to be signed and dated by Mr Broening. The two
original contracts need to be signed and dated by Mr. Broening on page 4 under provider and
on page 14 (certification regarding lobbying).
Also enclosed is a sample letter of request for payment, which needs to be typed on your city
letterhead and then signed and dated by Mr. Broening.
Please send the memo of negotiation, debarment form, contracts and letter of request for
payment (all with original signatures) immediately back to me. We (the department) will sign
them and process the request for payment through Central Finance. I will send you one
Contract with original signatures and the department will keep one. You should receive your
check within six to eight weeks after we have received the signed contract from you.
!f you have any questions, please do not hesitate to call.
Sincerely,
Rhoda A. Lawrence, RDH
Fluoridation Project Coordinator
Public Health Dental Program
(850) 245-4333
Enclosures
4052 Bald Cypress Way, Bin #A-I4, Tallahassee, FL 32399-1724
The Ci o Bo nton Beach
OFFICE OF ~ CITY MANAGER
1 O01~. ~oynton t~ecwh Bc~lev~d
P.O. B~ 310
~ynt~ B~ ~ ~25-0310
F~' (~61) 742~011
~' ~.~ b~ton-b~
December 5, 2000
Dr. I-Lany W. Davis, D.D.S.
Department of Health
Dental Executive Director
Public Health Dental Program
4052 Bald Cypress Way
Bin #A-14
Tallahassee, FL 32399-1724
Contract No: COHV4
Amount: $248,000.00
Dear Dr. Davis:
In reference to contract COHV4, the City of Boynton Beach requests funding in the
amount of $248,000.00 from the Florida Fluoridation Grant administered by the
Department of Health. These funds will be used to fluoridate our community water
supply.
We agree to comply with the conditions of the State of Flodda, Department of Health,
other Governmental Agencies Contract #COHV4.
We are aware that the grant program is based upon the availability of funds under this
or any duly authorized successor grant; and that the Public Health Dental Program has
no funding obligation if the grant ends without a successor grant.
Sincerely,
Gerald Broening,
Mayor, City of Boynton Beach
59-6000282
Federal I.D. Number
Memorandum of Negotiation
Contract # COHV4
The amount of the contract was discussed and confirmed on 9/19/00 in a telephone
conversation with:
Name: Position
Bob Kenyon Utilities Director
Representing:
the City of Boynt0n Beach. and
Name:
Rhoda Lawrence
Position:
Fluoridation Project Coordinator
Representing the Department of Health, for the purpose of negotiating a contract for the
following services:
Fluoridation equipment and installation for water system
Contract terms and conditions were reviewed: []
Outcome measures were reviewed: []
Department Representative
CERTIFICATION REGARDING
DEBARMENT~ SUSPENSION~ INELIGIBILITY AND VOLUNTARY EXCLUSION
CONTRACTS / SUBCONTRACTS
This certification is required by the regulations implementing Executive Order 12549, Debarment
and Suspension, signed February 18, 1986. The guidelines were published in the May 29, 1987
Federal Register (52 Fed. Reg., pages 20360-20369).
INSTRUCTIONS
1. Each provider whose contract/subcontrect equals or exceeds $25,000 in federal monies
must sign this certification prior to execution of each contract/subcontract. Additionally,
providers who audit federal programs must also sign, regardless of the contract amount.
DOH cannot contract with these types of providers if they are debarred or suspended by
the federal government.
This certification is a material representation of fact upon which reliance is placed when
this contract/subcontract is entered into. If it is later determined that the signer knowingly
rendered an erroneous certification, the Federal Government may pursue available
remedies, including suspension and/or debarment.
The provider shall provide immediate written notice to the contract manager at any time
the provider learns that its certification was erroneous when submitted or has become
erroneous by reason of changed circumstances.
The terms "debarred", "suspended", "ineligible", "person", "principal", and ~voluntarily
excluded", as used in this certification, have the meanings set out in the Definitions and
Coverage sections of rules implementing Executive Order 12549. You may contact the
contract manager for assistance in obtaining a copy of those regulations.
The provider agrees by submitting this certification that, it shall not knowingly enter into
any subcontract with a person who is debarred, suspended, declared ineligible, or
voluntarily excluded from participation in this contract/subcontCact unless authorized by
the Federal Government.
The provider further agrees by submitting this certification that it will require each
subcontractor of this contract/subcontrect, whose payment will equal or exceed $25,000
in federal monies, to submit a signed copy of this certification.
The Department of Health may rely upon.a certification of a provider that it is not
debarred, suspended, ineligible, or voluntarily excluded from contracting/subcontrecting
unless it knows that the certification is erroneous.
This signed certification must be kept in the contract manager's file. Subcontractor's
certifications must be kept at the contractor's business location.
(1)
CERTIFICATION
The prospective provider certifies, by signing this certification, that neither it nor its
principals is presently debarred, suspended, proposed for debarment, declared ineligible,
or voluntarily excluded from participation in this contract/subcontract by any federal
department or agency.
(2) 'Where the prospective provider is unable to certify to any of the statements in this
.,certification, su.~h prospective provider shall attach an explanation to this certification.
Signature Date
Name Gerald Boening
Title Mayor, City of Boynton Beach
WD7/1/99
3/1/99
CFDA No. 93.991 ' Client f'-[Non-Client []
'~aats and Aids YES Multi-County []
STATE OF FLORIDA
DEPARTMENT OF HEALTH
STANDARD CONTRACT
THIS CONTRACT is entered into between the State of Florida. Department of Healfl".. hereinafter referred to as the department, and
Cl~( OF BOYNTON BEACH hereinafter referred to as the provider,
THE PARTIES AGREE:
I. THE PROVIDER AGREES:
A. To provide services in accordance with the conditions specified in Attachment I.
B. Requirements of §287.058, Flotida Statues (F$)
To provide untis of deliverables, including repods, findings, and drafts as specified in Attachment I. to be received and accepted by the contract manager prior to
sayment To Comply with the criteda and final date by which such criteria must be met for completion of this contract as specified in Section itl, Paragraph A. of
this contract To submit bills for fees or other compensation for cervices or exeenses in sufficient detail for a proper pre-audit and post-audit thereof. Where
applicable, to submit bills for any travel expenses in accordance with §112.061. FS. The deparbnent may, if specified in Attachment t. establish rates lower than
the maximum provided in §112.061 FS. To allow cub]lc access to all aocumen[s, papers, lettem, or other materials subject to the 3rovisions of Chapter 119, FS,
made or received by the provider in conjunction with this contract. It is exoressly undemtend that the provider's refusal to comply with this provision shall constitute
an immediate breach of contract.
