The URL can be used to link to this page

Backup Documents 10/11/2016 Item #16A16 (Panther Passage) ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT 1 1 0 A THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGlz L,t, i ri jc Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarder to t Ain yat the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later than Monday preceding the Board meeting. DEC 2O1c **NEW** ROUTING SLIP 9 U Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is alre dy complete with the exception of the Chairman's signature,draw a line through routing lines#1 through#2,complete the checklist,and forward to the Court/ ttblimlati +nt Routed by Procurement Services to the Office Initials Date "Following Addressee(s) (In routing order) 1. Risk Risk Management ("r I ry r,46, 2. County Attorney Office County Attorney Office 1-f(A-C, 3. BCC Office Board of County L,A • Commissioners y Z\\.Z\\—1 4. Minutes and Records Clerk of Court's Office 91(1-it 5. Return to Procurement Services Procurement Services Division Contact: Viviana Giarimoustas PRIMARY CONTACT INFORMATION Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees above,may need to contact staff for additional or missing information. Name of Primary Viviana Giarimoustas for Evelyn Colon Phone Number 239-252-8375 Procurement Staff Contact and Date Agenda Date Item was 10/11/2016 Agenda Item Number 16.A.16 Approved by the BCC Type of Document Contract Number of Original 2 Attached Documents Attached PO number or account N/A Solicitation/Contract 16-6595/Panther number if document is Number/Company Passage to be recorded Name INSTRUCTIONS & CHECKLIST Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not appropriate, (Initial) Applicable) 1. Does the document require the chairman's original signature?.} , t3� .FF G.- 2. Does the document need to be sent to another agency for additional signatres? If yes, N/A provide the Contact Information(Name;Agency;Address; Phone)on an attached sheet. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be VG signed by the Chairman,with the exception of most letters,must be reviewed and signed by the Office of the County Attorney. 4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/A Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the N/A document or the final negotiated contract date whichever is applicable. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's VG signature and initials are required. 7. In most cases(some contracts are an exception),the original document and this routing slip VG should be provided to the County Attorney Office at the time the item is input into SIRE. Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's actions are nullified. Be aware of your deadlines! 8. The document was approved by the BCC on the date above and all changes made VG during the meeting have been incorporated in the attached document. The County 9t Attorney's Office has reviewed the changes,if applicable. 9. Initials of attorney verifying that the attached document is the version approved by the BCC,all changes directed by the BCC have been made,and the document is ready for the \A Chairman's signature. I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;Revised 11/30/12 16A16 1 6 MEMORANDUM Date: February 17, 2017 To: Viviana Giarimoustas for Evelyn Colon Procurement Services From: Teresa Cannon, Deputy Clerk Minutes & Records Department Re: Contract #16-6595 "Mitigation Credits" Contractor: Panther Passage Conservation, LLC Attached is an original of the document referenced above, (Item #16A16) approved by the Board of County Commissioners on Tuesday, October 11, 2016. The original has been held by the Minutes and Records Department as part of the Board's Official Record. If you have any questions, please contact me at 252-8411. Thank you. Attachment OA 10 AGREEMENT 16-6595 for Mitigation Credits [Secondary: Endangered Species —Panther] THIS AGREEMENT, made and entered into on this ( day of C ` 10 2016, by and between Panther Passage Conservation, LLC, authorized to do business in the State of Florida, whose business address is 1137 North Lakeshore Blvd., Lake Wales, Florida 33853 (the "Contractor") and Collier County, a political subdivision of the State of Florida, (the "County"): WITNESSETH: 1. AGREEMENT TERM. The Agreement shall be for a two (2) year period, commencing on Board award date and terminating two (2) years from that date or until all outstanding Purchase Orders issued prior to the expiration of the Agreement period have been completed or terminated. The County may, at its discretion and with the consent of the Contractor, renew the Agreement under all of the terms and conditions contained in this Agreement for one (1) additional two (2) year period. The County shall give the Contractor written notice of the County's intention to renew the Agreement term prior to the end of the Agreement term then in effect. The County Manager, or his designee, may, at his discretion, extend the Agreement under all of the terms and conditions contained in this Agreement for up to one hundred and eighty (180) days. The County Manager, or his designee, shall give the Contractor written notice of the County's intention to extend the Agreement term prior to the end of the Agreement term then in effect. 2. COMMENCEMENT OF SERVICES. The Contractor shall commence the services upon the issuance of a County purchase order. 3. STATEMENT OF WORK. The Contractor shall provide the services in accordance with the terms and conditions of Invitation to Bid (ITB) #16-6595, incorporated by reference and made an integral part of this Agreement. 3.1 The execution of this Agreement shall not be a commitment to the Contractor that any Services will be awarded to the Contractor. Rather, this Agreement governs the rights and obligation of the procedure to obtain Services and all Services undertaken by Contractor for the County pursuant to this Agreement during the term and any extension of the term of this Agreement. Any County Agency may utilize the services offered under this Agreement, provided sufficient funds are included in the budget(s). Page 1 of 10 #16-6595 Mitigation Credits Panther Passage Conservation Bank [Endangered Species—Panther A 3.2 The Contractor is the Secondary for the following credits: Credit Description Endangered Species —Panther If the Primary Contractor cannot provide requested services within the timeframe specified by the user division, then the Secondary Contractor will then be contacted; see Exhibit A. 3.3 This Agreement contains the entire understanding between the parties and any modifications to this Agreement shall be mutually agreed upon in writing by the Parties, in compliance with the County's Procurement Ordinance, as amended, and Procurement Procedures in effect at the time such services are authorized. 4. THE AGREEMENT SUM. The County shall pay the Contractor for the performance of this Agreement the aggregate of the mitigation credits furnished at the unit price, in Exhibit A— Fee Schedule and the methodology as defined in Section 4.1. Payment will be made upon receipt of a proper invoice and upon approval by the Project Manager or designee, and in compliance with Chapter 218, Fla. Stats., otherwise known as the "Local Government Prompt Payment Act." 4.1 Price Methodology: Unit Price: The County agrees to pay a firm total fixed price (inclusive of all costs, including labor, materials, equipment, overhead, etc.) for a repetitive product or service delivered (i.e. installation price per ton, delivery price per package or carton, etc.). The invoice must identify the unit price and the number of units received (no contractor inventory or cost verification. 4.2 Any County agency may utilize this Agreement, provided sufficient funds are included in their budget(s). 4.3 Payments will be made for services furnished, delivered, and accepted, upon receipt and approval of invoices submitted on the date of services or within six (6) months after completion of the Agreement. Any untimely submission of invoices beyond the specified deadline period is subject to non-payment under the legal doctrine of "laches" as untimely submitted. Time shall be deemed of the essence with respect to the timely submission of invoices under this Agreement. 5. SALES TAX. Contractor shall pay all sales, consumer, use and other similar taxes associated with the Work or portions thereof, which are applicable during the performance of the Work. Collier County, Florida as a political subdivision of the State of Florida, is exempt from the payment of Florida sales tax to its vendors under Chapter 212, Florida Statutes, Certificate of Exemption # 85-8015966531C-2. 6. NOTICES. All notices from the County to the Contractor shall be deemed duly served if mailed or faxed to the Contractor at the following Address: Page 2of10 #16-6595 Mitigation Credits Panther Passage Conservation Bank (Endangered Speaes—Panther I l6AlcS Panther Passage Conservation, LLC 1137 North Lakeshore Blvd. Lake Wales, Florida 33853 Attn: George Milicevic, Jr., President Phone: 239-290-1012 Fax: 888-793-6444 All Notices from the Contractor to the County shall be deemed duly served if mailed or faxed to the County to: Collier County Government Center Procurement Services Division 3327 Tam iami Trail, East Naples, Florida 34112 Attention: Director, Procurement Services Division Telephone: 239-252-8407 Facsimile: 239-252-6480 The Contractor and the County may change the above mailing address at any time upon giving the other party written notification. All notices under this Agreement must be in writing. 7. NO PARTNERSHIP. Nothing herein contained shall create or be construed as creating a partnership between the County and the Contractor or to constitute the Contractor as an agent of the County. 8. PERMITS: LICENSES: TAXES. In compliance with Section 218.80, F.S., all permits necessary for the prosecution of the Work shall be obtained by the Contractor. The County will not be obligated to pay for any permits obtained by Subcontractors. Payment for all such permits issued by the County shall be processed internally by the County. All non-County permits necessary for the prosecution of the Work shall be procured and paid for by the Contractor. The Contractor shall also be solely responsible for payment of any and all taxes levied on the Contractor. In addition, the Contractor shall comply with all rules, regulations and laws of Collier County, the State of Florida, or the U. S. Government now in force or hereafter adopted. The Contractor agrees to comply with all laws governing the responsibility of an employer with respect to persons employed by the Contractor. 