Backup Documents 11/15/2016 Item #16C1 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLI
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO C 1
THE O
BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNA 1V
Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office
at 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.
**NEW** ROUTING SLIP
Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already 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 County Attorney Office.
Route to Addressee(s) (List in routing order) Office Initials Date
1.
2.
3. County Attorney Office County Attorney Office SRT 11-15-16
4. BCC Office Board of County -
Commissioners \f"\$/6/ kkkOc.kk 6
5. Minutes and Records Clerk of Court's Office
TO t(1fb(lb (5fin
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 Staff Phillip Snyderburn ; Contact Information 239-252-50 1
Contact/ Department
Agenda Date Item was November 15,2016 Agenda Item Number 16C1 t
Approved by the BCC
Type of Document A Settlement Agreement between Collier County Number of Original One
Attached and the Florida Department of Environmental Documents Attached
Protection in the amount of$3,778.60 to
reconcile payment for services rendered by
County staff related to regulation of underground
storage tanks.
PO number or account N/A
number if document is
to be recorded
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 STAMP OK N/A
4L 2. Does the document need to be sent to another agency for additional signatures? If yes, t5 Imo'
7�` provide the Contact Information(Name;Agency;Address; Phone)on an attached sheet. 7
3. Original document has been signed/initialed for legal sufficiency. (All documents to be SRT
signed by the Chairman,with the exception of most letters,must be reviewed and signed t''
by the Office of the County Attorney.
4. All handwritten strike-through and revisions have been initialed by the County Attorney's SRT
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 SRT
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 SRT
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip SRT
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 11/15/16 and all changes made during SRT
the meeting have been incorporated in the attached document. The County
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 1
Chairman's signature.
I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revis= ! ;Revised 11/30/12
S ".G Q 1V
1 6 01
Ann P. Jennejohn
From: Ann P.Jennejohn
Sent: Monday, November 21, 2016 11:35 AM
To: 'JessicaHayes@colliergov.net'
Subject: Settlement Agreement (#16C1 BCC Meeting 11-15-16)
Attachments: Item #16C1 (11-15-16 BCC Meeting).pdf
Good Morning Jessica,
A copy of the Settlement Agreement between the County and FDEP,
to reconcile payment for services rendered, that was approved by the
Board last week (November 15th, 2.016 Itevv► #16C1) is attached for your records.
Please let me know of any further instructions in regards to this agreement.
Thank you!
Ann Jennejohn, Deputy Clerk
Clerk of the Circuit Court
Clerk to the Value Adjustvnent Board
Collier County Board Minutes & Records Dept.
239-252-8406 Fax 239-252-8408
1
16C1
SETTLEMENT AGREEMENT
THIS AGREEMENT is made and entered into this 12 day of July,
2016 by and between the Department of Environmental Protection,
an agency of the State, (hereinafter "Department") , 3900
Commonwealth Boulevard, Tallahassee, Florida 32399-3000 and
Collier County Board of County Commissioners, (hereinafter
"CONTRACTOR") , 3339 Tamiami Trail East, Suite 302, Naples, FL 34112-
5361.
WITNESSETH:
WHEREAS, pursuant to Section 287 . 058 (1) , F.S. , a procurement
of contractual services in excess of $35, 000 is required to be
evidenced by a written agreement embodying all provisions and
conditions of the procurement of such services, including but
not limited to subsections (a) , (b) , (c) , (d) , and (e) , and
WHEREAS, pursuant to Section 287 .058 (2) , F.S. , except in
cases involving a valid emergency, said written agreement is
required to be signed by both the agency head and the contractor
prior to the rendering of services, and
WHEREAS, pursuant to Section 287 . 058 (2) , F.S. , if the
agreement is not signed by both parties, and if a valid
emergency does not exist, the agency head is required no later
than thirty (30) days after the contractor begins rendering the
service to certify the specific conditions and circumstances, as
well as describe actions taken to avoid the recurrence of the
noncompliance, and
6)
16C1
WHEREAS, contractual services described in the task
assignments between the Contractor and the Department attached
as Composite Exhibit A have been rendered without a fully
executed task assignment authorizing the work, and the agency
head has not within the prescribed thirty (30) day period either
certified a valid emergency, or in the absence of a valid
emergency, certified the specific conditions and circumstances
which caused the noncompliance, and
WHEREAS, the Chief Financial Officer of the State of Florida
(Comptroller Memorandum No. 4 (87/88) requires a settlement
agreement be executed for services rendered without a written
agreement, within the prescribed thirty (30) day period and in
accordance with statutory requirements, and
WHEREAS, the Contractor has a claim for payment for the said
services as set forth in the summary sheet and invoices attached
as Composite Exhibit B, and the Department desires to settle and
discharge such claim, and
WHEREAS, the Contractor agrees to be bound by the terms and
conditions set forth in Exhibit C, attached hereto and
incorporated by reference herein, in the performance of the work
subject of this settlement agreement.
NOW, THEREFORE, in consideration of the mutual covenants set
forth herein, the parties agree as follows:
a. The Department agrees to pay to the Contractor the sum
of Three Thousand Seven Hundred Seventy-Eight Dollars and Sixty
Cents, ($3,778. 60) , which amount represents the total claim of
the Contractor for providing the products or services listed in
6)
16C1
the invoices attached as Composite Exhibit B hereto, payable by
State of Florida warrant, to be paid to the Contractor.
b. Upon receipt of payment, as provided in paragraph (a) ,
the contractor, for its attorneys, heirs, executors or
administrators, does hereby fully, finally and forever release
and discharge the State of Florida, Department of Environmental
Protection, and its agents, representatives, and attorneys, of
and from all claims, demands, actions, causes of action, suits,
damages, losses and expenses, of any and every nature
whatsoever, arising out of or in any way related to the
contracts and state project and invoices for such work
including, but not limited to, those claims asserted or other
claims that were or maybe asserted in any federal, state or
local agency or court, by or on behalf of the contractor.
c. This Agreement shall be binding on and inure to the
benefit of the parties and their respective legal
representatives, successors, and assigns.
d. The Contractor agrees to be bound by the terms and
conditions set forth in Exhibit C, attached hereto and
incorporated by reference herein, for performance of the work,
which is subject of this settlement agreement.
e. Upon the execution of this Agreement, the terms
hereunder shall become effective only upon the subsequent
approval thereof by the Chief Financial Officer of the State of
Florida, pursuant to Section 17.03, Florida Statutes.
1 C 1
IN WITNESS WHEREOF, the parties have executed this agreement
AAAA
this mi.,0 day of KafitryNbtr, 20.1.61.
DEPARTME OF ENVIRONMENTAL COLLIER COUNTY BOARD OF COUNTY
PROTEC 0,44 COMMISSI ERS leetto
, .
BY: C By
Title: G./1/c cd Title: C.-Vkiond
v-
Date: ebVIA Date:
Approved a t form and legality:
TME
T ATTO*4 'Y
ATTEST
DWIGHT E. BRDCK, CLERK
'
BY: S.12 1_4 A "IIA
Attest a-, •
signature"only.
( )pprovedro fom and legality
ti
Scott R.Teach,Deputy County Attorney
Item# (-0
Agenda
Date t
Date \Hip-A
Reed „
•Depu -r:
16C1
EXHIBIT A
Attachment B
Florida Department of Environmental Protection
Task Assignment Notification Form for COLLIER COUNTY
Contract No.GC690 Task No.9 Amendment No. Bate June 26,2015
Performance Period: Effective the date of execution of this Task Assignment or July I,2015,
whichever is later,and shall remain in effect until June 30, 2016.
Description: (Additional Pages May be Ittilir-ed)
The Contractor shall complete the lollorring serried;in accordance with the requirements in DIA'Contract No.
GC690
- Conduct routine compliance inspections at the 173 facilities identified in Exhibit 01 (provided
clectninicully)storage lank*stew;within Collier Count).
- Perform all rt.-inspections per Guidance Document A to confirm compliance within Collier(ounty.
Comply with the Revised Invoke Procedure(Attached)
- Utilize the new Contractual tilers Invoke Form for all monthly inroieLs(Attached)
Compensation will only occur for routine annual compliance inspections conducted at the facilities
explicitly identified in the revised Payment Calculation Sheet(Attached)
(Continued on Page 2)
Payment schedule: Compensation will occur on a monthly basis,per the fee schedule listed in
Exhibit t41. Invoices arc due no later than the 15''day of the month proceeding work activity. The
contractor must submit a signed'Contractual Services Invoice'noting the quantity and location of
Inspections.
Task Managers:
DEP Task Manager: Charles Masella Phone: 239-344-5667
Contractor Task Manager: Phil Snyderbum Phone: 239-994-4535
Authorization:
•
Ae --••.-Amor o-r"'--- 6 2,9 /..C"
DE ' —1 ct Ma :ge ate
\,. .,_ ) gr., ,___________ ___Gy( / fp/f
tiirric-tor'. ',.diiitract onager / Dd'e
(A.,/
DEP Budget Representative Date
Funding
oaciANIzAt ION It IA P 011111'1 CI n)1,. MOM,I I, SPECIAL CA ILOOK V YR AhlOt;NI
37450305000 JD 132500 4562 IPTF 100029 15 5101,945.44
16
, ,..