C. TO the Following Governing Law
1. State of Florida Law
a. This contract is executed and entered into in the State of Flodda. and shall be construed, performed, and enforced in all respects in accordance with the laws,
rules, eno rsgulations of'the State of Flodda. Each party shall perform its obligations herein in accordance with the terms and conditions of the contract
b. The provider or its agent agrees to notify the Florida Depatiment of Children and Families of all entry level employment opportunities associated with this
contract which requ re a high school education or less. The Department of Children eno Families will contact the WAGES Coordinator fn the Florida
Department of Labor and Employment Secudty reg~enal office and request that WAGES participams be referred to the provider. WAGES is an initiative to
empower recipients in the Temporary Assistance for Needy Families (TANF) program to enter and remain in gainful employment. Employment of WAGES
parficipenta is a mutually beneficial goal for the provider and the State of Florida. in that it provides qualified entPJ level employees needed by many providers
and provides substantial savings to the citizens of Flodda.
2, Federal Law
· ~a; ]f this contract contains federal funds, the srovider shall comply with the provisions of 45 CFR, Part 74 and/or 45 CFR. Part 92. and other appliceble
regulations as specified in Attachment I.
If this corm'act contains federal funds and is over $100,000. the provider shall comply with ail applicable standards, ordain, or regulations issued unbar §306 of
the Clean Air ACt. as amended I42 U.S.C. 1857(h) et seq.), §508 of the Clean Water Act. as amended (33 U.S.C. 1368 et seq J, Executive Order 11738, and
- Environmental Protecaon Agency regutabons (40 CFR Part 15). The provider shell repor~ any violations of the above fu the department
c, ]f this contract contains federal funding in excess of $100.000. the provider must, pdor to contract execution, complete the Certification Regarding Lobbying
form, Attachment lW. If a Disclosure of Lobbying Activities form. Standard Form LLL. is required, ti may be obtained from the comract manager. All
disciesuro;forms as required by the Certification Regarding Lobbying form must be comptsted and returned to the contract manager.
o Not to employ unauthorized aliens. The department shall consider employment of unauthodzec aliens a violation of §§274A(e) of the Immigration and
Natueiizabon Act. Such violation shall be cause for unilateral cancellation of this contract by the department.
e. The provider and any subcontractnts agree to comply with Pro-Children ACt of 1994. Public Law 103-277. which requires that smoking not be permitted in any
portion of :any indoor facility used for the pro.sion of federally funded services including health, day care, early childbood development education or library
services on a routine or regular basis, to children up to age 18. Failure to comply with the orovisiens of the law may result in the imposition of civil monetary
penalty of up to $1.000 for each violation end/er the impesit on of an adm n strafive comp anco order on the responsible entity.
D. Audits, Records, and Records Retention
To establish and maintain books, records, and documents (including electronic storage media) n accordance with generally accepted accounting procedures
and practices which sufficiently and properly reflect all revenues and expenditures of funds provided by the department under this contract.
2. To retain gll client records, financial records, supps~ng documents, statistical records, ano any other documents (including electronic storage media) pertinent
to this contract for a betiud of ~ve (5) years after termination of the contract, or if an audit has been initiated and audit findings have not been resolved at the
end of five (5) years, the records shall be retained until resolution of the audit findings or any litigation which may be based on the terms of this contract.
3. Upon completion or termination of the contract and at the request of the department, the provider will cooperate with the depadment to facilitata the duplication
and transfer of any said records or documents during the required retention pefind as specified in Section I, paragraph D.2. above.
4. To assure that these records shall be subject at all reasonable times to inspection, review, or audit by Federal. state, or other personnel duly authorized by the
depadment.
5, Persons duly authorized by the department and Federal auditors, oursuant fo 48 CFR, pati 92.36(i}(10}, shall have full access ta end the tight to examine any
of provider's contract and related records and documents, regardless of the form in which kept, at all reasonable times for as long as records are retained.
6. To provide a financial and compliance audit to the department as specified in Attachment I.~_1 and to ensure that all related party transactions are disciesed to
the auditor.
7. To include:these aforementioned audit and record keeping requirements in all approved subcontracts and assignments
E.Monitoring by the Department
To permit persons duly authorized by the department to inspec~ any records, papers, documents, facilities, and/or goods and services of the provider which are
relevant to this contract, and/or interview any ctieuls and employees of the provider to assure the department of seflsfactory performance of the terms and
conditions of this contract. Following such evaluaUon the department will deliver to the provider a written report of its findings and will include written
~commendatibes with regard to tbe provider's performance of the terms and conditions of this contract. The provider will correct all noted deficiencies identified by
; department within the specified period of time set forth in the recommendations. The provider's failure to correct noted deficiencies may, at the sole and
~usive discretion of the deparinlent result in any one or any combination of the following: (1) the provider being deemed in breach or default of this contract; (2)
; withholding of payments to the provider by the deparlment; and (3) the termination of this contract for cause.
DH STDCT WI' 7/1/99 1 CONTRACT # COl-IV4
3/1/99
F. indemnification
NOTE: Paragraph I.F.1. and LF.2. are not appllceble to contracts executed between state agencies or subdivisions, as defined in §768.28, FS.
1. The provider shall be liable for and shall indemnify, defend, and hold harmless the department and all of its officers, agents, and employees from all ctalms-
suits, judgments, or damages, consequential or otherwise and including attorneys' fees and costs, adsing out of any act, actions, neglect, or omissions by th
p o~der, ts agents, or employees dur ng the performance or operat on of th s contract or any subsequent mod~ficafions thereof, whether direct or ind]re¢
and whether to any person or tangible or intangible properfy.
2. The provider's inability to evaluate liability or its evaluation of liability shall not excuse the provideCs duty to defend and indemnify within seven (7) days after "'
such notice by the department is given by certh3ed mail. Only adjudication or judgment after highest appeal is exhausted specifically finding the provider not
liable shall excuse performance of this provision. The provider shall pay all costs and fees related to this obligation and its enforcement by the department.
The department's failure to notify the provider of a claim shall not release the provider of the above duty to defend.