9. NO IMPROPER USE. The Contractor will not use, nor suffer or permit any person to use in any manner whatsoever, County facilities for any improper, immoral or offensive purpose, or for any purpose in violation of any federal, state, county or municipal ordinance, rule, order or regulation, or of any governmental rule or regulation now in effect or hereafter enacted or adopted. In the event of such violation by the Contractor or if the County or its authorized representative shall deem any conduct on the part of the Contractor to be objectionable or improper, the County shall have the right to suspend the Agreement of the Contractor. Should the Contractor fail to correct any such violation, conduct, or practice to the satisfaction of the County within twenty-four Page 3 of 10 #16-6595 Mitigation Credits Panther Passage Conservation Bank [Endangered Speaes—Panther] 16A16 6 A 1 (24) hours after receiving notice of such violation, conduct, or practice, such suspension to continue until the violation is cured. The Contractor further agrees not to commence operation during the suspension period until the violation has been corrected to the satisfaction of the County. 10. TERMINATION. Should the Contractor be found to have failed to perform his services in a manner satisfactory to the County as per this Agreement, the County may terminate said Agreement for cause; further the County may terminate this Agreement for convenience with a thirty (30) day written notice. The County shall be sole judge of non- performance. In the event that the County terminates this Agreement, Contractor's recovery against the County shall be limited to that portion of the Agreement Amount earned through the date of termination. The Contractor shall not be entitled to any other or further recovery against the County, including, but not limited to, any damages or any anticipated profit on portions of the services not performed. 11. NO DISCRIMINATION. The Contractor agrees that there shall be no discrimination as to race, sex, color, creed or national origin. 12. INSURANCE. The Contractor shall provide insurance as follows: A. Commercial General Liability: Coverage shall have minimum limits of $1,000,000 Per Occurrence, $2,000,000 aggregate for Bodily Injury Liability and Property Damage Liability. This shall include Premises and Operations; Independent Contractors; Products and Completed Operations and Contractual Liability. B. Workers' Compensation: Insurance covering all employees meeting Statutory Limits in compliance with the applicable state and federal laws. Special Requirements: Collier County Government shall be listed as the Certificate Holder and included as an Additional Insured on the Comprehensive General Liability Policy. Current, valid insurance policies meeting the requirement herein identified shall be maintained by Contractor during the duration of this Agreement. The Contractor shall provide County with certificates of insurance meeting the required insurance provisions. Renewal certificates shall be sent to the County ten (10) days prior to any expiration date. Coverage afforded under the policies will not be canceled or allowed to expire until the greater of: ten (10) days prior written notice, or in accordance with policy provisions. Contractor shall also notify County, in a like manner, within twenty-four (24) hours after receipt, of any notices of expiration, cancellation, non-renewal or material change in coverage or limits received by Contractor from its insurer, and nothing contained herein shall relieve Contractor of this requirement to provide notice. Contractor shall ensure that all subcontractors comply with the same insurance requirements that he is required to meet. Page 4of10 #16-6595 Mitigation Credits Panther Passage Conservation Bank (Endangered Speaes—Panther] 16A16 6 13. INDEMNIFICATION. To the maximum extent permitted by Florida law, the Contractor shall indemnify and hold harmless Collier County, its officers and employees from any and all liabilities, damages, losses and costs, including, but not limited to, reasonable attorneys' fees and paralegals' fees, whether resulting from any claimed breach of this Agreement by Contractor, any statutory or regulatory violations, or from personal injury, property damage, direct or consequential damages, or economic loss, to the extent caused by the negligence, recklessness, or intentionally wrongful conduct of the Contractor or anyone employed or utilized by the Contractor in the performance of this Agreement. This indemnification obligation shall not be construed to negate, abridge or reduce any other rights or remedies which otherwise may be available to an indemnified party or person described in this paragraph. This section does not pertain to any incident arising from the sole negligence of Collier County. 13.1 The duty to defend under this Article 13 is independent and separate from the duty to indemnify, and the duty to defend exists regardless of any ultimate liability of the Contractor, County and any indemnified party. The duty to defend arises immediately upon presentation of a claim by any party and written notice of such claim being provided to Contractor. Contractor's obligation to indemnify and defend under this Article 13 will survive the expiration or earlier termination of this Agreement until it is determined by final judgment that an action against the County or an indemnified party for the matter indemnified hereunder is fully and finally barred by the applicable statute of limitations. 14. AGREEMENT ADMINISTRATION. This Agreement shall be administered on behalf of the County by the Growth Management Division. 15. CONFLICT OF INTEREST. Contractor represents that it presently has no interest and shall acquire no interest, either direct or indirect, which would conflict in any manner with the performance of services required hereunder. Contractor further represents that no persons having any such interest shall be employed to perform those services. 16. COMPONENT PARTS OF THIS AGREEMENT. This Agreement consists of the following component parts, all of which are as fully a part of the Agreement as if herein set out verbatim: Contractor's Proposal, Insurance Certificate(s), ITB #16-6595 Scope of Services and Exhibit A— Fee Schedule. 17. SUBJECT TO APPROPRIATION. It is further understood and agreed by and between the parties herein that this Agreement is subject to appropriation by the Board of County Commissioners. 18. PROHIBITION OF GIFTS TO COUNTY EMPLOYEES. No organization or individual shall offer or give, either directly or indirectly, any favor, gift, loan, fee, service or other item of value to any County employee, as set forth in Chapter 112, Part III, Florida Statutes, Collier County Ethics Ordinance No. 2004-05, as amended, and County Administrative Procedure 5311. Violation of this provision may result in one or more of the following consequences: a. Prohibition by the individual, firm, and/or any employee of the firm from contact with County staff for a specified period of time; b. Prohibition by Page 5 of 10 #16-6595 Mitigation Credits Panther Passage Conservation Bank [Endangered Species—Panther I 1 6A 1 6 the individual and/or firm from doing business with the County for a specified period of time, including but not limited to: submitting bids, RFP, and/or quotes; and, c. immediate termination of any Agreement held by the individual and/or firm for cause. 19. COMPLIANCE WITH LAWS. By executing and entering into this Agreement, the Contractor is formally acknowledging without exception or stipulation that it agrees to comply, at its own expense, with all federal, state and local laws, codes, statutes, ordinances, rules, regulations and requirements applicable to this Agreement, including but not limited to those dealing with the Immigration Reform and Control Act of 1986 as located at 8 U.S.C. 1324, et seq. and regulations relating thereto, as either may be amended; taxation, workers' compensation, equal employment and safety (including, but not limited to, the Trench Safety Act, Chapter 553, Florida Statutes, and the Florida Public Records Law Chapter 119, including specifically those contractual requirements at F.S. § 119.0701(2)(a)-(b) as stated as follows: IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS AT: Communication and Customer Relations Division 3299 Tamiami Trail East, Suite 102 Naples, FL 34112-5746 Telephone: (239) 252-8383 The Contractor must specifically comply with the Florida Public Records Law to: 1. Keep and maintain public records required by the public agency to perform the service. 2. Upon request from the public agency's custodian of public records, provide the public agency with a copy of the requested records or allow the records to be inspected or copied within a reasonable time at a cost that does not exceed the cost provided in this chapter or as otherwise provided by law. 3. 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 contract term and following completion of the contract if the Contractor does not transfer the records to the public agency. 4. Upon completion of the contract, transfer, at no cost, to the public agency all public records in possession of the Contractor or keep and maintain public records required by the public agency to perform the service. If the Contractor transfers all public records to the public agency upon completion of the contract, the Contractor shall destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. If the Contractor keeps and maintains public records upon completion of the contract, the Contractor shall meet all applicable requirements for retaining public Page 6 of 10 #16-6595 Mitlgatlon Credits - Panther Passage Conservation Bank [Endangered Speaes-Panther I 16A16 records. All records stored electronically must be provided to the public agency, upon request from the public agency's custodian of public records, in a format that is compatible with the information technology systems of the public agency. If Contractor observes that the Contract Documents are at variance therewith, it shall promptly notify the County in writing. Failure by the Contractor to comply with the laws referenced herein shall constitute a breach of this Agreement and the County shall have the discretion to unilaterally terminate this Agreement immediately. 20. OFFER EXTENDED TO OTHER GOVERNMENTAL ENTITIES. Collier County encourages and agrees to the successful proposer extending the pricing, terms and conditions of this solicitation or resultant Agreement to other governmental entities at the discretion of the successful proposer. 21. AGREEMENT TERMS. If any portion of this Agreement is held to be void, invalid, or otherwise unenforceable, in whole or in part, the remaining portion of this Agreement shall remain in effect. 22. ADDITIONAL ITEMS/SERVICES. Additional items and/or services may be added to this Agreement in compliance with the Procurement Ordinance, as amended, and Procurement Procedures. 