____.....,.._„,..
DEP Contract No.GC690,Attachment 13.Page I of 2
le .
,
,
1601
EXHIBIT A
Attachment t3
I
Florida Department of Environmental Protection
Task assignment Notification Form for C'OL,I,IER COUNTY
Contract No.(C(9(I "rash No.') Amendment No. I Dale 1ta%3,2010
i. Verfttrm:ance Perrot(:Effective the ttSltt AA esecttnt tf this A ast tont or.Iut) 1,2015..
n Idctic%er is later,and shall remain in effect until.tune 30.20 .
Description: (Additional 1'n';es:ala) het`litifed)
In:rcaseanu4ut lite Variaisic iti'lly ijoo'.
t( )nnnned on c2i
l'a)inent schedule: Compensation oil!occur on a month!) lash..per the Ice schedule listed in
I. hitiit itI. invoices are duo no later than the 13".da) of the month proecediug nurh aetitit). 'fire
contractor toast submit a sietted`('t►ateactual tiers ices lin oiee nutima the quantity and local icor of
inspections.
Tusk \tanagers:
I)I.i'Task NI to u1er: Mark Sattler- Thile: 239-3-P-3(190
C'otttraetlir'task Mataxe:r: Phil Sn crluirn Plante: 23i) 9u1_I.4i3j
Authorization:
...474:.-A- -OA'
Date
l' '�'►n tract .tlt:ter /
Cog ctor's Contract ii aager I ate
/:1/4", t. . 12 C 7 /4
DEP Budget Represen alive tate
Funning
401( Ic'I01 vino sPIVlt1 ( .(Atte(:' VR N1tar'`.I
taf;t:��trtttta`:t'rtUt t.rt _
37450305009 JD 132500 4562 1PTF 100029 15 12,4)00.00
16
Notes:
(:c: 1)1`.l'I otatr3 is(NIS 40 t
l'itian e&Nixoutitiutz.Contract,.I)i.hursettrent Section t\IS 7N I c.p)
1)1.p 1n<k\t:m:i er
w ._,w...
IWP C7ontract No.(:CG911.Attachment 1I.l'ue 1 of
0
1 6 C1
EXHIBIT A
Description continued:
1 he Contractor must perform all Enforcement Actions in accordance with Guidance
Document F (Level of Laiort').
'Ilse contractor is reminded 01-the Perforntance I_ctels stated in paragraph 7B or the
contract.
The PREP will adjust the fundinu level of this task assignment as needed to complete the
scope of services described within this Task Assignntent, The Contractor will not
conduct the Discharge I'ret(anion Response Certificate(I)PRC) inspections detailed in
Paraeraph 9 of the contract.
Order of Inspection and Substitutions of facilities on Exhibit 1:
Contractor is to conduct routine inspection in order provided in Exhibit I. Substitutions
of Facilities are authorized with sites listed on the substitution list on Exhibit It 1. The
contractor wishing to substitute a facility shall email department at
S"TRInvoices;'il dep.state.t7.us stating the facility and reason fbrthe substitution. The
department will notify in email authorizing the substitution. Copies of authorizations
shall be retained by the contractor for the remainder of the contract.
Invoice Procedure
Review of Inspections:The Payment Calculation Sheet shall be submitted by the county
to the appropriate District t)tlice. The District will review in FIRST each variable
inspection listed on the Payment Calculation Sheet to ensure that it is correctly invoiced.
The District will ensure that each routine compliance inspection on the Payment
Calculation Sheet is also listed on the task assignment facilities list. Upon completion of
the review.the District shall report via email to the Permitting and Compliance
Assistance Program`s Contract Manager and the F.ocal Government that the review of the
inspections has been completed and if olany known contractual obligations that have not
been met.
Invoice Submission: All invoices with verified and approved Payment Calculation Sheet
by the appropriate District t.)f°tice will be directly submitted by the local governments to
the Permitting and Compliance Assistance Program's Contract Manager by the I'5`°of
each month. Submission of invoice shall be ia email to:STRIncoiecsiii..dcp.stateil.us.
°I.he email shall consist of:asinete PDF paackace.
The order document in the complete PDF package:
I,) Contractual Services Invoice
2) Verified Payment Calculation Sheet(please make sure the month of services
rendered appears below the"Invoice Period-)
3) FIRST Report (Compliance and Activity by Date Range)
4) °I racking Form (Monthly percentage of Routine Inspections Completed)
1)Kt'Contract No.G(19u.Attacttanent B.Page 2 or 2
16C1
Florida Department of Environmental Protection EXHIBIT B
�� INVOICE APPROVAL FOR CONTRACTS AND GRANT AGREEMENT DISBURSEMENTS FORM
,i FLORt Avieme t, ELECTRONIC CONTRACT INVOICE SUBMISSION ONLY
Required Signatures: Adobe Signature
This form should be completed in Ball and submitted electronically through the Shared Contract Invoice Document Drive along with the invoice and other
required documentation as defined by agreement.
Date Invoice Received 07/18/2016 Contract or Grant Agreement Number: GC690
Is this the Final Invoice? Yes No —
Capitalization? Yes ^ No I• I
Invoice Amount $ 5,361.80
Less:Retainage
Less:Amount Denied
Approved Payment Amount $ 5,361.80
Payment Funding Source(s)(Funding must agree with current FLAIR encumbrance information.):
ORGANIZATION OBJf:C:I" OCA! PROJECT
CODE:
11'.0 CODE FUND CA'FE:GORY YR GRANT MODULE NUMBERPAYMENT AMOUNT
37450305000 JO 132500 212001 100029 00 4562 $5,361.80
PAYMENT TOTAL $ 5,361.80
Program Area Use:
Fiscal Agent's Approval:
IIFA-D P55-263-A(Effective 10-01-2014)
1of1
0
1 6 C 1
FLAIR Contract ID: GC690 Page 1 of 8
EXHIBIT B
SUMMARY OF CONTRACTUAL SERVICES AGREEMENT
DEPARTMENT OF ENVIRONMENTAL
OLO/Department: PROTECTION Agency Contact:
FLAIR Contract#: GC690 Telephone#:
Agency Contract
GC600
#:
ContractorNendorlPayee: COLLIER COUNTY BOARD OF COUNTY
Original Contract Total SO 00 Contract
Si 194,389 64 Contract Type: Master Agreement
Amount: Amount:
Contract Start Date: 07/01/2007 Contract End Date:06/30/2017
Contract Last Signed Date:06/26/2007 'Advanced Funded No
METHOD OF PROCUREMENT: Exempt,Services or Commodities provided by Governmental Agencies Is 287 057
(3)(fj 12,& s.287057(22), FS)
AGENCY REFERENCE#:
Invoice Number: /Z Invoice Period: 61/7/4 — -6776//6
Total Amount of Previous Payments:
CONTRACT MANAGER CERTIFICATION:
I certify,by evidence of my signature, the information on this form is true and correct the goods and services have been
satisfactorily received and payment is now due I understand that the office of the State Financial Officer reserves the right to
require additional documentation and/or to conduct periodic post audits of any agreements
Contract Manager Name printed:
4‘/>
Contract Manager Signature: ate: ?,77-6i7/4
littps://facts.lidis.corn/Seareh/ContractualAgreernent.aspx?Agency1d-370000&ContractIcl... 7/18/2016
16C1
Cote-v •
.143-ity EXHIBIT B
Public Utilities Department
Solid & Hazardous Waste Management Division
July 5, 2016
Storage Tank Regulation, FDEP STR Invoicesgdep.statenus
Nereida Hernandez-Morales, FDEP NereidallernandezMorales(ibdep.statenus
Re: GC-690,Task Assignment#9
Invoice#12,June 2016
To whom it may concern:
Enclosed is the above referenced invoice package prepared and submitted by the Collier County
Solid & Hazardous Waste Management Division. If you have any questions concerning this
invoice, please contact me at 239-252-5081.