G. Insurance
To provide adequate liability insurance coverage on a comprehensive basis and to hold such liability insurance at all times during the existence of this contract and any
renewal(s) and extension(s) of it. Upon e,~ecution of this contract, unless it is a state agency or subdivision as defined by §768.28, FS, the provider accepts fuji responsibility
for identifying and date~nining the lype(s} and extent of liability insurance necessary te provide reasonable financial pratedJons for the provider and the clients to he served
under this contract. Upon the execufion of this contract, the ~rovider shall furnish the depariment written vepfication supporting both the determination and e.,dstence of such
insurance coverage. Such coverage may be provided by a self-insurance ~rogram estepllshed and ocoraling under the laws of the State of F]odda. The department resewes
the fight to require additional insurance as specified in Attachment ] where appropriate.
H. Safeguarding Information
Not to use or disclose any information concemieg a recipient of services under this contract for any purpose not in conformity with state regulations and federal law
or regulations (45 CFR. Part 205.50), except upon wdtten consent of the recipient, or his responsible parent or guardian when authedzed by law.
I. Assignments and Subcontracts
1. To se~her assign the rasponsibili'~ of this centract to anuther party nor subcontract for any of the wont corC~ernplated under this contract without pher wntten epproval of
the depadment which shat not be unreasonably withheld. Any sub4icense, assignment, or transfer othemdse occurring shalt be null and void.
2. ~ provider shall be mspnnsible for all work pen~m~cl and ali expenses incunsd with ~he projec[ ff ~e deperbnest permits the provider to su~ct all or pat of ~e
work contemplated under this cantmct, inclucling ente~bg into subea'Y~acts with vendors for sewices and commndi§es, it is understood by ~'e provider that the deparimest
shall not be liable to the subcordmctor for any e.xge~ses or lisbili~s incaned u~der the subesnf~act and the provider shall be salely lisb[e to the subcontractor for all
e~peeses and liablii~es incurred under the su~ct. ~ provider, at f~ eaq3enes, will defend the department against such claims.
3, q'ne Sfefe of Florida shall at all times be entitled to assign or transfer its ~ghts, duties, or obligations under this contract to another govemmental agency in the State of
Florida, upon giv~ pder written notice te tf~ provider. In the event the State of Ronda ?.ppreves transfer of the provider's obligations, the provider remains respons~ia
for all work performed and all expenses incurred in connection with the con~act, in addition, this contract shall bind the successors, assigns, and legal repmsentalives
oftbe provider and of any legal enti'[y that succeeds to the obligations of the State of Florida.
4. Unless othem4se stated in the contract between the provider and subcontractor, payments made by the provider to the subcontractor must be within seven (7) working
days alter receipt of full o~ pariial payments from the depa,"d~ent in accordance with ~j287.0585, FS. Failure to pay within seve~ (7) woridng days w? result in a penalty
charged against the provider and paid to the subcontractor in the amount of ons-half of one (1) percent of the amount due per day from the expirafion of the pedod
alloyed herein for payment. Suc~, penalty sha~ be in addifl(~ to actual payments owed and shell not exceed ~een (15) percent of the outstandi~4] balance des.
J, Return of Funds
To ratum to the depedment any oveq~aymente due to unsemed funds or funds disallows3 pursuant to the terms of this conb'a.c~ that v, ere disbu~ .ed to the provide~ ~j th
department. In the event that the provider or its independent auditer discovers that overpayment has been nmde, the provider &hall repay said overpayment within 4
caidndsr days without prior ~3tifiesfion from the depaYmlent. [n the ~ that the d ~ep~nt first dis~o~rs an ov.e. rpayment has been made, the depedment ,Mil notify
provider by teiter of such a finding. Should repayment not ~e made in atimely manner, the depedment ~all charge ~nterest of one (1} percent per month compounded on the
outstarafing belance after 40 calendar days alter the date of notification or discovery.
K. Incident Reporting
Client P, iak Prevention
If sendces to clients will be provided under this contract, the provider and any subcontractors shall, in accordance with the citent risk prevention system
report ~ese repealable sitoatioes listed in HRSR 215-6 Paragraph 5. in the manner prescribed in HRSR 215-6.
2 Abuse, Neglect, and Exploitation Reporting
In compliance with Chapter 415, FS, en employee of the provider who knows or has reasonable cause to suspect that a child, aged person, or disabled adult
is or has been abused, neglected, or exploited shall immediately rapott such knowledge or suspicion to the Florida Abuse Hatline on the single stetewide tell-
free telephone number (1-800-96ABUSE).
L Transportation Disadvantaged
If disets ara to be lmespo~ted under this contract, ~ provider will comply with the previaiaes of Chapter 427. FS, and Rule Chapter 41-2. FAC. The provider sh~ submit to
the deparbnsnt the raports required pursuant to Volume 10. Chapter 27. HRS .~z~countieg Proesdums Manual.
M. purchasing
1. PRIDE
it is agreed that any ar'dales which are ~ subject of. or am required to cam/out this con~'act shall be pun:~ased from prison Rehabilita~ve lndus~ies and DNeralfieq
Enteq3rises, Inc (pPJDE) ~ under Chapter ~16. FS, in the same manner and under the presedums se{ to~h id ~)46.515(2) and (4), FS. For puq~ases of this
required by law. An abdm~atbd ist of pmducts/ssn~ces avalable from pRIDE may ~e obtained by contacting PRIDE, (904] 487-3774.
2. procurement of Mataists w~h Resyded Content
tt is expressly unpenit~3nd and agreed that any products or materials which are the subject of. or ara requ[rsd to camJ sut thia co~ract shell he PraCUmd in acooatance with
N. Civil Rights Requirements
Note: N.I. applies only to providers with ~es~ [15) or more employees. N.2. applies only to p~oviders providing direct senaces to clients and if fiifeen (15) or more
~ The provider ~11 not discriminate against any en~ployee in the performance of fhia cordra_ct, or against any applicant for empioyme~, b~_.caus~ of age, fa?, mcre~d. ~
cctor, disability, national pdgin, or sex. The provider further assures that a. li contractors, subes~d~actors, su~.~, ~r cthe? with whom ~t.erranges to prov~
sewices or benefits to pantcipants er employees in connection with any of its programs and activities am nat d~scr~nthating against those gerti(~pents or employees
because of age, race, creed, co,er, disability, nafional origin, or sex.