23. DISPUTE RESOLUTION. Prior to the initiation of any action or proceeding permitted by this Agreement to resolve disputes between the parties, the parties shall make a good faith effort to resolve any such disputes by negotiation. The negotiation shall be attended by representatives of Contractor with full decision-making authority and by County's staff person who would make the presentation of any settlement reached during negotiations to County for approval. Failing resolution, and prior to the commencement of depositions in any litigation between the parties arising out of this Agreement, the parties shall attempt to resolve the dispute through Mediation before an agreed-upon Circuit Court Mediator certified by the State of Florida. The mediation shall be attended by representatives of Contractor with full decision-making authority and by County's staff person who would make the presentation of any settlement reached at mediation to County's board for approval. Should either party fail to submit to mediation as required hereunder, the other party may obtain a court order requiring mediation under section 44.102, Fla. Stat. 24. VENUE. Any suit or action brought by either party to this Agreement against the other party relating to or arising out of this Agreement must be brought in the appropriate federal or state courts in Collier County, Florida, which courts have sole and exclusive jurisdiction on all such matters. 25. AGREEMENT STAFFING. The Contractor's/ personnel and management to be utilized for this Agreement shall be knowledgeable in their areas of expertise. The County reserves the right to perform investigations as may be deemed necessary to ensure that competent persons will be utilized in the performance of the Agreement. The Contractor's shall assign as many people as necessary to complete the Agreement on a Page 7 of 10 #16.6595 Mitigation Credits Panther Passage Conservation Bank (Endangered Species—Panther 1 6 A I A. timely basis, and each person assigned shall be available for an amount of time adequate to meet the required service. 26. ORDER OF PRECEDENCE. In the event of any conflict between or among the terms of any of the Contract Documents, the terms of the ITB, the Contractor's Proposal, and/or the County's Board approved Executive Summary, this Agreement shall take precedence. 27. ASSIGNMENT. Contractor shall not assign this Agreement or any part thereof, without the prior consent in writing of the County. Any attempt to assign or otherwise transfer this Agreement, or any part herein, without the County's consent, shall be void. If Contractor does, with approval, assign this Agreement or any part thereof, it shall require that its assignee be bound to it and to assume toward Contractor all of the • obligations and responsibilities that Contractor has assumed toward the County. 28. SECURITY. The Contractor is required to comply with County Ordinance 2004-52, as amended. Background checks are valid for five (5) years and the Contractor shall be responsible for all associated costs. If required, Contractor shall be responsible for the costs of providing background checks by the Collier County Facilities Management Division for all employees that shall provide services to the County under this Agreement. This may include, but not be limited to, checking federal, state and local law enforcement records, including a state and FBI fingerprint check, credit reports, education, residence and employment verifications and other related records. Contractor shall be required to maintain records on each employee and make them available to the County for at least four (4) years. All of Contractor's employees and subcontractors must wear Collier County Government Identification badges at all times while performing services on County facilities and properties. Contractor ID badges are valid for one (1) year from the date of issuance and can be renewed each year at no cost to the Contractor during the time period in which their background check is valid, as discussed below. All technicians shall have on their shirts the name of the contractor's business. The Contractor shall immediately notify the Collier County Facilities Management Division via e-mail (DL-FMOPSCa�colliergov.net) whenever an employee assigned to Collier County separates from their employment. This notification is critical to ensure the continued security of Collier County facilities and systems. Failure to notify within four (4) hours of separation may result in a deduction of$500 per incident. Page 8 of 10 #16-6595 Mitigation Credits Panther Passage Conservation Bank [Endangered Speaes—Panther] 16416 IN WITNESS WHEREOF, the parties hereto, have each, respectively, by an authorized person or agent, have executed this Agreement on the date and year first written above. BOARD OF COUNTY COMMISSIONERS ATTEST: COLLIE-4pTY, FLORIDA Dwigh .E,,Brock, Clerk of Courts '' '' QD-N\Ak-faik, B c, , By: /..&(4/44,1 Penny Taylor�i'airman Dated: .�'`�' '� ��-- Att� 1 airman's ..sigtitiy`^ i, Panther Passage Conservation, LLC Contractor ---- �_ First Witn: s Sign- ure ,w .. � C v r_ Pi\ kiCe_v."(.._ \)k-- . l ct�.el..-vt— TType/print witness namet TType/print signature arld title"?' 4 - -.4._ / Z.> left.ten 12'Ll' S-cond fitness S-4e�1pphcr, H Co )lih_\ TType/print witness namet Appro ed asIcc to Form and Legality: 4 /\ L__- ----- Assistant County Attorney 1-MI6Ac -(-] ry - ( icka Print Name Item# 16 6 Agenda /0lit jib Date ted 01l 01 11." Q Deputy Clerk Page 9 of 10 #16-6595 Mitigation Credits Panther Passage Conservation Bank [Endangered Species—Panther] I 6 A 1 6 EXHIBIT A— FEE SCHEDULE CREDIT DESCRIPTION SECONDARY UNIT PRICE Endangered Panther Passage $750 Species — Conservation Bank Panther • Page 10of10 #16-6595 Mibgaton Credits Panther Passage Conservation Bank ]Endangered Spetaes—Panther] 1 6 Client#: 16353 FLORALAN c' 1 ACORam CERTIFICATE OF LIABILITY INSURANCE DATE ) 12/20/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Bouchard Insurance PHONE (A/C,No,Ext):407-847-2841 FAX (A/C,No): 407 846-2841 222 Church Street E-MAIL ADDRESS: cicertsY ftm erS bouchardinsurance.com Kissimmee, FL 34741 407 847-2841 INSURER(S)AFFORDING COVERAGE NAIL# NSURERA:Westfield Insurance Company 24112 INSURED INSURER B: Floraland Dairy,Inc.&Panther Passage INSURER C: Conservation LLC&Dr Robert G Gukich INSURER D: 1137 North Lakeshore Blvd Lake Wales, FL 33853 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE NSR WVD POLICY NUMBER (MM/DDY/YEYYY) (MM/DDYIYYYY) LIMITS I, A X COMMERCIAL GENERAL LIABILITY Y CAG5749387 02/18/2016 02/18/2017 EACH OCCURRENCE $1,000,000 CLAIMS-MADE X OCCUR PREMISES(EaEoccccu ence) $100,000 MED EXP(Any one person) $ _ PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000PRO- X POLICY ECT LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY accident) PEDAMAGE $ HIRED AUTOS AUTOS JPe UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Collier County Board of Count Commissioners is included as additional insured under the captioned General Liability policy to the extent required by written contract for any and all work performed in Collier County. CERTIFICATE HOLDER CANCELLATION Collier CountyBoardof SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. 3327 Tamiami Trail East Naples, FL 34112 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) 1 of 1 The ACORD name and logo are registered marks of ACORD #S565562/M565561 BRICA 6A 6 Client#: 16353 FLORALAN 1 1 /YYYY) ACORDTM CERTIFICATE OF LIABILITY INSURANCE 2/06/2017DATE(MM/DDDD7 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER C NNEACT Deloris(Dee)A Moore Bouchard Insurance(KIS) PHONE 407 569-1512 FAX 407 846-2841 (A/C,No,Ext): !(A/C,No): 222 Church Street E-MAIL ADDRESS: delorismoore@bochardinsurance.com Kissimmee, FL 34741 INSURER(S)AFFORDING COVERAGE NAIC# 407 847-2841 INSURER A:Westfield Insurance Company 24112 INSURED INSURER B: Floraland Dairy,Inc.& Panther Passage INSURER C: Conservation LLC&Dr Robert G Gukich INSURER D: 1137 North Lakeshore Blvd INSURER E: Lake Wales,FL 33853 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP UMITS LTR INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY Y CAG5749387 02/18/2017 02/18/2018 EACH �ES OCCURRENCE $1,000,000 E CLAIMS-MADE X OCCUR PREMIS (Ea occccurrence) $100,000 MED EXP(Any one person) $0 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRO- x POLICY JECT LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS _ AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS _ AUTOS (Per accident) UMBRELLA LIAR _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ WORKERS COMPENSATION PER I AND EMPLOYERS'LIABILITY Y/N I STATUTE I ERH OFFICER/MEMBERNEXCLUDED?ECUTIVE N/A E.L.EACH ACCIDENT $ (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) 16-6595"Mitigation Credits"for any and all work performed on behalf of Collier County Collier County Board of Count Commissioners is included as additional insured under the captioned General Liability policy to the extent required by written contract for any and all work performed in Collier County. CERTIFICATE HOLDER CANCELLATION Collier CountyBoard of SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. 3327 Tamiami Trail East Naples, FL 34112 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) 1 of 1 The ACORD name and logo are registered marks of ACORD #S606718/M600673 DELMO 0# Pt 1 ( A 0 Ll Workers Compensation Evaluation for Collier County Vendors Date: i,;/71411G Vendor Name: c 554,150_,, LC Scope of Work::enctalt. GAr. 011 N"." "a-7100x iLe." lisc)-41 I '4* 1. Are you a Registered business in Florida VES NO I Incorporated V I 440,. Sole Proprietor I 1 2. Number of employees 1,-,Grke., 3. If you are an officer in the company, have you elected to exempt yourself from Workers Compensation?* YES [-;;7r NO If you are not in the construction industry and employee four or more employees,you are required to secure and submit Worker Compensation insurance to the County. If you are in the construction industry you are required to secure and submit Workers Compensation insurance to the County. The only exception is if you do not have any employees and you have a- — valid/current workers compensation exemption issued by the State of Florida (sign attach :,„*.,:!.,:.:-, affidavit). 4 2,7 8.* If you are not required to carry Workers Compensation insurance, please sign this form, hay itm. notarized and return to C ntact name email address and fax number) 2 0 gc- a a a BY:1230,e4. „.T Notarized::1 iA../t1k4t., 4.---1, 3 7, em co. a a Print name Print name '4441 cci3 Datet 4+, cts a Fla.Stat.440-',Markers Compensatan r-Mr, .4441'4dg:11ury44-44:,4-.%,44.4,';0-e •-•.cb rat' `•• me••••-,-;.'c.ives tyl 4.77. ccr e;rp;','N44 r.. 'Cfl77<-7.e-,` ZrnpUlyee uniudes For rertaruction intiustey employen aaaerva C..4f z7at, T4,1,,,,;(`.. ,4 4".4v4i _ • . , :,••-ezte,4.1:1 Far ncr.