Regards,
Philip Snyderburt
Principal Environmental Specialist
Hazardous Materials
Enc: FDEP Contractual Services Invoice
Contractual Services Invoice Worksheet
Contract Management Form
FIRST Compliance& Enforcement Activity Report
Collier County BCC Invoice
c: GC-690 File (enclosures)
•••
k R R
Soldand Hazardous Waste Management Division•3339 Tamiami Trail East,Suite 302 •Naples,Florida 34112-5361•239-252-2506•FAX 239-774-9222
it c
EXHIBIT B
CONTRACTUAL SERVICES INVOICE
lovoice No Contract No Task No Date Period of Service
•
GC-690 9 7/5/2016 7/112015 to 6/30/2016
Vond,Qr Collier County BCC To Florida Department of Environmental Protection
3339 Tamiami Trail East,suite 302 Permitting and Compliance Assistance Program
Naples,Fl 34112 2800 Blair Stone Road,M.S.4565
Tallahassee.Florida 32399-2400
FEID No,. 56-00005558 Attn• Tanks Compliance Asisstance Amounting
Telephone- 239-252-5081
P,oent. Phil Snyderbum
Contractor Use:
•
Fixed Price: Cost Plus:
Contract/Task Amount Si 13945.44 ContreaTesk Amount
Less Previously invoiced 5112,362,24 Less Previously Invoiced
Less/Pius Retainage Less/Pius Retainage
invoice Total $5,3618C invOiCe Total
TOTAL AMOUNT OF INVOICE: 45,36110
FOEP Use Only:
SIRS Rev 5115 WB
1 C 1
Collier County Solid and Hazardous Waste Managment Division EXHIBIT B
CONTRACTUAL SERVICES INVOICE
Payment Calculations
Invoice No. Contract No. Task No. Date Invoice Period
12 GC-690 9 7/5/2016 6/1-3012016
Inspection Type I Value .Quantity List of Facilities (FAC. ID only)
Routine S 464.00 5 Attach FIRST spreadsheet
UST System Install S 1,140.68 1 9047539
UST Piping Install $ 380.23
8518292, 8626248
Component Install $ 190.11 2
8944898
UST System Closure S 760.45 1
UST Piping Closure S 380.23
Component Closure $ 190.11
9814502
AST System Install S 570.34 1
AST Piping Install S 190.11
AST Piping Closure S 190.11
AST System Closure S 380.23
Complaint S 190.11
Discharge S 190.11
Enforcement S 190.11
9808082
Non-Compliance $ 190.11 1
TOTAL
5,361.80
(//r-'"7-------
7/5 pe27 .
Signature ate
Page 3 of 3
16C1
co
coF-
x
w
N d o 0 0 0 0 0 4 0 0 0 n
co co M C)
r• N M •tr tp LO t0 N.N CO Of) O
c
0
I r
N
z a 0
O cry SI 2Q� o a o 0 o n o 0 0 0
�. a^ 0 ID N M O to tD t", CC)) A CM) O
(1) -
f" 47.7
0
d r M N N GO O co O N O Q
�'Y N P C) M 'V N N a- O) N to
YZ e- M GG GG) N tC) of GO G) W
w oO M N N. U) c0 M et C) GO GO N
d GO - N Nw t0 tr C> o o tt)
Z Q fMDOgNN
' CO T^ W3 4:4 i)to M Z.;
4tCi. VMi
CnC °).
O
Q <
Y F- hN.
Q Z
F-- 0
bq
2 c7 co co CO C CO CO n-
f t= O N - ,0 CO v N 00 10
Q Sid co us cN co N O (NI U) U) q
U, Q CO 4' O Lo co co O) tl) O O co
-t CD N co to O t?) N co O +t') co 0
zUfi b' u).O N-09 GA .N-- cry rr-- 474 4/4 _
Lai EH.GA EA GA 4d3
w >
L9 z
Z � u) co rn to co co co ro co co co co
0OOOOOOQQC)OO
„ N NNNNNNNNNNN
v. co 0) Ov- U) 7 r-
Z z
2 O Z
0 to
C.)
.:15 U) V) t0 IX) (.0 (D (D CO CO CD
0Z 7
° v) 0ZGia 4ce it
wLU
es- - N M V co h CO en `- N
0aZ
0 4 -
1 6 C 1
INVOICE
BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY COURTHOUSE COMPLEX
FINANCE DEPARTMENT
PO BOX 413016
NAPLES,FLORIDA 34101-3016
Invoice: 5 9 5 3 0
f•-,- 462/ce,
Date: /
TO:
Department:
51AY4r-te-Re4V111)
e Phone: •-• - ' /
DUE AND PAYABLE UPON RECEIPT
(BOARD DEPARTMENTS ONLY-CHARGES EXPENSED
UPON RECEIPT OF YELLOW COPY IN FINANCE)
DESCRIPTION AMOUNT
( Z)
/
7;47-5K-A- 37&/k7fri2/11-- "trP/6:6'
;2 /69
TOTAL AMOUNT s
MAKE CHECKS PAYABLE TO COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
DETACH AND MAIL THIS PORTION WITH YOUR CHECK TO:
FINANCE DEPARTMENT
PO BOX 413016
NAPLES, FLORIDA 34101-3016
REVENUE ACCOUNT Invoice: 59 5 30
FUND COST CENTER 05J/REV CODE PROJECT
q76C; ii75VY.q 554398 Amt. EncI,•
EXPENDITURE ACCOUNT NR No.•
FUND COST CENTER 05J iREV GOOE PROJECT
CUSTOMER - White DEPARTMENT- Yellow FINANCE - Pink
1 6 C 1
EXHIBIT C
DEP CONTRACT NO. GC690 i Lrt7IVED
FLORIDA DEPARTMENT OF ENVIRONMENTAL PROTECTION
AGREEMENT FOR STORAGE TANK SYSTEM G! f,FR 3 j ;m 9: 32
COMPLIANCE VERIFICATION PROGRAM
FOR COLLIER COUNTY ! L.GOV. ('REV. DEPT.
CONTRACTOR
COLLIER COUNTY BOARD OF
COUNTY COMMISSIONERS
Collier County Pollution Control
and Prevention Department
3301 Tamiami Trail E, Bldg H
Naples, Florida 34112
FEID NO.: 59-6000558
In consideration of the mutual benefits to be derived herefrom, the Florida Department of
Environmental Protection ("DEP" or "Department") does hereby retain Collier County Board of County
Commissioners ("CONTRACTOR") for the specific purposes and duties as outlined herein within Collier
County and the parties do hereby agree as follows:
INTRODUCTION
1. To assist the CONTRACTOR in complying with the terms and conditions established herein,
standard program terminology used throughout this Contract is defined and provided in Attachment
A,Standard Contract Definitions,attached hereto and made a part hereof.
2. It is hereby understood and agreed that all references in this Contract to Florida Statutes(F.S.)and
the Florida Administrative Code (F.A.C.) shall be for the laws, rules and guidance documents in
effect at the time work is performed by the CONTRACTOR.
SCOPE OF SERVICES
3. Perform compliance inspections within the jurisdictional (geographical) boundaries of the specified
counties, including facilities registered to the CONTRACTOR as required by an executed Task
Assignment(s) at the following Chapter 376, F.S., facilities: storage tanks regulated pursuant to
Sections 376.30 — 376.317, F.S. (excluding cattle dip vats, dry-cleaning facilities and designated
Brownfields)and Chapters 62-761 and 62-762, F.A.C.,including mineral acid tanks regulated by the
DEP in accordance with Sections 376.320-376.326, F.S. In addition, perform closure inspections,
installation inspections, discharge inspections, re-inspections, and emergency response activities,
as applicable, in accordance with each Task Assignment. All inspections shall be performed by an
individual(s) in a position equivalent to an Environmental Specialist I level or higher. Beginning on
the effective date of this Contract, the CONTRACTOR is authorized to enter private property in
order to carry out inspections pursuant to Sections 403.091 and 403.858, Florida Statutes.
4. Inspection Priorities. Inspections should be performed in accordance with each executed Task
Assignment in the following priority order:
A. Perform a discharge inspection at all facilities with known or suspected discharges involving
free product within twenty-four (24) hours of receipt of notification. Prepare and send a Site
Assessment Report request letter to the facility owner and operator, if appropriate, and as
directed by the DEP Task Manager.
DEP Contract No.GC690,Page 1 of 13 � '.
16 C 1
EXHIBIT C
B. Perform a discharge inspection at all facilities with known or suspected discharges within ten
(10) working days of receipt of notification. Prepare and send a Site Assessment Report
request letter to the facility owner and operator, if appropriate, and as directed by the DEP
Task Manager.
C. Perform all closure inspections at known storage tank system closure activities.
D. Perform all installation inspections of known new installations to ensure that the system or
system component is properly constructed and installed in accordance with Chapters 62-761
and 62-762, F.A.C., as applicable.
E. Perform routine compliance inspections and required re-inspections of facilities listed on each
executed Task Assignment based on resources and priorities. Facilities not inspected during
the current executed Task Assignment, will be prioritized to be inspected during the
subsequent Task Assignment. This list will include all facilities with at least one single-walled
regulated system.
F. Re-inspections should be performed as needed to verify compliance of items identified as
requiring a re-inspection, as referenced in the"Storage Tank System Program Violation List"
(Guidance Document A).All violations, regardless of severity,which solely involve notification
or reporting,wilt not require a re-inspection,unless otherwise required in Guidance Document
A. The CONTRACTOR will not be required to perform a re-inspection if the CONTRACTOR
and the DEP's Task Manager agree that it is unwarranted.
5. Site inspections responsibilities shall include:
A. Contacting facility owners or operators, verbally or in writing, to schedule compliance
inspections, installation inspections, closure inspections, discharge inspections, and re-
inspections. The DEP Task Manager may require written notification of inspections if verbal
methods have proven unsatisfactory.
B. With the exception of CONTRACTOR-owned/operated facilities, meeting with the owners,
operators, and/or other authorized representatives of all regulated facilities for the purpose of
determining compliance with Chapters 62-761 and 62-762, F.A.C.,and Chapter 376, F.S.