2 Compliance Questionnaire
in accordance with HRSM 220-2. the provider agrees to complete the Civil Rights Compliance Que~onnaira, DH Forms 946 A and B if sewioes are directly pravids
to of~eofs and if 15 or more indMduais ara employed.
DH STDCT w-r 7/1/99 2 CONTRACT # COHV4
3/1/99
O. Independent Capacity of the Cona-actor
In the pedormance of this contract, it ~s agreed ~ the pa~es that the provider is an independent contmcter and that the provider is so~ely liable for the
performance of all tasks contemplated by this contract which are not the exclusive respansibtiity of the depariment.
Except where the provider is a state agency, the provider, its officem, agents~ employees, subcontractors, or assignees, in performance of this contract, sha~l act in the
cepadty of an independent contractor and not as an officer, employee, or agent of the State of Florida. Nor shat[ the provider mpresant to others that it has the authority
· · te bind the department unless specifically authorized to do so.
3. Except wham the ProVider is a state agency, noither the Provider, ts officers, agents, em¢oyses, asbcnoaactom, nor assignees am entifisd to state retirement or state leave
be~s, or to any other compnosatlen of state employment as a resuti of performing the duties and obliga~ons of this cor~act.
4. 3Tie provider agrees to take such ac~ons as may be necessary to ensure that each subcontractor of the provider will be deemed to be an independent conb'acter and
will not be considered or permitted to be an agent, servant, joint venturer, or pariner of the State of Floitda.
5. Unless justified by the provider and agreed to by the department in Attachment I. the department will not fomish ee~ces ~f suppor~ (e.g., office soace, of~e supplies,
telanhone sen/ice, sacratadal, or dedcol support) to the provider, or ~s subcontractor or assignee.
6. All dedu~nos for social secunty, withholding taxes, income taxes, contdbuticns to unemDidymem compensation funds, and ali necessary insurance for the ~revider
the omvider's officers, employees, agenzs, suPcontractors or ass~nees shall ha the responsibll~ of the provider.
P. Sponsomhip
o~ar[~e~ by ~2.~8~..25, F.S, '.~ .~,e ? .m.~. ~ i~.~.r?nrgov, em~?tat organiz?~on which sponso? a program financed wholly or in par~ by state funds, including an~ ~nds
mreugn m~s conaa~ ~sna,. m pumicing, a~vemslng, or descnding the sponsorship of the program, state: Spoeeomd by (prevk~e~s name) and the S~te of
Florida, Depa~mant of Health. If the sponsorship reference is in written malapai, the words Slate of Florida. Deparime~t of Health shall appear in the same size letters or
type as the name of the organization.
Q. Final Inveice
To submit the final invoice for payment te the deperlmant no more than 45 days after the contract ends or is termineted. If the provider fails to do so. all dght to payment s
forfeited and the department will not honor any requests submitted after the aforesaid time pednd. Any payment due under the terms of this contract may be withheld until all
reports due fT0m the provider and necessary adjuslments tbemto have been approved by the depantnent.
R. Use Of Funds For Lobbying Prohibitsd
To comply with ~3e provleldns of ~?.16.347, FS, wflich pmhi~ the e~q;enditum of contract funds f~ the purpesa of lehoying the Lagislat~-e, judidal breach, or a state agnocy.
S. Public Entity Crime
Pursuant to §2S7.133, FS, the following res~'icfions am placed on the ability of parsons convicted of public enfily crimes to transact business with the deper~ent: Wbea a
parson or affiliate has been placed on the convicted vendor list following a conviction for a peblic erttAy c~me, ha/she may not submit a bid on a con~act to provide any gco~s
or sea,ices to a peblic er~y, may not submit a bid on a contract with a public entity for the constmc~on or repair of a public pudding or public work. may not submit bids on
teases of mai propaAy to a public antity, may not be awarded or perfon'n work as a conti'acten supplier, suPcontracter or consuitant under a contract with any public entity,
and may not transact business wi~ any public entity in excess of the threshold amount provided in §287.017. FS. for CATEGORY TWO for a pedod of 36 monks from ~e
date of being placed on the convicted vendor list.
T. Patents, Copyrights, and Royalties
~,=~= If an.y. di ~s~covery er inve ..n.?on ansee o.r is d~velopad in the course ~ as a result of w3rk or services parformed under this conb-act, or in anyway coonected hamwith, the
~rovider shall refer the discovery or mve~on to the department to be mfarred to the Depadment of State to determine whether patent protection will ha sought in the
name of the State of Florida. Any and all patent nghts aconJing under or in connection with the perfermance of this contract are bemby resanred to ~he State of Florida.
In the event that any books, manuals, rims, or other cpaynghteble materials are produced, the provider shall notify the Department of Steze. Any and all copyrights
acc~u~ag Under or in connec~no wi~ the performance under this contract are hereby resewed to the State of Fledda.
3 The provider without exception shall indemnify and save harmless ~e State of Florida and its employees from liepli~ of any nature or kind. including cost and
~ f~r or on account of any copyrighted, patented, dr unpate_,n,_t~?, inve?on,...p~.., or aritcle manufa<:A~ed by the provider. The provider has no liability wnefl
SUCh cJam ~s solely and exduavely due to the Depedment of States alteration of the allide. The State of Florida will provide prompt vaitten n~ of daJm of
copynght :or patent infringement. Further, if sudl claim is mede or is panding, the provider may, at tis ootion and ex~3ense, prooum for the Department of State. the dght
to confirtUe use of, mplaco, or mndify the at, de to render it non-infringing. If the pr-ovh:ler uses any design, device or matenais covered by ~ttem, patent, or copyright, it
is mutually agreed and understood without exception that the bid pit(es shall include all royalties or cost arising from the use of such design, device, or mate;iaJs in any
way invol~d in the work.
II, THE DEPARTMENT AGREES:
A. Contract Amount
To pay tar contracted santas accordi~ lo the condifloes of Attachment I in an amount not te exceed $248.000.00 subjest to the availability of funds.
The State of Flerlda's performance and obligation to pay under this contract is ~ona3gant upon an annual apprepdation by the Legislature. The costs of sarsices oaid under
any other coati-act or from a~y other source are not eligible for mimburesment under this contract.