--ctructort inttastv empla,ws :m C4404`-' n.4'..4 LP,..Me°her- An-ec• • - vale ecrel t - 4 t mtluded d are Mt ' .,TV74,c 4.74V- v,14, tr de • -7, c- ent,,c71 v.41" cactsztcyron rtzst-) ?cec,t; „ — • rttr 74- :.4,411,Jith. k .44 .4;trzer4,-Atar araz.1r1.11 1'the<1.71:1--ralUarat Pa'1 a v "- n.acme,' hor •- • c,;- Workers Compensation Collier County Vendors March 23,2016 A 1 6A 16 COLLIER COUNTY, FLORIDA INVITATION TO BID SOLICITATION 16-6595 Mitigation Credits BID OPEN DATE: March 31, 2016 — 3:00 P.M. SUBMITTED BY: PANTHER PASSAGE CONSERVATION, LLC dba PANTHER PASSAGE CONSERVATION BANK III 16A16 6 TABLE OF CONTENTS 1. Addendum 1 2. Vendor's Checklist 3. Bid Response Form 4. Bid Spreadsheet 5. Immigration Law Affidavit 6. Vendor Substitute W-9 7. Insurance and Bonding Requirements 8. Proof of Panther Passage Conservation Bank's US Fish and Wildlife Approval 1 6 A _ _ 1. Addendum 1 7 I 6 A 1 6 Colter County Email: evelyncolon@colliergov.net Administatr,e._;ervIces Deoartrnert Telephone: (239) 252-2667 ("..S --FAX-2. (239) 252-2810 ADDENDUM Memorandum Date: March 21, 2016 From: Evelyn Colon, Procurement Strategist To: interested Bidders Subject: Addendum # 1 Solicitation#and Title 16-6595 Mitigation Credits The following information is issued as an addendum identifying the following change (s) for the referenced solicitation: • Solicitation due date is extended to March 31, 2016 @ 3:00PM: Sealed bid responses for Solicitation 16-6595 Mitigation Credits, will be received electronically only at the Collier County Government, Purchasing Department, 3327 Tamiami Trail E, Naples, FL 34112 until 3:00PM, Collier County local time on March 31, 2016. Solicitation responses received after the stated time and date will not be accepted. Projected Timetable Event Date Issue Solicitation Notice March 9, 2016 Last Date for Receipt of Written Questions March 21, 2016 @ 3:00PM Addendum Issued Resulting from Written Questions March 23, 2016 Solicitation Deadline Date and Time A, 7. 47# ...:!!! March 31, 2016 0,3:00PM Anticipated Evaluation of Submittals April 2016 Anticipated Board of County Commissioner's Contract Approval May 2016 Date 1 6 A 1 6 12. The mailing envelope must be addressed to: Procurement Director Collier County Government Purchasing Department 3327 Tamiami Trail E Naples FL 34112 The mailing envelope must be sealed and marked with: • Solicitation: 16-6595 Mitigation Credits • Opening Date: Mareh4034046-@-340-PM March 31, 2016 3:00PM If you require additional information please post a question on the Online Bidding site or contact me using the above contact information. Please sign bolo anreturn a copy of this Addendum with your submittal for the above referenced solicitation -c4 (Signa 6 - Date LLC Q_47 c (Name of Firm) 16A16 2.Vendor's Checklist 1 6 A 1 6 Coitier County Admnsstratve SiTv;ces D-msrtr-ent Attachment 2: Vendor's Check List IMPORTANT: THIS SHEET MUST BE SIGNED BY VENDOR. Please read carefully, sign in the spaces indicated and return with bid. Vendor should check off each of the following items as the necessary action is completed: 1. The Bid has been signed. 2. The Bid prices offered have been reviewed. 3. The price extensions and totals have been checked. 4. The payment terms have been indicated. 5. Any required drawings, descriptive literature, etc. have been included. 6. Any delivery information required is included. 7. If required, the amount of bid bond has been checked, and the bid bond or cashiers check has been included. 8. Addendum have been signed and included, if applicable. 9. Affidavit for Claiming Status as a Local Business, if applicable. 10. Immigration Affidavit and company's E-Verify profile page or memorandum of understanding. 11. Copies of licenses, equipment lists, subcontractors or any other information as noted in this ITB. 12. The mailing envelope must be addressed to: Procurement Director Collier County Government Purchasing Department 3327 Tamiami Trail E Naples FL 34112 The mailing envelope must be sealed and marked with: • Solicitation: 16-6595 Mitigation Credits • Opening Date: March 30, 2016 t 3:00PM 13. The bid will be mailed or delivered in time to be received no later than the specified opening date and time. (Otherwise bid cannot be considered.) 14. If submitting a manual bid, include any addenda (initialed and dated noting understanding and receipt). If submitting bid electronically, bidder will need to download all related documents on www.colliergov.net/bid. The system will date and time stamp when the addendum files were downloaded ALL COURIER DELIVERED BIDS MUST HAVE THE BID NUMBER AND TITLE ON THE OUTSIDE OF THE COURIER PACKET. LC SignUre SVN-K gT &Title Date 16-6595 Mitigation Credits 22 I 6 A I 6 3.Bid Response Form 16 16 CA icy Co toity Attachment 3: Vendor Submittal -Bid Response Form FROM: Board of County Commissioners Collier County Government Center Naples, Florida 34112 RE: Solicitation: 16-6595 Mitigation Credits Dear Commissioners: The undersigned, as Vendor, hereby declares that the specifications have been fully examined and the Vendor is fully informed in regard to all conditions pertaining to the work to be performed for as per the scope of work. The Vendor further declares that the only persons, company or parties interested in this Bid or the Contract to be entered into as principals are named herein; that this Bid is made without connection with any other person, company or companies submitting a Bid; and it is all respects fair and in good faith, without collusion or fraud. The Vendor proposes and agrees if this bid is accepted, to comply with the requirements in full and in accordance with the terms, conditions and specifications denoted herein. The Vendor agrees to provide the following: * * * SEE FOLLOWING PAGES*** Any discounts or terms must be shown on the Bid Response Form. Such discounts, if any, will be considered and computed in the tabulation of the bids. In no instance should terms for less than fifteen (15) days payment be offered. Prompt Payment Terms: % Days; Net.:C Days Z Bid Response Form is electronic. Please input your prices online. Note: If you choose to bid manually, please submit an ORIGINAL and ONE COPY of your bid response pages. The undersigned do agree that should this Bid be accepted, to execute a formal contract, if required, and present the formal contract to the County Procurement Director for approval within fifteen (15) days after being notified of an award. 16-6595 Mitigation Credits 23 1 6A 1 6 IN WITNESS WHEREOF,WE have hereunto subscribed our names on this ,2: day of , 20 't Cr- in the County of W2-,---A=e-L\) , in the State of Firm's Complete Legal Name Address L:\v„,,L A14._ City, State, Zip Florida Certificate of Authority LC 'ICC CC C Document Number Federal Tax Identification _27 1 0'1 LC: Number CCR#or CAGE Code \'-` Telephone Number , I 7 k C (L, FAX Number 75. Signature/Title Type Name of Signature v k Date 72_1 **************************************************************************************************** Additional Contact Information Send Payments To: (REQUIRED ONLY if different from above) Firm's Complete Legal Name Address City, State, Zip Contact Name Telephone Number FAX Number Email Address 16-6595 Mitigation Credits 24 I 6A 16 4.Bid Spreadsheet 1 6 A i 6 K D) so 0) CP .4=• 0.) is..) --, ro K m m m CD m m "ii m i I I 7)• „?‘ z = el) 0 0 0 0 CD CD CD Cc. C.. —1 —1 0 it , 26, g ii 3 i 113 -63 ('3 3- 0- 0- CD =___L = = ,,, 0) CP CI) (..I) AD cu co c otl '',-' 6 'CD+ a) F) 0 0 0 o.) = CD CD CD CD (i) CD CD (1) m 71 0 0 0 C C C o 0 0. 0. g)_ ci) F 13 co co co cp 0, (I) Cl) z CP Cf) (f) 71 m 1 1 -0 -0 -0 0- 0" 1.-1C3 <-1') CD 0 a * * -a C) 0 co) CD co to g co 0 0,3 6 CD 45- — FA' CD0" = E * * CO Co 0,) --, -, 0, CI) W C.D., ---, —, • 90 0 --1° °') K oc -.... 0 CS = K K a> ...._ cn R- U) 0 6 —s. ..0 et. 0 = g o) co r.t. ..4 0 crl = I cs) r) tri (14 vs a_ .7.7 1 0......-, -.....,...-1' .,, -......1 ....._, , - --r— — -v.- 0 ____ .--.- (D .,.. --- •,-- ..*-- '.7 .4.--' - 1 16A1Ô 5.Immigration Law Affidavit 1 CA_ _ler County 1 6A 1 u Admnstratrve Ser,ces Departmert c,cc,- --lefit'Der oti Attachment 5:Vendor Submittal—immigration Affidavit Solicitation: 16-6595 Mitigation Credits This Affidavit is required and should be signed, notarized by an authorized principal of the firm and submitted with formal Invitations to Bid (ITB's)and Request for Proposals (RFP) submittals. Further, Vendors/ Bidders are required to enroll in the E-Verify program, and provide acceptable evidence of their enrollment, at the time of the submission of the vendor's/bidder's proposal. Acceptable evidence consists of a copy of the properly completed E-Verify Company Profile page or a copy of the fully executed E-Verify Memorandum of Understanding for the company. Failure to include this Affidavit and acceptable evidence of enrollment in the E-Verify program, may deem the Vendor! , Bidder's proposal as non-responsive. Collier County will not intentionally award County contracts to any vendor who knowingly employs unauthorized alien workers, constituting a violation of the employment provision contained in 8 U.S.C. Section 1324 a(e) Section 274A(e)of the Immigration and Nationality Act("INA"). Collier County may consider the employment by any vendor of unauthorized aliens a violation of Section 274A(e)of the INA. Such Violation by the recipient of the Employment Provisions contained in Section 274A(e) of the INA shall be grounds for unilateral termination of the contract by Collier County. Vendor attests that they are fully compliant with all applicable immigration laws (specifically to the 1986 Immigration Act and subsequent Amendment(s)) and agrees to comply with the provisions of the Memorandum of Understanding with E- Verify and to provide proof of enrollment in The Employment Eligibility Verification System (E-Verify), operated by the Department of Homeland Security in partnership with the Social Security Administration at the time of submission of the Vendor's/Bidder's proposal. ) r. Company Name i- L Print Name c*,.\ Title Signature , .213 Date '6\c'`'-':" • State of jilt— County of , The foregoing instrument wallib•igned and acknowledged before me this day of Ck_A LIL ,201 1.4 by • 11'V Y L -3-7( who has produced \... l'(\' ,\•-100. . %41.,i1-1 identification. ("krit or Type Name) (Type of Identification and Number) ji-1111k: 4.,LOCLkk — - Notary Public Signature lk MOENA.1 EDWARDS ir„--ii•• I Notary Public-State of Flaida • 11` • it-I Commission IP FF 235613 Printed Name of Notary Public My Comm.Expires Aug 1,2019 - s ' q ( ) %A. Bonded through Notional Notary Assn. Notary Commission Number/Ex. t on The signee of this Affidavit guarantees, as evidenced by the sworn affidavit required herein, the truth and accuracy of this affidavit to interrogatories hereinafter made. 16-6595 Mitigation Credits 26 .01.