C. Distributing registration forms to all unregistered facilities that become known to the
CONTRACTOR as they are discovered, performing compliance inspections at all
unregistered facilities that are subject to Chapters 62-761 and/or 62-762, F.A.C., as they are
discovered, and taking appropriate measures where required to bring these facilities into
compliance,
E. Completing all inspection reports using the Florida Inspection Reporting for Storage Tanks
(FIRST) database and in accordance with the minimum standards referenced in the "FIRST
User's Guide"(Guidance Document B),
F. Responding to complaints by performing a complaint investigation, documenting actions taken
and maintaining appropriate copies of all complaint information as directed by the DEP Task
Manager.
G. Responding to requests for public assistance both in the office and during inspections.
H. Completing Storage Tank System Leak Autopsy Report Forms in electronic format and
submitting them to the DEP Contract Manager within ten (10) days of the Discharge
Inspection. Submit the complete electronic form with comments, the Discharge Reporting
Form(DRF)and photographs.
DEP Contract No.GC690,Page 2 of 13 el)
1 6C1
EXHIBIT C
I. Completing an Underwriters Laboratories (UL) Flex-Pipe incident Notification Form upon the
discovery of any structural or material compatibility problems involving Flex-Pipes and
submitting them to the DEP Contract Manager within ten (10) days of discovery. A copy
should also be submitted to UL.
6. Perform Level 1 enforcement actions.
A. These actions shall include investigation and documentation of violations of Chapters 62-761
and 62-762, F.A.C., or the county's equivalent regulations, preparation of noncompliance
letters and related activities as described in Attachment A and in accordance with the
"Storage Tank System Program Violation List" (Guidance Document A) and "Level of Effort
Guidance"(Guidance Document F).
B. An individual(s)in a position equivalent to an Environmental Specialist II level or higher shall
conduct Level 1 enforcement activities_ Noncompliance letters may be prepared and sent by
an individuals) at the Environmental Specialist I level under the direction of an individual at
the Environmental Specialist II level or higher.
C. All enforcement documents shall be on DEP forms,in DEP format, or have DEP approval.
D. All noncompliance letters shall be issued through FIRST in such a way as to ensure the
database's capture of these activities for report purposes.
E. Any penalties assessed under this Contract shall be in accordance with DEP Directive 923:
Settlement Guidelines for Civil and Administrative Penalties(Guidance Document J).
F. If there is any indication that enforcement actions are not being performed;the DEP Task
Manager may request the submission of a Corrective Action Plan. The Task Manager shall
be responsible for reviewing the plan and notifying the CONTRACTOR if the plan is approved
or In need of revision.
7. Assessment of Performance Levels.
A. The CONTRACTOR shall perform inspections as directed in the previously stated Priority
Order in paragraph 4, above, and assess performance levels monthly to determine its
progress towards completion of each Task Assignment. Upon discovery of any problems that
would delay or prevent the timely progress and completion of each Task Assignment, the
Contractor shall notify the DEP Task Manager.
B. Following the effective date of each Task Assignment, the CONTRACTOR should have
completed the following percentage of the required routine compliance inspections unless
otherwise indicated in the Task Assignment:
(1) After four (4) months, thirty-three percent (33%) of inspections should have been
completed.
(2) After eight (8) months, sixty-six percent (66%) of inspections should have been
completed.
(3) After twelve(12)months, one hundred percent(100%) of inspection should have been
completed.
C. If the actual number of required routine compliance inspections falls below twenty percent
(20%)for the fourth month,thirty percent(30%)for the fifth month,forty percent(40%)for the
sixth month, forty-eight percent(48%)for the seventh month, fifty-seven percent(57%)for the
eighth month, sixty-five percent (65%) for the ninth month, seventy-three percent (73%) for
DEP Contract No.00690,Page 3 of 13
1. 6C 1
EXHIBIT C
the tenth month or eighty-two percent for(82%)the eleventh month,then the CONTRACTOR
shall submit a Corrective Action Plan, within ten (10)days of receipt of a written request from
the DEP Task Manager, to the DEP Task Manager describing the steps that will be taken to
meet the terms of the Task Assignment.
D. If there is any indication that other required inspections or activities are not being performed,
the DEP Task Manager may request the submission of a Corrective Action Plan (Plan).
E. The DEP Task Manager shall be responsible for reviewing the plan and notifying the
CONTRACTOR if the Plan is approved or in need of revision.
F. If the CONTRACTOR does not successfully implement the Plan as approved by the DEP
Task Manager for the remaining months of the Task Assignment, the DEP may withhold
further payment of monthly invoices until such time as the CONTRACTOR comes into
compliance with those performance levels as outlined in paragraph 7.8.,above.
G. A completion rate of 100 percent is required for those activities described in Paragraph 3,
above, and as set forth in each Task Assignment, unless otherwise indicated in the Task
Assignment,
H. in the event the CONTRACTOR is unable to meet 100% performance levels set forth in the
Task Assignment, the DEP reserves the right to seek cost recovery according to the
percentage of the amount identified in each executed Task Assignment, unless failure of the
CONTRACTOR to perform is documented to be beyond the foreseeable control of the
CONTRACTOR(Le.a force majeure event),
8. The DEP shall authorize the CONTRACTOR to provide services under this Contract utilizing the
Task Assignment Notification Form, attached hereto and made a part hereof as Attachment B. The
CONTRACTOR acknowledges that no work shall be performed until a Task Assignment authorizing
work has been fully executed by the DEP and the CONTRACTOR. If, during the term of an
executed Task Assignment,a modification of the Task Assignment is needed,the DEP may issue a
new Task Assignment Form clearly marked with the original task number and the appropriate
amendment number, detailing the revised description of the work to be performed. As with the
original Task Assignment, all amendments to Task Assignments must be executed by both the DEP
and the CONTRACTOR prior to the work being performed.
CONTRACTOR RESPONSIBILITIES
9. The CONTRACTOR shall administer the compliance verification program, provide technical
assistance, and perform level 1 enforcement actions. Data generated from all inspections
conducted under the direction of the DEP shall be entered into FIRST prior to the submittal of an
invoice to the District. The CONTRACTOR shall also conduct "Discharge Prevention Response
Certificate(DPRC) Inspections" (Guidance Document H)at all applicable facilities pursuant to Rule
62N-16.032, F.A.G.
10. The CONTRACTOR shall comply with all provisions of this Contract, verify facility compliance with
Chapter 376, F.S., Chapters 62-761, 62-762, and 62N-16.032, F.A.C., and be knowledgeable of the
differences between the state and federal environmental statutes and rules applicable to
underground storage tanks.
11. The CONTRACTOR shall require that qualified individuals perform field inspections and that they
receive training on Chapters 62-761, 62-762, and 62N-16,032, F.A.C., Chapter 376, F.S., RCRA
Subtitle I standards and DEP enforcement procedures.
DEP Contract No.GC690.Pace 4 of 13
40 1
Egt1
12. The CONTRACTOR shall provide a sufficient number of qualified staff to satisfactorily complete all
the responsibilities included in this Contract. All individuals hired after the effective date of this
Contract shall possess qualifications equivalent to DEP position levels as specified in this Contract.
13. All field inspectors and enforcement personnel shall attend and complete scheduled storage tank
inspector training courses and pass any examinations. if the employee fails to pass, the employee
may take the examination at the next offered training class. During this period the employee may
continue to perform inspections. However, subsequent failure to provide certified inspectors will
result in a reduction of the fixed price negotiated in the Task Assignment.
14. The CONTRACTOR shall determine the accurate latitude and longitude coordinates for each facility
inspected using DEP-approved procedures (Source Water Assessment Program (SWAP)
Webpoint)and ensure the proper entry of this data into the DEP inspection database.
15. The CONTRACTOR shall review closure reports filed by facility owners or operators to insure that
the DEP's "Storage Tank System Closure Requirements" (Guidance Document C) have been
followed. In cases where these requirements have not been met, the CONTRACTOR shall initiate
Level 1 enforcement actions to compel compliance. In cases where these requirements have been
met and none the of DEP's cleanup target levels have been exceeded, the CONTRACTOR shall
issue a Closure Report Review Letter for the system or component described in the Closure Report
indicating the Closure Report meets the requirements of Chapter 62-761 and/or 62-762, F.A.C. In
cases where cleanup target levels have been exceeded, the CONTRACTOR,shall follow further
direction from the DEP Task Manager.
16. The CONTRACTOR shall maintain files on regulated facilities for inspection reports,noncompliance
letters, warning letters, or any other related enforcement documentation, telephone logs and written
correspondence from the facility that may not be available in FIRST. In the event a case referral to
the DEP District Office for further enforcement is necessary, a case summary, a copy of any
documents pertinent to the case that are not available in FIRST, and a letter of referral shall be
submitted to the DEP District Office in accordance with the "Guidelines for Case Referrals"
(Guidance Document I).
17. Facility files must be kept until the site has been determined closed. Once the facility has been
closed for five (5)years, the records shall be sent to the DEP Contract Manager in Tallahassee for
preservation, unless the CONTRACTOR is subject to more stringent local record retention
requirements. Copies can be maintained by the CONTRACTOR at the CONTRACTOR's expense.
If, for any reason, the DEP's contractual arrangement with the CONTRACTOR to perform the
inspection program (through this Contract or any future contracts)ceases, the CONTRACTOR shall
return all original facility files to the DEP Task Manager within 30 calendar days of Contract
expiration or termination.