B. Contract Payment
Pursuant to §2~5.422. FS, the depalmeflt has ifve (5) va3kJng days to inspect ~ approve [~cods and sen~ce& unless the bid specifications. Pumhase Order. or this
contract spact~ee ntha~'wise. W'~ the exception of pa.~mente to health care providers for hospital, medical, er other health care services, if payment is not available within 40
days, measured from the latter of the date the invoice is reee~ved or the goods or se~x:es am received, inspected a~l a~, a separate interest pane~ set by the
Comptroller pumuant to ~x5.03, FS, will be due an~ payable in additfon to the invoice amount. To obtain the applicat~ interest rote. contact the fiscal office/contract
adminis~ator. Payments to heai~ care providers for hospitals, medical, or ofhen health care sapless, shall be made nm mom than 35 days from the date elig~ility for
payment is determined, at the daily irdemst rate of 0.03333%. tnvoices ratumed to a vender dee to pmperafion errors will rasuit in a payment delay. Interest palatines less
than one dellar wili not be enforced unless the vendor requests payment. Invoies payment requirements do nof start until a properly completed invoice is provided th the
department.
C. Vando~' Ombudsman
A Vendar Ombudsman has been established wi~in ~e Depadment of Banking and Finance. The duties of ~his individual include acing as an advocate for vendam who may
~e e~pariencing problems in obtaining itmaty paymant(s} ~m a state ag~'~"y. ~ Veedor Ombudsman may be contacted at (850) 488-2924 or (800) 848-3792, the State of
Finrida Comptre~s Hatline.
itl. THIE PROVIDIER AND THE DEPARTMENT MUTUALLY AG REE
~,A~ Effective and Ending Dated
is contract shall begin on November ].~, 2000 ar on ~e dele on which the contmat has been signed by hoth padies, whichever is laten
haliend no November 14. 2001
DH STDCT w'r 7/1/99 3
CONTRACT# COHV4
3/1/99
B. Termination
· 1. Termination at Will
r~is contract may be terminated by either pa~y upon no less than thiAy (30) calendar days notice le wdfing to the other party, without cause, unless a lesser time is mutually
esd upon in wdting by bo~ parties. Said notice shall be delivered by ce~fled mail, tatum receipt requested, or in pemon with proof of delivery.
Terminafio~ Because of Lack of Funds
he event funds to finance this contract become unavailable, the deparlment may terminate the contract upon no less than Nventy~our (24) hours noUce Jn writiag to the
· v,..vider. Said no§ce shall be delivered by certified mail, return receipt requested, or in parson with proof of delivery. The department shall be the final authority as to the
availability and ~dequacy of funds. In the event of termination of this contract, the provider will be compensated for any work satisfactorily completed pdor to notification of
termination.
3. Terminaa0n for Broach
This contract may be tenuina/ed for the provider's nomperfunnanca upon no less than twenty-four (24) hours notice in writing to the provider. If applicable, the department
may employ th~ default pmvisians in Chapter 60A-1.006 (3), FAC. Waiver of breach of any provisions of this contract shall not be deemed to be a waiver of any other breach
and shall not be construed to be a modification of the terms of this contract. 'me previsions herein do not limit the deperlmenfs dght to remedies at law or in equity.
4. Tenuiaalten for Faa]are to Satisfactorily Pedorm Pder Agreement
Failure to haX,~ performed any conlractual obligations with the depedment in a manner satisfactory to the depadmeot will be a suffident cause for termination. TO be
terminated as a provider under this prevision, the provider must have: (1) pmvtously failed to satisfactorily perform in a ContTact with the department, been notified by the
department of ~ unsatisfactory performance, and failed to correct the unsatisfactory performance to the satisfa~on of the deperlment; or (2) had a contract terminated by
the dedaflment f~r cause.
C. Renegoflafion or Modification
Modifica~ons of provisions of this contract shall ~ be valid when they have been mducad to writing and duly signed by both parties. The rate of payment and dollar amount
may be adjusted retroactively to reflect pdce level incmeses and changes in the rate of payment when these have been established threugh the apprepdations process and
subsequently identified ia the depadmenfs operating budget.
D. Official Payee and RepreseiitaLlves (Names, Addresses and Telephone Numbers)
1. The name (previder name as shown on page I of this contract) and mailing 3, The name, addmes, and telephone number of the contract manager fur
address oft~ Official payee to whom the payment shall be made is:
Cit~ of BoyntOn Beach
100 E. Bo~nton Beach Boulevard
Bo,mton Beach, Florida 33425
2. The name of the contact pamon and street addrees wlnem flnanciel
and administrative records am melnteined is:
Bob Kenyon
' ~ities Director
3 E. Bovnton Beach Boulevard
· Bognton Beach, Florida 33425
5. Upon change of representelA/es (names, addresses, tetephone numbere) by either party,
attached to onginals of this contract.
E, All Terms and Conditions Included
This contract and its attachmente as referenced~ L H. III mad IV
the depattrnant fur this contract is:
Rhoda A. Lawrence
4052 Bald Cwress Way, Bin #Al4
Tallahassee. Florida 32399-1724 '
(850~ 2454333 or SC 2054333
The name, address, and telephone number of the previdefs represent-
ative re=spoesible fur administration of the program under this contract is:
Diane Reese
100 E. Bovnton Beach Bouleverd
Bovnton Beach. Florida 33425
(561) 742-6312
notice shall be provided ia ~¥rlfing to the other pady and said notification
contain all the terms and conditions agreed upon by the probes. There are no provisions, temps, candifiona, or obligations other than those contained hamia, and this contract
shall supersede all previous communications, repmsentelJoes, or agreements, either vethal or written betwee~ the parties. If any term or provision of the contract is found to
be illegal or unenforceable, the remainder of the contract shall remain in full force and effact and such tem~ or pmvislen shall be stricken.
[ have read the above contract and understand each sectioa and paragraph.
L~ WIT~SS TflEREOF, the parties hereto have caused this 14 page eonuact to be executed by their undersigned officials as duly autfforized,
PROVIDER STATE OF FLORIDA, DEPARTMENT OF HEALTH
CITY OF BOYNTON BEACH
~y~ AGENCY 29-DIG~ F~ CODE:
amir FISC~ Ym E~ma DA~: 9~30
SIGNED BY:
NAME: ANN~ R. NF~SMAN. R.N.M.S.