• NJ A1 6 E- Venry Company ID Number: 517730 THE E-VERIFY PROGRAM FOR EMPLOYMENT VERIFICATION MEMORANDUM OF UNDERSTANDING ARTICLE PURPOSE AND AUTHORITY This Memorandum of Understanding (MOU) sets forth the points of agreement between the Department of Homeland Security (DHS) and Panther Passage Conservation, LLC (Employer) regarding the Employer's participation in the Employment Eligibility Verification Program (E- Verify). This MOU explains certain features of the E-Verify program and enumerates specific responsibilities of OHS, the Social Security Administration (SSA), and the Employer. E-Verify is a program that electronically confirms an employee's eligibility to work in the United States after completion of the Employment Eligibility Verification Form (Form 1-9). For covered government contractors, E-Verify is used to verify the employment eligibility of all newly hired employees and all existing employees assigned to Federal contracts or to verify the entire workforce if the contractor so chooses. Authority for the E-Verify program is found in Title IV, Subtitle A, of the Illegal Immigration Reform and Immigrant Responsibility Act of 1996 (IIRIRA), Pub. L. 104-208, 110 Stat. 3009, as amended (8 U.S.C. § 1324a note). Authority for use of the E-Verify program by Federal contractors and subcontractors covered by the terms of Subpart 22.18, "Employment Eligibility Verification", of the Federal Acquisition Regulation (FAR) (hereinafter referred to in this MOU as a "Federal contractor with the FAR E-Verify clause") to verify the employment eligibility of certain employees working on Federal contracts is also found in Subpart 22.18 and in Executive Order 12989, as amended. ARTICLE II FUNCTIONS TO BE PERFORMED A. RESPONSIBILITIES OF SSA 1. SSA agrees to provide the Employer with available information that allows the Employer to confirm the accuracy of Social Security Numbers provided by all employees verified under this MOU and the employment authorization of U.S.citizens. 2. SSA agrees to provide to the Employer appropriate assistance with operational problems that may arise during the Employer's participation in the E-Verify program. SSA agrees to provide the Employer with names, titles, addresses, and telephone numbers of SSA representatives to be contacted during the E-Verify process. 3. SSA agrees to safeguard the information provided by the Employer through the E-Verify program procedures, and to limit access to such information, as is appropriate by law, to individuals responsible for the verification of Social Security Numbers and for evaluation of the E-Verify program or such other persons or entities who may be authorized by SSA as governed Page 1 of 13 E-Verify MOU for Employer I Revision Date 09/01/09 www.dhs.gov/E-Verify 16A16 E_verify Company ID Number: 517730 by the Privacy Act (5 U.S.C. § 552a), the Social Security Act (42 U.S.C. 1306(a)), and SSA regulations (20 CFR Part 401). 4. SSA agrees to provide a means of automated verification that is designed (in conjunction with DHS's automated system if necessary) to provide confirmation or tentative nonconfirmation of U.S. citizens'employment eligibility within 3 Federal Government work days of the initial inquiry. 5. SSA agrees to provide a means of secondary verification (including updating SSA records as may be necessary)for employees who contest SSA tentative nonconfirmations that is designed to provide final confirmation or nonconfirmation of U.S. citizens' employment eligibility and accuracy of SSA records for both citizens and non-citizens within 10 Federal Government work days of the date of referral to SSA, unless SSA determines that more than 10 days may be necessary. In such cases, SSA will provide additional verification instructions. B. RESPONSIBILITIES OF DHS 1. After SSA verifies the accuracy of SSA records for employees through E-Verify, DHS agrees to provide the Employer access to selected data from DHS's database to enable the Employer to conduct, to the extent authorized by this MOU: •Automated verification checks on employees by electronic means, and • Photo verification checks (when available)on employees. 2. DHS agrees to provide to the Employer appropriate assistance with operational problems that may arise during the Employer's participation in the E-Verify program. DHS agrees to provide the Employer names, titles, addresses, and telephone numbers of DHS representatives to be contacted during the E-Verify process. 3. DHS agrees to make available to the Employer at the E-Verify Web site and on the E-Verify Web browser, instructional materials on E-Verify policies, procedures and requirements for both SSA and DHS, including restrictions on the use of E-Verify. DHS agrees to provide training materials on E-Verify. 4. OHS agrees to provide to the Employer a notice,which indicates the Employer's participation in the E-Verify program. DHS also agrees to provide to the Employer anti-discrimination notices issued by the Office of Special Counsel for Immigration-Related Unfair Employment Practices (OSC), Civil Rights Division, U.S. Department of Justice. 5. OHS agrees to issue the Employer a user identification number and password that permits the Employer to verify information provided by employees with DHS's database. 6. OHS agrees to safeguard the information provided to DHS by the Employer, and to limit access to such information to individuals responsible for the verification of employees' employment eligibility and for evaluation of the E-Verify program, or to such other persons or entities as may be authorized by applicable law. Information will be used only to verify the accuracy of Social Security Numbers and employment eligibility, to enforce the Immigration and Page 2 of 13IE-Verify MOO for Employer I Revision Date 09/01109 www.dhs.govlE-Verify 11ÔA16 E-Verify • . 73 IS.5" Company ID Number:517730 Nationality Act (INA) and Federal criminal laws, and to administer Federal contracting requirements. 7. OHS agrees to provide a means of automated verification that is designed (in conjunction with SSA verification procedures) to provide confirmation or tentative nonconfirmation of employees'employment eligibility within 3 Federal Government work days of the initial inquiry. 8. DHS agrees to provide a means of secondary verification(including Updating OHS records as may be necessary) for employees who contest DHS tentative nonconfirmations and photo non- match tentative nonconfirmations that is designed to provide final confirmation or nonconfirmation of the employees' employment eligibility within 10 Federal Government work days of the date of referral to DHS, unless OHS determines that more than 10 days may be necessary. In such cases, OHS will provide additional verification instructions. C. RESPONSIBILITIES OF THE EMPLOYER 1. The Employer agrees to display the notices supplied by DHS in a prominent place that is clearly visible to prospective employees and all employees who are to be verified through the system. 2. The Employer agrees to provide to the SSA and DHS the names, titles, addresses, and telephone numbers of the Employer representatives to be contacted regarding E-Verify. 3. The Employer agrees to become familiar with and comply with the most recent version of the E-Verify User Manual. 4. The Employer agrees that any Employer Representative who will perform employment verification queries will complete the E-Verify Tutorial before that individual initiates any queries. A.The Employer agrees that all Employer representatives will take the refresher tutorials initiated by the E-Verify program as a condition of continued use of E-Verify. B. Failure to complete a refresher tutorial will prevent the Employer from continued use of the program. 5.The Employer agrees to comply with current Form 1-9 procedures, with two exceptions: • If an employee presents a"List B"identity document, the Employer agrees to only accept"List B" documents that contain a photo. (List B documents identified in 8 C.F.R. §274a.2(b)(1)(6)) can be presented during the Form 1-9 process to establish identity.) If an employee objects to the photo requirement for religious reasons, the Employer should contact E-Verify at 888-464-4218. • If an employee presents a DHS Form 1-551 (Permanent Resident Card) or Form 1-766 (Employment Authorization Document)to complete the Form 1-9,the Employer agrees to make a photocopy of the document and to retain the photocopy with the employee's Form 1-9.The photocopy must be of sufficient quality to allow for verification of the photo Page 3 of 13 1E-Verify MOU for Employer!Revision Date 09/01/09 www.dhs.gov/E-Verify 1 6A 16 , E-Veraly Company ID Number: 517730 and written information. The employer will use the photocopy to verify the photo and to assist OHS with its review of photo non-matches that are contested by employees. Note that employees retain the right to present any List A, or List B and List C, documentation to complete the Form 1-9. OHS may in the future designate other documents that activate the photo screening tool. 6. The Employer understands that participation in E-Verify does not exempt the Employer from the responsibility to complete, retain, and make available for inspection Forms 1-9 that relate to its employees, or from other requirements of applicable regulations or laws, including the obligation to comply with the antidiscrimination requirements of section 274B of the INA with respect to Form 1-9 procedures, except for the following modified requirements applicable by reason of the Employer's participation in E-Verify: (1) identity documents must have photos, as described in paragraph 5 above; (2) a rebuttable presumption is established that the Employer has not violated section 274A(a)(1)(A) of the Immigration and Nationality Act (INA)with respect to the hiring of any individual if it obtains confirmation of the identity and employment eligibility of the individual in good faith compliance with the terms and conditions of E-Verify; (3) the Employer must notify DHS if it continues to employ any employee after receiving a final nonconfirmation, and is subject to a civil money penalty between $550 and $1,100 for each failure to notify DHS of continued employment following a final nonconfirmation; (4) the Employer is subject to a rebuttable presumption that it has knowingly employed an unauthorized alien in violation of section 274A(a)(1)(A)if the Employer continues to employ an employee after receiving a final nonconfirmation; and (5) no person or entity participating in E-Verify is civilly or criminally liable under any law for any action taken in good faith based on information provided through the confirmation system. DHS reserves the right to conduct Form 1-9 and E-Verify system compliance inspections during the course of E-Verify, as well as to conduct any other enforcement activity authorized by law. 7. The Employer agrees to initiate E-Verify verification procedures for new employees within 3 Employer business days after each employee has been hired (but after the Form 1-9 has been completed), and to complete as many (but only as many) steps of the E-Verify process as are necessary according to the E-Verify User Manual, or in the case of Federal contractors with the FAR E-Verify clause, the E-Verify User Manual for Federal Contractors. The Employer is prohibited from initiating verification procedures before the employee has been hired and the Form 1-9 completed. If the automated system to be queried is temporarily unavailable, the 3-day time period is extended until it is again operational in order to accommodate the Employer's attempting, in good faith, to make inquiries during the period of unavailability. Employers may initiate verification by notating the Form 1-9 in circumstances where the employee has applied for a Social Security Number (SSN) from the SSA and is waiting to receive the SSN, provided that the Employer performs an E-Verify employment verification query using the employee's SSN as soon as the SSN becomes available. 