18. The CONTRACTOR shall provide complete copies of discharge packages (discharge reporting
form, discharge inspection report, Site Assessment Request letter (if required)) to the DEP Task
Manager and DEP Contract Manager within thirty(30)days of receipt of the reported discharge.
19. The CONTRACTOR shall provide attendance of at least one program staff member at scheduled
meetings and at scheduled teleconferences, including the Tanks Conference. The DEP Task
Manager may authorize attendance at a location other than the District Office. The CONTRACTOR
shall provide attendance of additional staff members as requested by the DEP.
20. The CONTRACTOR shall maintain a current set of the reference standards as contained in
Chapters 62-761 and 62-762,F.A.G.
21. The CONTRACTOR shall ensure that all field personnel receive the health and safety training
required to meet OSHA standards (an initial 24 or 40 hour course within 6 months of employment
under this Contract,followed by an annual 8 hour refresher course),
DEP Contract No.GC690,Page 5 of 13 ,
1 C 1
EXHIBIT C
22, The CONTRACTOR shall supervise the Local Compliance Program with an individual at a minimum
equivalent to the DEP's Environmental Specialist III personnel category.
23. The CONTRACTOR shall perform all clerical activities for the above-mentioned tasks, by an
individual at a minimum equivalent to a Secretary Specialist level or higher.
24. The CONTRACTOR shall provide copies of applicable rules, inspection forms, and other
program/public assistance information to the public and regulated interests. However, this provision
does not authorize photocopying of reference documents in violation of copyright law.
25. The CONTRACTOR shall use recycled paper for all program correspondence and documents.
26. The CONTRACTOR shall maintain financial books, records, and documents directly pertinent to
performance under this Contract in accordance with generally accepted accounting principles
consistently applied. All books, records, and documents pertinent to performance under this
Contract shall be maintained for the entire term of this Contract and for five years following the
expiration or termination of this Contract. The DEP, the State, or their authorized representatives
shall have access to such records for audit purposes during the entire term of this Contract and for
five years following the expiration or termination of this Contract. A penalty of 8.3% of the current
Task Assignment amount will be assessed for each year that shows insufficient record keeping.
27. The CONTRACTOR shall maintain a separate account (Trust Fund or Cost Center) within the
CONTRACTOR's accounting system for the receipt and disbursement of funds provided under this
Contract so as to trace and monitor Inland Protection Trust Fund(IPTF)expenditures.
28. The CONTRACTOR shall provide a Statement of Revenue, Expenses and Fund Balance utilizing
the"Guidelines for Preparing Year End Financial Statement"(Guidance Document G)for the period
of the executed Task Assignment within forty-five(45)days of payment of the twelfth invoice for the
current Task Assignment. If the CONTRACTOR fails to timely provide a Statement of Revenue,
Expenses and Fund Balance within the forty-five (45) day period, the CONTRACTOR will be
assessed a five percent (5%) penalty based on the current Task Assignment amount. The penalty
amount will be subtracted from Invoice Number 12 in the current Task Assignment Year. The
CONTRACTOR is still obligated to provide the Statement of Revenue, Expenses and Fund Balance
to the DEP even if the CONTRACTOR provides this statement after the 45-day deadline and is
assessed the five percent(5%)penalty.
29. If the CONTRACTOR's fund balance is less than or equal to ten percent (10%) of its current year
Task Assignment, the CONTRACTOR may retain the surplus provided that such surplus must be
used pursuant to the provisions of this Contract, the Task Assignment and Section 376.3071, F.S.
If the CONTRACTOR's fund balance is greater than ten percent (10%) of its current year Task
Assignment amount, the CONTRACTOR shall refund to the DEP any and all amounts in excess of
ten percent(10%)of the current year Task Assignment amount. However, the CONTRACTOR can
submit to the DEP,with the Fund Balance Report, a written proposal to retain the funds that exceed
the ten percent (10%) of the current year Task Assignment. The DEP, at its sole discretion, will
then determine whether the CONTRACTOR may retain the funds greater that ten percent(10%)of
the current year Task Assignment.
30. The CONTRACTOR shall not allocate funding to non-program activities outside the scope of this
Contract or any Task Assignment. Sections 376.3071 and 376.11, FS., prohibit the use of IPTF
and Florida Coastal Protection Trust Fund (FCPTF)moneys for purposes other than those specified
in these sections,
31. Access to DEP databases shall be made by using an Internet connection. Therefore, the
CONTRACTOR is responsible for subscribing to and paying for all charges related to use of the
(i
rI )
FP nnntrant Nn Pnna elf 0
1 C 1
EXHIBIT C
services of a reputable Internet service provider. The CONTRACTOR must have a dedicated
Internet line for FIRST.
32. Guidance Documents, The CONTRACTOR agrees that the services required under this Contract
shall be performed in accordance with the guidance documents listed below and in accordance with
the provisions of this Contract. The CONTRACTOR acknowledges that these documents may be
amended and the services required under this Contract shall be performed in accordance with the
versions in effect at the time work is performed by the CONTRACTOR. The CONTRACTOR
hereby acknowledges receipt of the following guidance documents:
A. Guidance Document A — Storage Tank System Program Violation List.
B. Guidance Document B -- Florida Inspection Reporting for Storage Tanks (FIRST) User
Requirements
C. Guidance Document C -- Storage Tank System Closure Requirements
D. Guidance Document D Compliance Verification Program Local Program Review Form."
E. Guidance Document E — Contractual Services Invoice
F. Guidance Document F -- Level of Effort Guidance
G. Guidance Document G Guidelines for Preparing Year End Financial Statement
H. Guidance Document H — Discharge Prevention Response Certificate(DPRC)Inspections
I. Guidance Document I -- Guidelines for Case Referrals
J. Guidance Document J -- DEP Directive 923: Settlement Guidelines for Civil and
Administrative Penalties
33. The CONTRACTOR shall provide a written response to the Program Review findings conducted in
accordance with paragraph 42, below, and at a minimum, provide details on any corrective actions
that will be implemented.
34. The CONTRACTOR shall submit a satisfactory Corrective Action Plan to the DEP Task Manager
upon notification of a score below seventy-five (75) on the Program Review within fourteen (14)
calendar days of notification of the score. Because a score below 75 reflects an unacceptable level
of performance, if the CONTRACTOR receives a score below 75, a penalty of 8.3% of the current
Task Assignment amount will be assessed. The penalty amount will be subtracted from invoice
Number 12 in the current Task Assignment Year.
35. The CONTRACTOR is responsible for the professional quality,technical accuracy.and coordination
of all reports and other services furnished by the CONTRACTOR under this Contract. The
CONTRACTOR shall, without additional compensation, correct or revise any errors, omissions, or
other deficiencies in its reports and other services.
DEP RESPONSIBILITIES
36. The DEP shall administer the "Storage Tank Training Course" to provide inspector training for all
CONTRACTOR inspectors and enforcement personnel.
37. The DEP shall serve in an advisory capacity to the CONTRACTOR. The DEP shall make legal
interpretations of DEP rules, which shall be binding with respect to the CONTRACTOR's ordinances
to the extent that those ordinances adopt the provisions of Chapters 62-761 and 62-762, F.A.C.,as
required by this Contract.
38. The DEP shall review completed inspection reports when and as deemed necessary.
39. The DEP shall provide program and regulatory guidance for the CONTRACTOR. The DEP shall
provide training In new technology and program management changes at the Annual Program and
Supervisors'Meetings.
ftc:7)
DEP Contract No.GC630,Page 7 of 13
1 6 0 1
EXHIBIT C
40. The DEP shall conduct enforcement activities for violations of Chapters 62-761 and 62-762, F.A.C.,
when case referrals are properly made and forwarded to the District Office in accordance with the
"Guidelines for Case Referrals"(Guidance Document I).
41. The DEP shall provide information to the CONTRACTOR about DEP registered storage tank
system equipment, alternate procedures (waivers, variances, or registrations), licensed Pollutant
Storage Systems Contractors (PSSC),and Registered Precision Tank Testers.
42. At least once annually, the DEP shall perform a Program Review using the`Compliance Verification
Program Local Program Review Form" (Guidance Document D),and provide a copy of the Program
Review findings to the CONTRACTOR upon completion of the Program Review. The
CONTRACTOR shall be notified at least fourteen (14) calendar days prior to a review of the
CONTRACTOR'S hard copy facility files so that the CONTRACTOR may make arrangements to
have files and personnel available for the review as needed. The DEP may conduct inspections,
including accompanied inspections and follow-up inspections, at any reasonable time. In addition,
the DEP may also conduct facility file reviews through FIRST at any time. The DEP Task Manager
may perform additional program reviews,as deemed necessary, to insure the required performance
of the CONTRACTOR. The DEP Task Manager may forgo a Program Review for the next Task
Assignment for a CONTRACTOR that receives a score of 95 or greater on the Program Review
during the current Task Assignment.
TERM OF CONTRACT
43. This Contract shall become effective on the date of execution or July 1, 2007, whichever date is
later; and shall remain in effect until June 30, 2017. In accordance with Section 287.058(2), Florida
Statutes, the CONTRACTOR shall not be eligible for reimbursement for services rendered prior to
the execution date of this Contract and the execution of a Task Assignment. The DEP anticipates
Task Assignments will be executed no later than July 1 of each year detailing the requirements for
the next twelve (12) month period. Task Assignment performance periods may not extend beyond
the completion date of the Contract established above. This Contract may be renewed for an
additional term not to exceed the original Contract period or three (3) years, whichever is longer.