TITLE: D~.ECTOR
DIVISION OF FAMILY HEALTH SERVICES
DH STDCT WI' 7/1/99
CONTRACT # COHV4
FLUORIDATION SYSTEM INSTALLATION
PUBLIC HEALTH DENTAL PROGRAM
ATTACHMENTI
A. Services to be Provided - General Description.
1. General Statement.
The provider will use the funds from the contract to purchase, install, and maintain the
equipment to fluoridate the community's water system and will monitor the level of fluodde
to ensure it is in the optimal range as specified in the Flodda Administrative Code, Chapter
62-555. The provider agrees to use the equipment for fluoridation purposes only, and to
continue to fluoridate after contract funds are expended.
2. Authority.
Chapter 381.0052, F/ofida Statutes, and Specific Appropriations 484.
3. Scope of Service.
The provider agrees to purchase, install, operate and maintain the fluoridation equipme, nt in
thee proper order, and use the equipment for fluoridation purposes only.
4.i Major Program Goals,
Tl~e major Fluoridation Program Goal is to increase the percentage of the Florida population
on community water systems being served by optimally fluoridated water to 75% by 2010.
A~lditionally, the program has a goal to effectively monitor the fluoride levels, and provide
technical assistanCe to all fluoridating community water systems in Florida maintaining at
least 95% compliance with optimal levels.
B. Method of Payment.
1.; This is a one time advance fixed price fixed fee contract. The Department shall make a
oBe time advance payment for liable expenses incurred pursuant to terms of the contract for
a itotal dollar amount not to exceed $ 248,000.00 (per Attachment III), subject to the
availability of funds.
2. A letter of request for payment for the total contract amount of $ 248,000.00 will be
s~.bmitted to the department and shall be received and approved by the contract manager
pq~or to payment. The advance payment will be based on an approved cost-estimate
(~ttachment III). Funds paid to the provider according to the terms of this contract must be
spent by the provider as detailed in Attachment III.
3.i The provider must maintain on file backup documentation needed for specific charges
incurred under this contract. Allowable expenditures under this contract are limited to the
fo!lowing items which are listed in Attachment II1: all or a portion of the designing engineer's
fete, cost of purchase and installation of fiuoridetion equipment, cost of safety and testing
equipment and cost of one year fluodde supply. !
4.i The provider must submit a final reconciliatio~ report to the department no more than 45
d~ys after the contract ends or is terminated. Any funds awarded by this contract that
remain unspent shall be applied to the second year chemical costs. Any funds remaining
after second year chemical costs have been paidiwill be returned to the department.
C. Special Provisions.
1. The contract award will be based on the amount of the approved cost estimate
(Attachment III).
2. Engineenng fees to design the system shall not exceed 15% of total equipment costs.
3. Equipment should be purchased, installed and operating within one year from the date
that the contract is awarded. If the provider is unable to complete the installation within this
time frame, a written explanation detailing the reason for the delay must be submitted to the
contract manager within 30 days prior to the end of the contract. The letter will extend the
contract for a period of 6 months and no longer.
4. Invoices for the first year's chemical costs will be submitted within 90 days after the end
of the first year's operation. The second year chemical cost grant award will be calculated
based on the first year's cost.
5. Daily fluoride results and monthly split sample results for monitoring purposes will be
submitted to the Public Health Dental Program on a monthly basis for monitoring purposes
within 15 days after the end of the month (as required by the Flodda Administrative Code
Chapter 62-555).
6. If contract funds are temporarily invested in an interest bearing account, any and all
interest earned on these funds shall be used for fluoridation equipment and supplies not
funded by the contract. Documentation of interest earned and expenditures will be
submitted with the final reconciliation report to the department no more than 45 days after
the contract ends. Any interest not used will be applied to second year chemical costs. Any
interest earned remaining after second year chemical costs are paid will be returned to the
department. If funds are not invested in an interest beadng account, a statement to that
effect will be provided with the final reconciliation report referred to above.
7. Both parties agree that the grant program is based upon the availability of federal funds
under this or any duly authorized successor grant, and the department program has no
funding obligation if the grant ends without a successor grant.
8. No travel expenses may be incurred under this contract.
9. Both parties agree that the equipment acquired with contract funds shall be vested with
the provider and shall be used for fluoridation purposes only.
10. Discriminatory Vendor List. Provider acknowledges it is informed of the previsions of
287.134 (2)(a), FS., and represents to the Department that those provisions do not prohibit
the Department from contracting with the Provider or any subcontractors hereunder.
End of Text
6
ATTACHMENT II
FINANCIAL AND COMPLIANCE AUDIT
This attachment is applicable if the provider is any state or local government entity, nonprofit organization,
orfor profit organization. An audit performed by the Auditor General shall satisfy the requirements of this
attachment. If the provider does not meet any of the requirements below, no audit is required by l~e
attachment. The administration of funds awarded by the Department of Health to the provider may be
subject to audits and monitoring by the department, as described in this section.
MONITORING
In addition to reviews of audits conducted in accordance with OMB Circular A-133, as revised (see
",~LIDITS" below), monitoring procedures may include, but not be limited to, on-site visits by Department
ofiHealth staff, limited scope audits as defined by OMB Circular A-133, as revised, and other procedures.
By entering into this contract, the provider agrees to comply and cooperate with any monitoring
procedures/processes deemed appropriate by the department. In the event the department determines
that a limited scope audit of the provider is appropriate, the provider agrees to comply with any additional
instructions provided by the department regarding such audit. The provider further agrees to comply and
cooperate with any inspections, reviews, investigations, or audits deemed necessary by the Comptroller
or:Auditor General of the State of Florida.
AUDITS.
PARTI:FEDERALLY FUNDED
This part is applicable if the provider is a State or local government or a non-profit organization as defined
in OMB Circular A-133. as revised.
In the event that the provider expends $30(3.000 or more in Federal awards in aggregate during
its fiscal year. the provider must have an audit conducted in accordance with the provisions of
OMB Circular A-133, as revised. EXHIBIT 1 to this attachment indicates Federal funds awarded
through the department by this contract. In determining the Federal awards expended in its fiscal
year, the provider shall consider all sources of Federal awards, including Federal funds from the
department. The determination of amounts of Federal awards expended should be in
accordance with the guidelines established by OMB Circular A-133, as revised. An audit of the
provider conducted by the Auditor General in accordance with the provisions of OMB Circular A-
133. as revised, will meet the requirements of this part.