8. The Employer agrees not to use E-Verify procedures for pre-employment screening of job applicants, in support of any unlawful employment practice, or for any other use not authorized by this MOU. Employers must use E-Verify for all new employees, unless an Employer is a Federal contractor that qualifies for the exceptions described in Article 11.0.1.c. Except as provided in Article 11.0, the Employer will not verify selectively and will not verify employees hired before the effective date of this MOU. The Employer understands that if the Employer Page 4 of 13 1E-Verify MOU for Employers Revision Date 09/01/09 www.dhs.gov/E-Verify 16A16 .• , E_veri ry Company ID Number:517730 uses the E-Verify system for any purpose other than as authorized by this MOU, the Employer may be subject to appropriate legal action and termination of its access to SSA and DHS information pursuant to this MOU. 9, The Employer agrees to follow appropriate procedures (see Article III. below) regarding tentative nonconfirmations, including notifying employees in private of the finding and providing them written notice of the findings, providing written referral instructions to employees, allowing employees to contest the finding, and not taking adverse action against employees if they choose to contest the finding. Further, when employees contest a tentative nonconfirmation based upon a photo non-match, the Employer is required to take affirmative steps (see Article III.B. below)to contact DHS with information necessary to resolve the challenge. 10. The Employer agrees not to take any adverse action against an employee based upon the employee's perceived employment eligibility status while SSA or OHS is processing the verification request unless the Employer obtains knowledge (as defined in 8 C.F.R. § 274a.1(I)) that the employee is not work authorized. The Employer understands that an initial inability of the SSA or OHS automated verification system to verify work authorization, a tentative nonconfirmation, a case in continuance (indicating the need for additional time for the government to resolve a case), or the finding of a photo non-match, does not establish, and should not be interpreted as evidence, that the employee is not work authorized. In any of the cases listed above, the employee must be provided a full and fair opportunity to contest the finding, and if he or she does so, the employee may not be terminated or suffer any adverse employment consequences based upon the employee's perceived employment eligibility status (including denying, reducing, or extending work hours, delaying or preventing training, requiring an employee to work in poorer conditions, refusing to assign the employee to a Federal contract or other assignment, or otherwise subjecting an employee to any assumption that he or she is unauthorized to work) until and unless secondary verification by SSA or DHS has been completed and a final nonconfirmation has been issued. If the employee does not choose to contest a tentative nonconfirmation or a photo non-match or if a secondary verification is completed and a final nonconfirmation is issued, then the Employer can find the employee is not work authorized and terminate the employee's employment. Employers or employees with questions about a final nonconfirmation may call E-Verify at 1-888-464-4218 or OSC at 1-800- 255-8155 or 1-800-237-2515 (TOD). 11. The Employer agrees to comply with Title VII of the Civil Rights Act of 1964 and section 2748 of the INA, as applicable, by not discriminating unlawfully against any individual in hiring, firing, or recruitment or referral practices because of his or her national origin or, in the case of a protected individual as defined in section 2746(a)(3) of the INA, because of his or her citizenship status. The Employer understands that such illegal practices can include selective verification or use of E-Verify except as provided in part 0 below, or discharging or refusing to hire employees because they appear or sound "foreign" or have received tentative nonconfirmations. The Employer further understands that any violation of the unfair immigration- related employment practices provisions in section 274B of the INA could subject the Employer to civil penalties, back pay awards, and other sanctions, and violations of Title VII could subject the Employer to back pay awards, compensatory and punitive damages. Violations of either section 274B of the INA or Title VII may also lead to the termination of its participation in E- Page 5 of 13 I E-Verify MOU for Employer I Revision Date 09101/09 www.dhs.gov/E-Verify I 6A 16 EVerfy Company ID Number: 517730 Verify. If the Employer has any questions relating to the anti-discrimination provision, it should contact OSC at 1-800-255-8155 or 1-800-237-2515 (TDD). 12. The Employer agrees to record the case verification number on the employee's Form 1-9 or to print the screen containing the case verification number and attach it to the employee's Form 1-9. 13. The Employer agrees that it will use the information it receives from SSA or OHS pursuant to E-Verify and this MOU only to confirm the employment eligibility of employees as authorized by this MOU. The Employer agrees that it will safeguard this information, and means of access to it (such as PINS and passwords) to ensure that it is not used for any other purpose and as necessary to protect its confidentiality, including ensuring that it is not disseminated to any person other than employees of the Employer who are authorized to perform the Employer's responsibilities under this MOU,except for such dissemination as may be authorized in advance by SSA or DHS for legitimate purposes. 14. The Employer acknowledges that the information which it receives from SSA is governed by the Privacy Act (5 U.S.C. § 552a(i)(1) and (3)) and the Social Security Act (42 U.S.C. 1306(a)), and that any person who obtains this information under false pretenses or uses it for any purpose other than as provided for in this MOU may be subject to criminal penalties. 15. The Employer agrees to cooperate with DHS and SSA in their compliance monitoring arid evaluation of E-Verify, including by permitting DHS and SSA, upon reasonable notice, to review Forms 1-9 and other employment records and to interview it and its employees regarding the Employers use of E-Verify, and to respond in a timely and accurate manner to OHS requests for information relating to their participation in E-Verify. D. RESPONSIBILITIES OF FEDERAL CONTRACTORS WITH THE FAR E-VERIFY CLAUSE 1. The Employer understands that if it is a subject to the employment verification terms in Subpart 22.18 of the FAR, it must verify the employment eligibility of any existing employee assigned to the contract and all new hires, as discussed in the Supplemental Guide for Federal Contractors. Once an employee has been verified through E-Verify by the Employer, the Employer may not reverify the employee through E-Verify. a. Federal contractors with the FAR E-Verify clause agree to become familiar with and comply with the most recent versions of the E-Verify User Manual for Federal Contractors and the E-Verify Supplemental Guide for Federal Contractors. b. Federal contractors with the FAR E-Verify clause agree to complete a tutorial for Federal contractors with the FAR E-Verify clause. c. Federal contractors with the FAR E-Verify clause not enrolled at the time of contract award: An Employer that is not enrolled in E-Verify at the time of a contract award must enroll as a Federal contractor with the FAR E-Verify clause in E-Verify within 30 calendar days of contract award and, within 90 days of enrollment, begin to use E-Verify to initiate verification of employment eligibility of new hires of the Employer who are working in the United States, Page 6 of 131 E-Verrry MOU for Employer l Revision Date 09101/09 VAVW.dhs.g ov/E-V e ri fy 1 6 A 1 E..... .... er. . „..,.. ,....„ , Company ID Number: 517730 whether or not assigned to the contract. Once the Employer begins verifying new hires, such verification of new hires must be initiated within 3 business days after the date of hire. Once enrolled in E-Verify as a Federal contractor with the FAR E-Verify clause, the Employer must initiate verification of employees assigned to the contract within 90 calendar days from the time of enrollment in the system and after the date and selecting which employees will be verified in E-Verify or within 30 days of an employee's assignment to the contract, whichever date is later. d. Employers that are already enrolled in E-Verify at the time of a contract award but are not enrolled in the system as a Federal contractor with the FAR E-Verify clause: Employers enrolled in E-Verify for 90 days or more at the time of a contract award must use E-Verify to initiate verification of employment eligibility for new hires of the Employer who are working in the United States, whether or not assigned to the contract, within 3 business days after the date of hire. Employers enrolled in E-Verify as other than a Federal contractor with the FAR E-Verify clause, must update E-Verify to indicate that they are a Federal contractor with the FAR E- Verify clause within 30 days after assignment to the contract. If the Employer is enrolled in E- Verify for 90 calendar days or less at the time of contract award, the Employer must, within 90 days of enrollment, begin to use E-Verify to initiate verification of new hires of the contractor who are working in the United States, whether or not assigned to the contract Such verification of new hires must be initiated within 3 business days after the date of hire. An Employer enrolled as a Federal contractor with the FAR E-Verify clause in E-Verify must initiate verification of each employee assigned to the contract within 90 calendar days after date of contract award or within 30 days after assignment to the contract, whichever is later. e. Institutions of higher education, State, local and tribal governments and sureties: Federal contractors with the FAR E-Verify clause that are institutions of higher education (as defined at 20 U.S.C. 1001(a)), State or local governments, governments of Federally recognized Indian tribes, or sureties performing under a takeover agreement entered into with a Federal agency pursuant to a performance bond may choose to only verify new and existing employees assigned to the Federal contract. Such Federal contractors with the FAR E-Verify clause may, however, elect to verify all new hires, and/or all existing employees hired after November 6, 1986. The provisions of Article 11.D, paragraphs 1.a and 1.b of this MOU providing timeframes for initiating employment verification of employees assigned to a contract apply to such institutions of higher education, State, local and tribal governments,and sureties. f. Verification of all employees: Upon enrollment, Employers who are Federal contractors with the FAR E-Verify clause may elect to verify employment eligibility of all existing employees working in the United States who were hired after November 6, 1986, instead