Renewal of this Contract shall be in writing and subject to the same terms and conditions of this
Contract. All renewals are contingent upon satisfactory performance by the CONTRACTOR and the
availability of funds.
NOTICES
44. Any and all notices shall be delivered to the parties at the following addresses:
CONTRACTOR DEP
Robert Ward Mr.Marshall Mott-Smith
Collier County Board of Department of Environmental Protection
County Commissioners Bureau of Petroleum Storage Systems
Collier County Pollution Control 2600 Blair Stone Road,MS4525
and Prevention Department Tallahassee, Florida 32399-2400
3301 Tamiami Trail E,Bldg H
Naples, Florida 34112
COMPENSATION
45. For satisfactory performance, DEP agrees to compensate the CONTRACTOR on a fixed price basis
as described by each executed Task Assignment. It is hereby understood and agreed by both
parties that the compensation provided under this Contract shall not exceed the amount negotiated
in each executed Task Assignment for each specified period. The DEP's calculation of the fixed
price identified above is outlined in the executed Task Assignment Notification Form.
DEP Contract No.GC690.Paoe 11 of 13 #2)
1601
EXHIBIT C
46. The State of Florida's performance and obligation to pay under this Contract is contingent upon an
annual appropriation by the Legislature and continuation of other funding presently anticipated.
PAYMENTS
47. The CONTRACTOR shall submit monthly invoices in the amount specified in the executed Task
Assignment. Each invoice shall be submitted using the "Contractual Services Invoice" (Guidance
Document E). Each invoice is due no later than the 15th day of the month following the month of
services. Travel expenses associated with the annual meeting, Tanks Program Supervisor's
Meetings, and travel required for inspections, enforcement re-inspections, district coordination,
training and monthly teleconferences are included in the monthly payment schedule and no
additional travel expenses will be authorized. Each invoice must be submitted in detail sufficient for
pre-audit and post-audit review. A final invoice for each Task Assignment must be submitted as
directed by the DEP prior to the completion date of the executed Task Assignment to assure the
availability of funding for payment. The DEP shall pay all satisfactory invoices in accordance with
Section 215.422,F.S. Two copies of each invoice shall be submitted to:
Department of Environmental Protection
South District Office
Attn.:Send to the DEP Task Manager's Attention
2295 Victoria Ave.,Suite 364
Fort Myers,Florida 33902
48. Pursuant to Section 215.422, Florida Statutes, the DEP's Task Manager shall have five (5)working
days, unless otherwise specified herein, to inspect and approve the services for payment; the DEP
must submit a request for payment to the Florida Department of Financial Services within twenty
(20)days; and the Department of Financial Services is given ten(10)days to issue a warrant. Days
are calculated from the latter date the invoice is received or services received, inspected, and
approved. invoice payment requirements do not start until a proper and correct invoice has been
received. Invoices which have to be returned to a contractor for correction(s)will result in a delay in
the payment. A Vendor Ombudsman has been established within the Florida Department of
Financial Services who may be contacted if a contractor is experiencing problems In obtaining timely
payment(s) from a State of Florida agency. The Vendor Ombudsman may be contacted at 850-
410-9724 or 1-800-848-3792.
49. In accordance with Section 215.422, Florida Statutes,the DEP shall pay the Contractor,interest at a
rate as established by Section 55.03(1), Florida Statutes on the unpaid balance, if a warrant in
payment of an invoice is not issued within forty (40) days after receipt of a correct invoice and
receipt, inspection, and approval of the goods and services. Interest payments of less than $1 will
not be enforced unless a contractor requests payment. The interest rate established pursuant to
Section 55.03(1), Florida Statutes may be obtained by calling the Department of Financial Services,
Vendor Ombudsman at the telephone number provided above or the DEP's Procurement Section at
850-245-2361.
REPORTS AND DELIVERABLES
50. The DEP Task Manager shall review the monthly invoice for accuracy and completeness and review
such things as the number of inspections completed in the FIRST application before the monthly
invoice is forwarded to the Bureau of Petroleum Storage Systems in Tallahassee, Florida for
processing. The DEP has ten (10)working days from the receipt of all deliverables and reports to
review the work performed by the CONTRACTOR during the invoice period. If the CONTRACTOR
fails to perform as directed by the terms of this Contract, the DEP shall return the unpaid invoice
and/or reports and deliverables to the CONTRACTOR documenting the areas in which the
CONTRACTOR has failed to meets its contractual obligations.
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
DEP Contract No.GC690,Page 9 of 13 42)
1 6 C 1
EXHIBIT C
EQUIPMENT
51, Upon satisfactory completion of this Contract, the CONTRACTOR may retain ownership of the non-
expendable personal property or equipment purchased under this Contract. However, the
CONTRACTOR shall complete and sign a Property Reporting Form, DEP 55-212, provided as
Attachment C,and forward it along with the appropriate invoice to the DEP's Contract Manager.The
•
following terms shall apply:
A. The CONTRACTOR shall have use of the non-expendable personal property or equipment for
the authorized purposes of the contractual arrangement as long as the required work is being
performed.
B. The CONTRACTOR is responsible for the implementation of adequate maintenance
procedures to keep the non-expendable personal property or equipment in good operating
condition.
C. The CONTRACTOR is responsible for any loss,damage, or theft of,and any loss,damage or
injury caused by the use of, non-expendable personal property or equipment purchased with
state funds and held in his possession for use in a contractual arrangement with the DEP,
D. In the event that the DEP determines a need to loan equipment needed for the completion of
services under this Contract to the CONTRACTOR, a DEP Property Loan Agreement shall be
completed and maintained in the Contract file.
E. If the CONTRACTOR fails to perform its obligations under this Contract, the CONTRACTOR
shall deliver possession and custody of all such equipment to the nearest District Office
location, unless otherwise agreed,within thirty(30)calendar days of Contract termination.
MANAGEMENT
52, The DEP Contract Manager is Marshall T. Mott-Smith, Phone 850-245-8842 or Suncom 205-8842.
The CONTRACTOR's Contract Manager is Robert Ward, Phone 239-732-2502 or Suncom 751-
2502, Each Task Assignment will identify the DEP Task Manager and the CONTRACTOR's Task
Manager. All matters relating to a specific Task Assignment shall be directed to the DEP Task
Manager for appropriate action or disposition. All matters relating to this Contract shall be directed
to the DEP Contract Manager.
TERMINATION
53. Either party may terminate this Contract for its convenience by giving the other party thirty(30)days
written notice. If termination is effected by the DEP, the CONTRACTOR shall be compensated for
work satisfactorily completed and irrevocable commitments made. If termination is effected by the
CONTRACTOR,the CONTRACTOR shall be compensated for work satisfactorily completed.
54. If the CONTRACTOR fails to perform in a timely and proper manner, in the judgment of the DEP,
the DEP may terminate this Contract by thirty (30) days written notice, specifying the effective
time/date of termination. In this event, the CONTRACTOR shall be compensated for any work
satisfactorily completed.
55. This Contract may be terminated by the DEP for refusal by the CONTRACTOR to allow public
i access to all documents, papers, letters, or other material made or received by the CONTRACTOR
in conjunction with this Contract, unless the records are exempt from Section 24(a) of Article 1 of
the State Constitution and Section 119,07(1), Florida Statutes.
•
•
0
rIPP r.rtrdrnet kin itetWiti Partia lil rtf 11
16C 1
EXHIBIT C
56. it is hereby understood and agreed that in the event the DEP makes a clear determination that the
CONTRACTOR has breached this Contract to the extent that the CONTRACTOR is (at the sole
discretion of the DEP) inadequate to administer the Storage Tank System Compliance Verification
Program, compliance inspections, and preliminary enforcement activities under Chapters 62-761
and 62-762, F.A.C., and Chapter 376, F.S., for regulated storage tank systems in its jurisdiction,or
that such program is being carried out in a manner inconsistent with the requirements of this
Contract, the DEP may, as an alternative to termination of this Contract, and at the DEP's sole
discretion, require corrective measures to be taken by the CONTRACTOR within a reasonable
period of time, not to exceed 45 days. In the event the CONTRACTOR fails to take such necessary
corrective action within the time required, the DEP may terminate this Contract in accordance with
paragraph 54,above.
ADDITIONAL PROVISIONS
57. All services shall be performed by the CONTRACTOR to the satisfaction of the Secretary of the
DEP or his/her designated representative.
58. The DEP and the CONTRACTOR may at any time, by written order designated to be a change
order, make any change in the work within the general scope of the Contract (e.g., specifications,
time, method or manner of performance, requirements, etc.). Changes to Task Assignment
Notification Forms issued by the DEP shall be evidenced by an amendment to the Task Assignment
as described in paragraph 8, above. All change orders are subject to mutual agreement of both
parties and shall be evidenced in writing. Any change order,which causes an increase or decrease
in the CONTRACTOR's cost or time, shall require an appropriate adjustment and modification
(amendment)to this Contract.