In connection with the audit requirements addressed in Part I, paragraph 1., the provider shall
fulfill the requirements relative to auditee responsibilities as provided in Subpart C of OMB
Circular A-133, as revised. This includes, but is not limited to, preparation of financial statements,
a schedule of expenditures of Federal awards, a summary schedule of prior audit findings, and a
corrective action plan.
Such audits shall cover the entire organization for the organization's fiscal year. Compliance
findings related to contracts with the department shall be based on the contract requirements,
including any rules, regulations, or statutes referenced in the contract. The financial statements
shall disclose whether or not the matching requirement was met for each applicable contract. All
questioned costs and liabilities due to the department shall be fully disclosed in the audit report
with reference to the department contract involved
7
If no[ otherwise disclosed as required by Section .310(b)(2) of OMB Circular A-133. as revised.
the schedule of expenditures of Federal awards shall identify expenditures by contract number for
each contract with the department in effect during the audit period.
If the provider expends less than $300.000 in Federal awards in its fiscal year. an audit
conducted in accordance with the provisions of OMB Circular A-133, as revised: is not rec Jired.
In the event that the provider expends less than $300,000 in Federal awards in its fiscal year and
elects to have an audit conducted in accordance with the provisions of OMB Circular A-133, as
revised, the cost of the audit must be paid from non-Federal funds (i.e., the cost of such audit
must be paid from the provider funds obtained from other than Federal entities.)
PARTII:STATE FUNDED
This partis appticableifthe previderis a nonma~ ent~ as defined by Section 216.3491(2)(I),Florida
S~tutas.
In the event that the provider expends a total amount of State awards (i.e.. State financial
assistance provided to the provider to carry out a State project) equal to or in excess of $30(3.000
in any fiscal year of such provider, the provider must have a State singte audit for such fiscal year
in accordance with Section 216.3491, Florida Statutes: applicable rules of the Executive Office of
the Governor and the Comptroller, and Chapter 10.600. Rules of the Auditor General. EXHIBIT I
to this attachment indicates State funds awarded through the department. In determining the
State awards expended in its fiscal year, the provider shall consider all sources of State awards,
including State funds received from the Department of Health except that State awards received
by a nonstate entity for Federal program matching requirements shall be excluded from
consideration,
In connection with the audit requirements addressed in Part II, paregreph 1, the provider shall
ensure that the audit complies with the raquirements of Section 216.3491(7), Florida Statutes.
This includes submission of a reporting package as defined by Section 216.3491(2)(d), Florida
Statutes, and Chapter 10.60C, Rules of the Auditor General.
If the provider expends less than $300,000 in State awards in its fiscal year. an audit conducted
in accordance with the provisions of Section 216.3491, Florida Statutes, is not required. In the
event that the provider expends less than $300,000 in State awards in its fiscal year and elects to
have an audit conducted in accordance with the provisions of Section 216.3491. Florida Statutes.
the cost of the audit must be paid from non-State funds (i.e., the cost of such an audit must be
paid from provider funds obtained from other than State entities).
PART II1: REPORT SUBMISSION
Copies of audit reports for audits conducted in accordance with OMB Circular A-133, as revised,
and required by PART I of this contract shall be submitted, when required by Section .320 (d),
OMB Circular A-133, as revised, by or on behalf of the provider directly to:
The Federal Audit Clearinghouse designated in OMB Circular A-133, as revised (the number
of cop~es required by Sections .320 Id)(1) and (2), OMB Circular A-133, as revised, should be
submitted to the Federal Audit Clearinghouse), at the following address:
Federal Audit Clearinghouse
Bureau of the Census
120~ East 10th Street
Jeffereonville, IN 47132
B. Other Federal agencies and pass-through entities in accordance with Sections .320 (e) and
(f), OMB Circular A-133, as revised.
Copies of audit reports for audits conducted in accordance with OMB Circular A-133, as revised,
and required by Part I of this attachment (in correspondence accompanying the audit report,
indicate the date that the provider received the audit report); copies of the reporting package
described in Section .320 (c), OMB Cimular A-133, as revised, and any management letters
issued by the auditor; copies of reports required by Part II of this attachment must be sent to the
department at each of the following addresses:
Contract Administration
4052 Bald Cypress Way, BIN B01 (HAFARM)
Tallahassee, Florida 32399-1729
B. · The contract manager for this contract listed in the Standard Contract.
Additionally, copies of reports and management letters required by Part II of this attachment must
be sent to the following address:
State of Flodda Auditor General
Room 574, Claude Pepper Building
111 West Madison Street
Tallahassee, Florida 32302-1450
Any reports, management letter, attestations, or other information are required to be submitted
within 180 days of the provideCs fiscal year end (or as otherwise allowed by Florida Statutes) or
within 30 days of the provider's receipt of the auditor's report, whichever occurs first. Other
submissions should be timely in accordance with OMB Circular A-133 or Florida Statutes, as
applicable.
PART IV: RECORD RETENTION
The provider shall retain sufficient records demonstrating its compliance with the terms of this contract for
a @eriod of five years from the date the audit report is issued or until resolution of audit findings or
litigation related to the terms and conditions of the this contract and shall allow the Department of Hea th
or !its designee, access to such records upon request. The provider shall ensure that audit working
papers ara made available to the department upon request for a period of five years from the date the
audit report is issued, unless extending in writing by the department.
EXHIBIT - 1
FEDERAL FUNDS AWARDED TO THE PROVIDER PURSUANT TO THIS CONTRACT CONSIST OF THE
FOLLOWING:
Centers for Disease Control and Prevention CFDA No. 93-991
Preventive Health and Health Services Block Grant
$148,000
Centers for Disease Control and Prevention CFDA No, 93-945
Water Fluoridation Assistance Program
$100,000
TOTAL FEDERAL AWARDS
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL FUNDS AWARDED PURSUANT TO THIS
CONTRACT ARE AS FOLLOWS:
CFDA No. 93-991: Funds are tobe used forfluorid~ion equ~pmentand first yearchemicalco~forthe ~tyof
Boynton
Beach.
CFDA No. 93-945: Funds are to be used for fluoridation equipment for the city of Boynton Beach,
STATE FUNDS AWARDED TO THE PROVIDER PURSUANT TO THIS CONTRACT CONSIST OF THE
FOLLOWING:
Matching funds for federal programs $.
State funds subject to Section 216.3491. Florida Statutes $.