of verifying only new employees and those existing employees assigned to a covered Federal contract. After enrollment, Employers must elect to do so only in the manner designated by DHS and initiate E- Verify verification of all existing employees within 180 days after the election. g. Form 1-9 procedures for existing employees of Federal contractors with the FAR E- Verify clause: Federal contractors with the FAR E-Verify clause may choose to complete new Forms 1-9 for all existing employees other than those that are completely exempt from this process. Federal contractors with the FAR E-Verify clause may also update previously completed Forms 1-9 to initiate E-Verify verification of existing employees who are not completely exempt as long as that Form 1-9 is complete (including the SSN), complies with Page 7 of 13 1E-Verify MOU for Employer 1 Revision Date 09/01109 www.dhs.goviE-Verify 1 1 6 A 6 E-Verify Company ID Number: 517730 Article 11.C.5, the employee's work authorization has not expired, and the Employer has reviewed the information reflected in the Form 1-9 either in person or in communications with the employee to ensure that the employee's stated basis in section 1 of the Form 1-9 for work authorization has not changed (including, but not limited to, a lawful permanent resident alien having become a naturalized U.S. citizen). If the Employer is unable to determine that the Form 1-9 complies with Article II.C.5, if the employee's basis for work authorization as attested in section 1 has expired or changed, or if the Form 1-9 contains no SSN or is otherwise incomplete, the Employer shall complete a new 1-9 consistent with Article II.C.5, or update the previous 1-9 to provide the necessary information. If section 1 of the Form 1-9 is otherwise valid and up-to- date and the form otherwise complies with Article II.C.5, but reflects documentation (such as a U.S. passport or Form 1-551) that expired subsequent to completion of the Form 1-9, the Employer shall not require the production of additional documentation, or use the photo screening tool described in Article II.C.5, subject to any additional or superseding instructions that may be provided on this subject in the Supplemental Guide for Federal Contractors. Nothing in this section shall be construed to require a second verification using E-Verify of any assigned employee who has previously been verified as a newly hired employee under this MOU, or to authorize verification of any existing employee by any Employer that is not a Federal contractor with the FAR E-Verify clause. 2. The Employer understands that if it is a Federal contractor with the FAR E-Verify clause, its compliance with this MOU is a performance requirement under the terms of the Federal contract or subcontract, and the Employer consents to the release of information relating to compliance with its verification responsibilities under this MOU to contracting officers or other officials authorized to review the Employer's compliance with Federal contracting requirements. ARTICLE III REFERRAL OF INDIVIDUALS TO SSA AND OHS A. REFERRAL TO SSA 1. If the Employer receives a tentative nonconfirmation issued by SSA, the Employer must print the notice as directed by the E-Verify system and provide it to the employee so that the employee may determine whether he or she will contest the tentative nonconfirmation. The Employer must review the tentative nonconfirmation with the employee in private. 2. The Employer will refer employees to SSA field offices only as directed by the automated system based on a tentative nonconfirmation, and only after the Employer records the case verification number, reviews the input to detect any transaction errors, and determines that the employee contests the tentative nonconfirmation. The Employer will transmit the Social Security Number to SSA for verification again if this review indicates a need to do so. The Employer will determine whether the employee contests the tentative nonconfirmation as soon as possible after the Employer receives it. 3. If the employee contests an SSA tentative nonconfirmation, the Employer will provide the employee with a system-generated referral letter and instruct the employee to visit an SSA office within 8 Federal Government work days. SSA will electronically transmit the result of the referral to the Employer within 10 Federal Government work days of the referral unless it Page 8 of 13 E-Verify MOO for Employer I Revision Date 09/01/09 www.dhs.govlE-Verify 1 6A 1 - E-Verify I Company ID Number: 517730 determines that more than 10 days is necessary. The Employer agrees to check the E-Verify system regularly for case updates. 4. The Employer agrees not to ask the employee to obtain a printout from the Social Security Number database (the Numident) or other written verification of the Social Security Number from the SSA. B. REFERRAL TO DHS 1. If the Employer receives a tentative nonconfirmation issued by DHS, the Employer must print the tentative nonconfirmation notice as directed by the E-Verify system and provide it to the employee so that the employee may determine whether he or she will contest the tentative nonconfirmation. The Employer must review the tentative nonconfirmation with the employee in private. 2. If the Employer finds a photo non-match for an employee who provides a document for which the automated system has transmitted a photo, the employer must print the photo non-match tentative nonconfirmation notice as directed by the automated system and provide it to the employee so that the employee may determine whether he or she will contest the finding. The Employer must review the tentative nonconfirmation with the employee in private. 3. The Employer agrees to refer individuals to DHS only when the employee chooses to contest a tentative nonconfirmation received from DHS automated verification process or when the Employer issues a tentative nonconfirmation based upon a photo non-match. The Employer will determine whether the employee contests the tentative nonconfirmation as soon as possible after the Employer receives it. 4. If the employee contests a tentative nonconfirmation issued by DHS, the Employer will provide the employee with a referral letter and instruct the employee to contact 01-IS through its toll-free hotline (as found on the referral letter)within 8 Federal Government work days. 5. If the employee contests a tentative nonconfirmation based upon a photo non-match,the Employer will provide the employee with a referral letter to DHS. DHS will electronically transmit the result of the referral to the Employer within 10 Federal Government work days of the referral unless it determines that more than 10 days is necessary. The Employer agrees to check the E- Verify system regularly for case updates. 6. The Employer agrees that if an employee contests a tentative nonconfirmation based upon a photo non-match,the Employer will send a copy of the employee's Form 1-551 or Form 1-766 to DHS for review by: • Scanning and uploading the document, or •Sending a photocopy of the document by an express mail account(paid for at employer expense). 7. If the Employer determines that there is a photo non-match when comparing the photocopied List B document described in Article 11.C.5 with the image generated in E-Verify, the Employer must forward the employee's documentation to OHS using one of the means described in the preceding paragraph, and allow OHS to resolve the case. Page 9 of 13 1E-Verify MOD for Employer I Revision Date 09/01)09 www.dhs.gov/E-Verify . 1 6 A 1 6 - eri y E Company ID Number: 517730 ARTICLE IV SERVICE PROVISIONS SSA and DHS will not charge the Employer for verification services performed under this MOU. The Employer is responsible for providing equipment needed to make inquiries. To access E- Verify, an Employer Will need a personal computer with Internet access. ARTICLE V PARTIES A. This MOU is effective upon the signature of all parties, and shall continue in effect for as long as the SSA and OHS conduct the E-Verify program unless modified in writing by the mutual consent of all parties, or terminated by any party upon 30 days prior written notice to the others. Any and all system enhancements to the E-Verify program by DHS or SSA, including but not limited to the E-Verify checking against additional data sources and instituting new verification procedures, will be covered under this MOU and will not cause the need for a supplemental MOU that outlines these changes. DHS agrees to train employers on all changes made to E- Verify through the use of mandatory refresher tutorials and updates to the E-Verify User Manual, the E-Verify User Manual for Federal Contractors or the E-Verify Supplemental Guide for Federal Contractors. Even without changes to E-Verify, OHS reserves the right to require employers to take mandatory refresher tutorials. An Employer that is a Federal contractor with the FAR E-Verify clause may terminate this MOU when the Federal contract that requires its participation in E-Verify is terminated or completed. In such a circumstance, the Federal contractor with the FAR E-Verify clause must provide written notice to OHS. If an Employer that is a Federal contractor with the FAR E-Verify clause fails to provide such notice, that Employer will remain a participant in the E-Verify program, will remain bound by the terms of this MOU that apply to participants that are not Federal contractors with the FAR E-Verify clause, and will be required to use the E-Verify procedures to verify the employment eligibility of all newly hired employees. B. Notwithstanding Article V, part A of this MOU, DHS may terminate this MOU if deemed necessary because of the requirements of law or policy, or upon a determination by SSA or DHS that there has been a breach of system integrity or security by the Employer, or a failure on the part of the Employer to comply with established procedures or legal requirements. The Employer understands that if it is a Federal contractor with the FAR E-Verify clause,termination of this MOU by any party for any reason may negatively affect its performance of its contractual responsibilities. C. Some or all SSA and OHS responsibilities under this MOU may be performed by contractor(s), and SSA and DHS may adjust verification responsibilities between each other as they may determine necessary. By separate agreement with OHS, SSA has agreed to perform its responsibilities as described in this MOU. i ! 