59. The CONTRACTOR covenants that it presently has no interest and shall not acquire any interest,
which would conflict in any manner or degree with the performance of services required.
60. The CONTRACTOR warrants that no person or agency has been employed or retained to solicit or
secure this Contract upon an agreement or understanding for a commission, percentage,
brokerage, or contingent fee except bona fide employees or agencies maintained by the
CONTRACTOR for the purpose of securing business.
61. A person or affiliate who has been placed on the convicted vendor list following a conviction for a
public entity crime may not perform work as a contractor, supplier, subcontractor, or consultant
under a contract with any public entity, and may not transact business with any public entity in
excess of the threshold amount provided in Section 287.017, F.S., for Category Two for a period of
36 months from the date of being placed on the convicted vendor list.
62. The CONTRACTOR shall comply with all federal, state and local rules and regulations in providing
services to the DEP under this Contract. The CONTRACTOR acknowledges that this requirement
includes compliance with all federal,state and local health and safety rules and regulations.
63. No delay or failure to exercise any right, power or remedy accruing to either party upon breach or
default by either party under this Contract, shall impair any such right, power or remedy of either
party; nor shall such delay or failure be construed as a waiver of any such breach or default, or any
similar breach or default thereafter.
64. This Contract is an exclusive contract for services and the CONTRACTOR may not subcontract,
assign, or transfer, in whole or in part, any work under this Contract without the prior written consent
of the DEP.
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
DEP Contract No.GC690,Page 11 of 13 (10
16C1
EXHIBIT C
65. Discriminatory Practices.
A. No person, on the grounds of race, creed,color, national origin,age,sex,or disability,shall be
excluded from participation in; be denied the proceeds or benefits of; or be otherwise
subjected to discrimination in performance of this Contract.
B. Art entity or affiliate who has been placed on the discriminatory vendor list may not submit a
bid on a contract to provide goods or services to a public entity, may not submit a bid on a
contract with a public entity for the construction or repair of a public building or public work,
and may not submit bids on leases of real property to a public entity. The Florida Department
of Management Services is responsible for maintaining the discriminatory vender list and
intends to post the list on its website. Questions regarding the discriminatory vender list may
be directed to the Florida Department of Management Services,Office of Supplier Diversity at
850-487-0915.
66. To the extent required by law, the CONTRACTOR will be self-insured against, or will secure and
maintain during the life of this Contract, Workers' Compensation Insurance for all its employees
connected with the work under this Contract. In case any work is subcontracted, the
CONTRACTOR shall require the subcontractor similarly provide Workers'Compensation Insurance
for all of the latter's employees unless such employees are covered by the protection afforded by
the CONTRACTOR. Such self-insurance program or insurance coverage shall comply fully with the
Florida Workers' Compensation law, In case any class of employees engaged in hazardous work
under this Contract is not protected under Workers' Compensation statutes, the CONTRACTOR
shall provide, and cause each subcontractor to provide,adequate insurance satisfactory to the DEP,
for the protection of his employees not otherwise protected.
67. For purposes of this Contract, the CONTRACTOR is not authorized to issue variances or waivers
pursuant to Section 120.542, F.S., to issue declaratory statements pursuant to Section 120.565,
F.S., or the County equivalent of these provisions where the affect would be to issue a variance,
waiver or declaratory statement of a state law or rule that has been adopted as a County ordinance.
68. Nothing in this Contract shall be considered an approval by the DEP of equivalent, more stringent or
extensive local programs pursuant to Section 376.317, F.S.
LIABILITY
69. The CONTRACTOR, as an independent contractor and not an agent, representative, or employee
of the DEP, agrees to carry adequate liability and other appropriate forms of insurance. The DEP
shall have no liability except as specifically provided in this Contract,
70. Each party hereto agrees that it shall be solely responsible for the negligent or wrongful acts of its
employees and agents. However, nothing contained herein shall constitute a waiver by either party
of its sovereign immunity or the provisions of Section 768.28, F.S.
SEVERABILITY
71. In the event one or more provisions of this Contract are declared invalid, the balance of this
Contract shall remain in full force and effect.
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
DPP Contract No.GC65111 Paola 12 of 13
1 6 C 1
EXHIBIT C
...
ENTIRE AGREEMENT
it is hereby understood and agreed that this Contract states the entire agreement and that the
parties are not bound by any stipulations, representations,agreements, or promises, oral or otherwise,not
printed in this Contract. This Contract may be modified by written amendment executed by the parties
hereto,
COLLIER COUNTY BOARD OF FLORIDA DEPARTMENT OF
COUNTY COMMISSIONERS ENVIRONMENTAL PROTECTION
Collier County Pollution Contra
and Prevention D,•I.rtrrient
,' ''',:. -0Nitstor Air •
;.nue James Colett -ar*Fr- , etireau • *-re eum S . •- Systems
Chairrtia,r)
4 h,Date: pAote a./ 2P,67 Date:
ATTEST DWIGHT E. ,BROe(, ';I,ERK
71
ficr
__1144_ L
ili _..,‘ _
.. I' ' --. Ma hall Mot-Smith,DEP Contract Manager
ATtest an" to C rran signature only
, , • ., ,
) 4,,,_,,_.
\.....„,.. ,[3 ' k.A-1-14-n
Approved as to 4un & legal aufficiency 5 DEP iContracts Administrator
As:711:71ftnuity Attorney
Approved as to form/legality:
DEP Assistant General Counsel
*For contracts with governmental boards/commissions: If someone other than the Chairman signs this
Contract, a resolution, statement or other document authorizing the person to sign the Contract on behalf
of the CONTRACTOR must accompany the Contract.
List of Attachments included as part of this Contract:
Attachment Description (include number of pages)
Attachment A Standard Contract Definitions(5 pages)
Attachment B Task Assignment Notification Form (1 Page)
Attachment C Property Reporting Form (1 Page)
DEP Contract No.GC690,Page 13 of 13 0
16C1
EXHIBIT C
ATTACHMENT A
STANDARD CONTRACT DEFINITIONS
STATE OF FLORIDA DEPARTMENT OF ENVIRONMENTAL PROTECTION
Storage Tank Program
Contractor
Clean Closure Review Letter
A letter sent by the contractor to storage tank system owners notifying them that their Closure
Assessment Report has been reviewed and that no cleanup is required based on the data submitted.
Cleanup Notification Letter
A letter sent by the contractor based on the review of Closure Assessment Reports or Discharge
Inspections informing owners of their responsibility to proceed with a cleanup of their site in accordance with
Chapter 62-770, F.A.C., or wait for Department authorization to proceed with cleanup in accordance with
Section 376.30711, Florida Statues (F.S.)
Closure Event
The closure of a tank(s)or component(s)from a single excavation or location (Aboveground Storage
Tank)during a continuous time period.
Closure Inspection
An inspection performed during or after a storage tank system closure event in order to determine if
the system was closed in accordance with Department rules. Additional site visits may be needed to
complete the closure inspection form for a closure event. No compliance inspection will be performed at a
closed facility after a closure inspection.
Complaint
An expression of dissatisfaction received by DEP or local government personnel from a person who
is concerned about a storage tank system installation, removal,operation,or contamination situation.
Complaint Investigation
All work associated with responding to verbal or written complaints and inquiries including the
investigation and reporting of possible violations of storage tank system rules and suspected releases. The
contractor shall conduct complaint investigations for any complaints received from any source or as
requested by the Department. The investigation should include a complete and thorough Chapter 62-761
and 62-762, F.A.C. inspection for regulated facilities as appropriate. Inspections of regulated and
unregulated facilities should be conducted using the FIRST system.
Complaint Referral
If it is determined to be beyond the scope of authority of the contractor, a complaint may be referred
to the Department District Office or other appropriate agency. The referrals shall include copies of all forms
and documented findings of the investigation as required by the Department.
Compliance Verification Program
A locally administered program for the inspection of storage tanks as authorized in 376.303(1)(a)F.S.
The purpose of this program is to determine and enforce compliance with Chapter 62-761, F.A.C.
DEP Contract No.GC690.Attachment A.Paco 1 of 5
1 601
EXHIBIT C
Compliance without Enforcement(CWOE)
A return to full compliance without formal enforcement. Full compliance can be verified through a re-
inspection, closure or installation inspection, receipt of records in the county office, or the receipt of any other
information, through the mail, during a meeting, or a site visit, that indicates a facility, previously determined
to be out-of-compliance is now in-compliance. Once a case has been referred to the Department's District
Office for formal enforcement, it is no longer a CWOE.
Contractor-owned Facility
A regulated facility owned or directly controlled by the local county government(the Contractor).
Discharge Inspection
An inspection performed by the contractor as a result of a notification of a discharge from a regulated
facility or a potentially regulated facility. A compliance inspection where a discharge is initially noted will only
be counted as a compliance inspection and a Discharge Report Form inspection would not be required. A
discharge discovered at any other time would require a separate inspection within ten (10)working days of
reporting.
Ecosystems Management and Restoration Trust Funds
Any fund with disbursements made in a manner consistent with the intent of Section 403.1651,
Florida Statutes.