TOTAL STATE FUNDS AWARDED PURSUANT TO SECTION 216.3491, F.S, $.
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE FUNDS AWARDED PURSUANT TO THIS
CONTRACT ARE AS FOLLOWS:
NA
l0
CH2MHILL
August 8, 2000
ATTACHMENT II/
Ms. Rhoda Lawrence
Coordinator, Florida Fluoridation Project
Public Health Dental Program
Florida Department of Health
2020 Capital Circle SE
Tallahassee, FL 3239%1700
Subject: City of Boynton Beach Fluoridation Grant Application
Dear Ms. Lawrence:
CFl2M HILL is filing this grant application for Preventative Health and Health Services
Block Grant funds on behalf of the City of Boynton Beach. The City is requesting grant
assistance for the construction and installation of a two fluoridation systems - one at its East
and one at the West water treatment facility in the amounts of $139,229 and $132,673,
respectively.
Enclosed please find a copy of the cost estimate for fluoridation equipment, installation,
chemicals, and partial engineering services for each facility. Manufacturers' quotations for
the equipment are also included. Finally, a copy of the ~anuary 2000, motion passed by City
Commission approving the addition of fluoride to the City's 4dnking water is included.
If you have any questions regarding this grant application, please contact me at (954) 426-
6112, ext. 283. The City of Boynton Beach is committed to protecting the health of its
citizens and is looking forward to receiving the Department of Health's approval of this
application and associated grant funds to assist in this effort. Please make the check for the
funds payable to the City of Boynton Beach.
Sincerely,
CH2M HILL
Shondra M. Neumeister, P.E.
Project Engineer
EnclOsures
c: Mr. Robert Kenyon, City of Boynton Beach
Mr. Paul Wobma, CH2M HILL
Mr. David McNabb, CH2M HILL
11
COST ESTIMATE
July 31, 2000
Fluoridation System for: City of Boynton Beach
Plant Capacity: '9.6 mqd maximum daily flow Average Dally Flow Rate: 8,0 mqd
Site: East Water Treatment Plant Natural Fluoride Level: <0.05 m,q/L
*Equipment:
Item Unit Price Units Total Price
Metering Pump $1500 3 $4500
2 Anti-Siphon Valves $200 3 $600
Scale (2,500 lb) $4500 1 $4500
Bulk Storage Tank $15000 I $15000
Day Tank $1500 1 $1500
Transfer Pump $2800 2 $5600
Containment for bulk storage tank $13000 I $13000
* Please include manufacturer's name, model or series #, and manufacturer's quotes
for all equipment and optional equipment listed above.
Safety Equipment
Item Unit Price Units Total Price
Gloves $31 4 $124
Apron $17 2 $34
Boots $63 4 $252
Face shield/mask $40 2 $80
Eyewash $2000 1 $2000
Installation
Piping, Valves, Fittings
Electrical / I&C
$39000
$23400
Subtotal
Engineering Fee (up to 15% of subtotal)
Chemical (fluoride supply for one year based on average MGD flow)
Apperson Chemical, 4000 gallon tanker, 0.8 mg/L dose, $1.10/gal
TOTAL
$109,590
$16439
$13200
$139,229
COST ESTIMATE
July 31, 2000
Fluoridation System for: City of Boynton Beach
Plant Capacity: 19.2 mqd maximum daily flow Average Daily Flow Ra~e: 8.8 m,qd
Site: West Water Treatment Plant Natural Fluoride Level: <0.05 mq/L
*Equipment:
Item Unit Price Units Total Price
Metering Pump $1500 2 $3000
2 Anti-Siphon Valves $200 2 $400
Scale (2,500 lb) $4500 1 $4500
Bulk Storage Tank $15000 1 $15000
Day Tank $1500 1 $1500
Transfer Pump $2800 2 $5600
Containment for bulk storage tank $13000 I $13000
' Please include manufacturer's name, model or series #, and manufacturer's quotes
for all equipment and optional equipment listed above.
Safety Equipment
item Unit Price Units Total Price
Gloves $31 4 $124
Apron $17 2 $34
Boots $63 4 $252
Face shield/mask $40 2 $80
Eyewash $2000 I $2000
~stallation
Piping, Valves, Fittings
Electrical / I&C
$36000
$224O0
Subtotal $103,890
Engineering Fee (up to 15% of subtotal) $15583
Chemical (fluoride supply for one year based on average MGD flow)
Apperson Chemical, 4000 gallon tanker, 0.8 mg/L dose, $1.10/gal $13200
TOTAL
$132,673
13
ATTACHMENT IV
CERTIFICATION REGARDING LOBBYING
CERTIFICATION FOR CONTRACTS, GRANTS, LOANS AND COOPERATIVE AGREEMENTS
The undersigned certifies, to the best of his or her knowledge and belief, that:
(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the
undersigned, to any person for influencing or attempting to influence an officer or an
employee of any agency, a member of Congress, an officer or employee of Congress,
or an employee of a member of Congress in the connection with the awarding of any
Federal contract, the making of any Federal grant, the making of any Federal loan, the
entering into of any cooperative agreement, and the extension, continuation, renewal,
amendment or modification of any Federal contract, grant, loan or cooperative
agreement.
(2)
If any funds other than Federal appropriated funds have been paid or will be paid, to any
person for influencing or attempting to influence an officer or an employee of any
agency, a member of Congress, an officer or employee of Congress, or an employee of
a member of Congress in the connection with this Federal contract, grant, loan or
cooperative agreement, the undersigned shall complete and submit Standard Form-LLL,
Disclosure Form to Report Lobbying, in accordance with its instructions.
(3)
The undersigned shall require that the language of this certification be included in the
award documents for all sub-awards at all tiers (including subcontracts, sub-grants and
contracts under grants, loans and cooperative agreements) and that all sub-recipients
shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this
transaction was made or entered into. Submission of this certification is a prerequisite for
making or entering into this transaction imposed by {}1352, Title 31, U.S. Code. Any person who
fails to file the required certification shall be subject to a civil penalty of not less than $10,000
and not ~ore than $1¢p,000 for each such failure.
'
sig~ture ~ date
Gerald Broeninq, Mayor
name of authorized individual
City of Boynton Beach
name of organization
COHV4
Application or Contract Number
100 E. Boynton Beach Blvd. Boynton Beach, FI 33425
address of organization
JF 12/96 14