1 Page 10 of 131 E-Verrly MOU for Employer I Revision Date 09/01/09 www.dhs.gov/E-Verify ' le 6 A t‘„,! Everify_ Company ID Number:517730 D. Nothing in this MOU is intended, or should be construed, to create any right or benefit, substantive or procedural, enforceable at law by any third party against the United States, its agencies, officers, or employees, or against the Employer, its agents, officers, or employees. E. Each party shall be solely responsible for defending any claim or action against it arising out of or related to E-Verify or this MOU, whether civil or criminal, and for any liability wherefrom, including (but not limited to) any dispute between the Employer and any other person or entity regarding the applicability of Section 403(d) of IIRIRA to any action taken or allegedly taken by the Employer. F. The Employer understands that the fact of its participation in E-Verify is not confidential information and may be disclosed as authorized or required by law and DHS or SSA policy, including but not limited to, Congressional oversight, E-Verify publicity and media inquiries, determinations of compliance with Federal contractual requirements, and responses to inquiries under the Freedom of Information Act(FOIA). G. The foregoing constitutes the full agreement on this subject between OHS and the Employer. H. The individuals whose signatures appear below represent that they are authorized to enter into this MOU on behalf of the Employer and OHS respectively. Page 11 of 13 I E-Verify MOU for Employer I Revision Date 09/01/08 www.dhs.gov/E-Verify 1 iv0 A A A , 1 0 Evenly Company ID Number: 517730 To be accepted as a participant in E-Verify, you should only sign the Employer's Section of the signature page.If you have any questions, contact E-Verify at 888-464-4218. Employer Panther Passage Conservation,LLC [George Milicevic Name(Please Type or Print) ' Title i lectronically Signed 1E 3/08/2012 Signature ate Department of Homeland Security—Verification Division USCIS Verification Division Name(Please Type or Print) 'Title Electronically Signed 03108/2012 Signature ate I Information Required for the E-Verify Program Information relating to your Company: i Company Narnev-anther Passage Conservation,LLC Company Facility Address:1137 North Lakeshore Blvd ' Ice Wales,FL 33852 Company Alternate N Dt Address: County or Parish: POLK Employer Identification Number: 271790940 Page 12 of 13 I E-Verify MOD for Employer I Revision Date 09101/09 www.dhs.govIE-Verify 16 ,416 E en Company ID Number: 517730 North American Industry Classification Systems Code: 541 Administrator Number of Employees: 1 to 4 Number of Sites Verified for 1 Are you verifying for more than 1 site?If yes,please provide the number of sites verified for in each State: . FLORIDA t site(s) Information relating to the Program Administrator(s) for your Company on policy questions or operational problems: Name: Desmond Duke Telephone Number: (239)530-8044 Fax Number: E-mail Address: dduke@ecoresolve.com Page 13 of 131E-Verify MOU for Employer j Revision Date 09/01/09 www.dhs.gov/E-Verify 16A16 6.Vendor Substitute W-9 Colter County 16A16 Admrstavve ServIces Dopomnent rent ,es Attachment 6: Vendor Substitute W-9 Request for Taxpayer Identification Number and Certification In accordance with the Internal Revenue Service regulations, Collier County is required to-collect-the-following information for tax reporting purposes from individuals and companies who do business with the County (including social security numbers if used by the individual or company for tax reporting purposes). Florida Statute 119.071(5) require that the county notify you in writing of the reason for collecting this information, which will be used for no other purpose than herein stated. Please complete all information that applies to your business and return with your quote or proposal. 1. General Information (provide all informa.4on) Taxpayer Name (as shown on income tax return) Business Name (if different from taxpeyer name) Address k 1\AIAN'\-- ' City State Zip Telephone-)-415:\ DIC \CT)--. FAX N(t)<- rZ) (' LO-k k.-k Email \ Order Information Remit/Payment Information Address 117,;1 Address \k City1-0,-\t-L'•-:-1":1`,State 1-\- ZiP City'-' - State Zi cl> 1"1:C P - FAX (• S('-‘; (...1 FAX Ci-tL1/4 Email X--‘-)k. Email k (?-• 2. Company Status(check only one) Individual/Sole Proprietor -/--,Corporation Partnership Tax Exempt(Federal income tax-exempt entity Limited Liability Company under Internal Revenue Service guidelines IRC 501 (c)3) C Enter the tax classification (D=Disregarded Entity, C=Corporation, P=Partnership) 3. Taxpayer Identification Number(for tax reporting purposes only) Federal Tax Identification Number(TIN) 2T7 - 1-1 1.0c1 LC (Vendors who do not have a TIN,will be required to provide a social security number prior to an award of the contract) 4. Sign and Date Form Certification:Under penaltie of perjury, I certify that the info• ation shown on this form is correct to my knowledge. = -4 ./ Signature de" Date AO" Title Phone Number:)7-ft t(.2t 16-6595 Mitigation Credits 27 1 6A 1 6 7.Insurance and Bonding Requirements A 6 Colter County AumnstradNe8ervioes Attachment 7: Vendor Submittal - Isurance and Bonding Requirements Insurance/Bond Type Required Limits 1 4, Worker's Statutory Limits of Florida Statute , Chapter 440 and all Federal Government Compensation Statutory Limits and Requirements 2. Employers Liability $ single limit per occurrence 3. Commercial General Bodily Injury and Property Damage Liability(Occurrence Form) patterned after the current $ 1,000,000 single limit per occurrence, $2.00.O00 aggregate for Bodily Injury ISO form Liability and Property Damage Liability. This shall include Premises and Operations; Independent Contractors; Products and Completed Operations and Contractual Liability. 4, 14 Indemnification To the maximum extent permitted by Florida law, the Contractor/Vendor/Consultant shall indemnify and hold harmless Collier County, its officers and employees from any and all liabilities, damages, losses and costs, including, but not limited to, reasonable attorneys'fees and paralegals' fees, to the extent caused by the negligence, recklessness, or intentionally wrongful conduct of the ContractorNendor/Consultant or anyone employed or utilized by the ContractorNendor/Consultant in the performance of this Agreement. 4. FlAutomobile Liability $ Each Occurrence; Bodily Injury& Property Damage, Owned/Non-owned/Hired; Automobile Included 5. 0 Other insurance as FlWatercraft Per Occurrence noted: Li United States Longshoreman's and Harborworker's Act coverage shall be maintained where applicable to the completion of the work. � Per Occurrence Li Maritime Coverage (Jones Act)shall be maintained where applicable to the completion of the work. � Per Occurrence Li Aircraft Liability coverage shall be carried in limits of not less than $5,000,000 each occurrence if applicable to the completion of the Services under this Agreement. � Per Occurrence FlPollution Per Occurrence 0 Professional Liability $ per claim and in the aggregate • $1,000,000 per claim and in the aggregate • $2,000,000 per claim and in the aggregate Li Project Professional Liability Per Occurrence Li Valuable Papers Insurance Per Occurrence 16-6595 Mitigation Credits 28 .� . �� cvpmy��umnon�w�/ un�m � Per Occurrence Including Employee Theft, Funds Transfer Fraud, Include a Joint Loss Payee endorsement naming Collier County. GE] Bid bond ShaH be submitted with proposal response in the form of certified funds, cashiers'check or an irrevocable letter of credit, a cash bond posted with the CountyC|erk. orpnopoma| bon� inasumequm|bn596ofdhe�oa PP Commissioners AllAli uheckm�haU �mmodmpayab|ehn�heCoUierCounb/GoamdofCounh/ Comnisoionenaonabonkorbomtoomnpeny|ocmtedintheGbateofFhzriduand insured by the Federal Deposit Insurance Corporation. 7. [] Performance and For projectin excess of$200,000, bonds shall be submitted with the Payment Bonds executed contract by Proposers receiving award, and written for 100%of the Contract award amount, the cost borne by the Proposer receiving an award. The Performance and Payment Bonds shall be underwritten by a surety authorized to do business in the State of Florida and otherwise acceptable to Owner; provided, however, the surety shall be rated as"A-a or better as to general policy holders rating and Class V or higher rating as to financial size category and the amount required shall not exceed 5% of the reported policy holders' surplus, all as reported in the most current Best Key Rating Guide, published by A.M. Best Company, Inc. of 75 Fulton Street, New York, New York 10038. 8. El Vendor shall ensure that all subcontractors comply with the same insurance requirements that he is required to meet. The same Vendor shall provide County with certificates of insurance meeting the required insurance provisions, 9. G. Collier County must be named as'ADDITIONAL INSURED"on the Insurance Certificate for Commercial General Liability where required. 10, L. The Certificate Holder shall be named as Collier County Board of County Commissioners, OR Board of County Comnnioo�nersinCollier County, ORCoUiar��ounh/GovernmentC>RCmUiar{�ounty. The Certificates rb --twnof|naunance must state the Contract Number, or ProjNumber, ead: For any and all work performed on behalf of Collier County. 11. A Thirty(30) Days Cancellation Notice required. RLC 2/29/2016 Vendor's Insurance Statement We understand the insurance requirements of these specifications and that the evidence of insurability may be required within five (5)days of the award ofthisolicitation. Name of Firm �|,��«� \�� V ^^� Date r��-r^\ `` - '^ . /^ � } Vendor Signature / ��.' -� �� ' ' ' -��---- Print Namer, `� Insurance Agency �Niu��,��`^-�z� -`� Agent Nome \sc (N\ Telephone Number {j�� - A 16-6595 Mitigation Credits 29 1 'HAA 8.Proof of Panther Passage Conservation Bank's US Fish and Wildlife Approval I . Es„) United States Department of the Interior ier.:(7 ------ -'1.-----------4 isi;t: aplig FISH AND WILDLIFE SERVICE -,- -,-_,_ -,t.'• .4-• tyr South Florida Ecological Services Office Abair" *S---zi 133920th Street '`---w Vero Beach,Florida 32960 Dr. Robert Gukich NOV 6 2009 Floraland Dairy, Inc. 1138 North Lakeshore Boulevard Lake Wales,Florida 33853 Service Federal Activity Code: 41420-2008-TA-0521 Date Received: October 26,2009 Applicant: Floraland Dairy,Inc. Project: Panther Passage Conservation Bank County: Hendry Dear Dr, Gukich: Thank you for providing the final certifying documentation necessary to complete the Panther Passage Conservation Bank. We have reviewed the submitted information,and find it complete. This letter certifies the Panther Passage Conservation Bank is a U.S. Fish and Wildlife Service approved source of habitat credit for the Florida panther(Puma concolor coryi)as specified in the Conservation Bank Agreement of October 28,2009. Please submit required reports in electronic form via email to the Conservation Banking Coordinator (georne dennisccpifws.gov)or,if large,via appropriate electronic medium to the following address: Attention: Conservation Banking Coordinator South Florida Ecological Services Office U.S.Fish and Wildlife Service 1339 2e Street Vero Beach, Florida 32960-3559 We appreciate your patience and continued cooperation in the effort to conserve fish and wildlife resources. If you have questions,please contact George Dennis at 772-562-3909,extension 309. Since ,,,, , rs, —41Ir 401 .10--41015 'aul Souza ifa Field Supervisor South Florida Ecological Services Office cc: electronic only Service,Atlanta,Georgia(David Dell) FWC,Tallahasssee, Florida(Tom Ostertag) TAKE PRIDE I NAM ERICA Alimil