Environmental Specialist I
An Environmental Specialist I must have:
-A bachelor's degree from an accredited college or university with a major in one of the physical or
natural sciences or engineering;or
-A master's degree from an accredited college or university in one of the physical or natural sciences
or engineering;or
-Professional experience in environmental protection, regulation or health; one of the physical or
natural sciences; or engineering can substitute on a year-for-year basis for the required college
education.
Note: Substitutions for qualified personnel can be made at the written discretion of the Department
based on the tenure of professional experience in a directly related field.
Environmental Specialist ii
An Environmental Specialist II must have:
-A bachelor's degree from an accredited college or university with a major in one of the physical or
natural sciences or engineering and two years of professional experience in environmental
protection,regulation or health;one of the physical or natural sciences;or engineering;or
-A master's degree from an accredited college or university in one of the physical or natural sciences
or engineering and one year of professional experience as described above;or
-A doctorate degree from an accredited college or university in one of the physical or natural sciences
or engineering; or
-One year of experience as an Environmental Specialist I with the State of Florida;or
-Professional experience in environmental protection, regulation or health; one of the physical or
natural sciences; or engineering can substitute on a year-for-year basis for the required college
education.
DEP Contract No.GC690,Attachment A,Page 2 of 5 41!,
16C1
EXHIBIT C
Note: Substitutions for qualified personnel can be made at the written discretion of the Department
based on the tenure of professional experience in a directly related field.
Environmental Specialist III
An Environmental Specialist III must have:
-A bachelor's degree from an accredited college or university with a major in one of the physical or
natural sciences or engineering and three years of professional experience in environmental
protection, regulation or health; one of the physical or natural sciences;or engineering;or
-A master's degree from an accredited college or university in one of the physical or natural sciences
or engineering and two years of professional experience as described above; or
-A doctorate degree from an accredited college or university in one of the physical or natural sciences
or engineering; or
-Two years of experience as an Environmental Specialist I or higher with the State of Florida;or
-Professional experience in environmental protection, regulation or health; one of the physical or
natural sciences; or engineering can substitute on a year-for-year basis for the required college
education.
Note: Substitutions for qualified personnel can be made at the written discretion of the Department
based on the tenure of professional experience in a directly related field.
Environmental Supervisor II
An Environmental Supervisor II must have:
-A bachelor's degree from an accredited college or university with a major in one of the physical or
natural sciences or engineering and three years of professional experience in environmental
protection,regulation or health;one of the physical or natural sciences;or engineering; or
-A master's degree from an accredited college or university in one of the physical or natural sciences
or engineering and two years of professional experience as described above; or
-A doctorate degree in one of the physical or natural sciences or engineering;or
-Two years of experience as an Environmental Specialist I or higher with the State of Florida;or
-Professional experience in environmental protection, regulation of health; one of the physical or
natural sciences; or engineering can substitute on a year-for-year basis for the required college
education.
An Environmental Supervisor II must supervise at least two professional environmental positions to be
classified as an Environmental Supervisor II, If this criterion is not met, the position must be classified as an
Environmental Specialist Ill (see requirements above).
Note: Substitutions for qualified personnel can be made at the written discretion of the Department
based on the tenure of professional experience in a directly related field,
Florida Inspection Reporting of Storage Tanks(FIRST)
FIRST is an information gathering application utilized by inspectors in the field to input data on the
conditions of any facility state-wide? The information is collected by the inspectors in ail 67 counties using a
laptop computer and then transferred to Tallahassee via the Internet multiple times daily.
nFp nantrart Na nr.fill11 Aftarhmant a Pana 3 evf
1 6 C 1
EXHIBIT C
Installation Inspections
The initial inspections performed at new facilities at the time of installation in order to determine if the
storage systems will be installed in accordance with Department rules.
Level 1 Enforcement
The minimum level of enforcement responsibility that a local government must perform as
part of the Compliance Verification Program. The Department has the responsibility for the lead in
enforcement actions. The contractor shall follow department enforcement guidelines and updates
thereto as specified in the DEP Enforcement Manual. The contractor is responsible for:
1. Issuing Noncompliance and Warning Letters.
2. Conducting or participating in informal compliance or technical meetings with
owner/operators to resolve violations.
3. Documentation of phone calls, meetings,etc.,to prepare enforcement referrals to the
Department.
4. On site inspections and re-inspections.
5. Testifying at hearings,witnessing as requested.
Level 2 Enforcement
The highest level of enforcement for a contracted local government where the contractor has the
enforcement lead and enforcement is carried out under the contractor's ordinance. The contractor must also:
1. Take the lead in the discovery process.
2. Be responsible for judicial remedies,including the determination of civil penalties, injunctive
relief,and assessment of damages.
3. Complete Consent Orders, Notices of Violation,and Final Orders.
4. Perform post judgment enforcement activities.
5. Obtain inspection warrants as needed.
Non-compliance Letter
A letter sent to a facility owner/operator after discovery of a violation or problem at a facility.
Public Assistance
Public assistance includes ail work related to providing technical,regulatory and other information to
citizens, government officials,associations,planning councils,and consultants in order to implement the
storage tank program for above and underground storage tank systems, Examples include rule interpretation
meetings or calls,speeches,presentations,and meetings with local officials.
Regulated Chapter 62-761 and 62-762,F.A.C.Facilities
A regulated facility,which has at least one storage tank system that stores a regulated substance that
is either in-service,temporarily out-of-service, or unmaintained,and includes federal facilities.
Registered Improperly Closed Facility
A facility with one or more storage tank systems,which have been registered as being closed; where
there is no information or confirmation regarding the closure, If there are regulated active tanks at this facility
it should be counted under the regulated (Chapter 62-761 and 62-762, F.A.C.) facilities category. These
facilities should only be inspected once and are normally only counted during the first contract year if
applicable.
C;;;)
DEP Contract No.GC690,Attachment A,Page 4 of 5
1 C 1
EXHIBIT C
Re-insoection
A follow-up inspection performed by the contractor to verify correction of noncompliance items
requiring verification at the site for storage tank system rules. Re-inspections are required for all violations
identified as having a moderate or major potential for harm to the environment and moderate or major extent
of deviation from the regulations, as references in the Storage Tank Penalty Guidelines and Assessments
Memo. All violations, regardless of severity involving notification or reporting will not require a re-inspection.
Routine Compliance Inspection
An inspection performed at a Chapter 62-761 or 62-762, F.A.C. regulated facility during the contract
period, for which a Storage Tank Facility Compliance Report Inspection Form has been completed. Routine
compliance inspections do not include enforcement-related re-inspections.
1. Unregistered Facility Compliance Inspection
A routine compliance inspection conducted at a site that contains one or more
petroleum storage systems that are regulated under Chapter 62-761 or 62-762, F.A.C.
and has not been registered with DEP as a regulated facility.
Secretary Specialist
One year of secretarial or office clerical experience and attainment of a typing score of at least 35
correct words per minute on the typing test administered by an office of the Job Service of Florida, the state
employment service of another state, or the central personnel agency of another state. Possession of a
Certified Professional Secretary Certificate; or College education can substitute at the rate of 30 semester or
45 quarter hours for the year of required experience;or Vocational/technical training in the area of secretarial
science or office/business studies can substitute at the rate of 720 classroom hours for the year of required
work experience; or A high school diploma or its equivalent can substitute for the one year of work
experience.
Warning Letter
A formal letter sent certified mail to a facility owner/operator when violations have not been resolved
as a result of a noncompliance letter or if the violation merits more stringent enforcement. These letters
should follow a format approved by DEP's Office of General Counsel.
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
C40.
nrP Crsntraett Nn nr:A4A AttathmAnt A Pe'nA nf
16C1
EXHIBIT C
Attachment B
Florida Department Of Environmental Protection
Task Assignment Notification Form for Collier County
Contract No.CC Task No. Amendment No. Date
Performance Period: Effective the date of execution of this Task Assignment or July 1,
whichever is later,and shall remain in effect until June 30,
Description: (Additional Pages May be Utilized)
1
Payment Schedule:
Task Managers:
DEP Task Manager:_ _ Phone:
Contractor Task Manager: Phone:
Authorization:
_
DEP Contract Manager Date
Contractor's Contract Manager Date
DEP Budget Representative Date
Funding:
Org.Code LEO.jObject Code.1Module !Special Categml Year j Amount
137 I_____1 1 _J$
137 J L. I 1. LS
Notes:
CC: DEP Procurement Section(MS 93)
Finance&Accounting,Contracts Disbursement Section(MS 78)-2 Copies
DEP Task Manager
Contractor Task Manager
CAO,
DEP Contract No.GC690,Attachment B,Page*I of 1
1 6 C 1
EXHIBIT C
SUMMARY OF CONTRACTUAL SERVICES AGREEMENT/PURCHASE ORDER
FOR TASK ASSIGMENTS
OW/Department: 37—Department of Environmental Protection Agency Contact:
Telephone#.
Collier County Board of County Commissioners Collier County Pollution Control&Prey
ContractorNendorlPayee: Department
Contract/P.O.#: GC690 Total Contract Amount or appezable)
Contract Start Date: Contract End Date:
Contract Last Signed Date:
Task Assignment#
Total Task Assignment Amount: Total Amount of Previous TA Payments;
Task Assignment Start Date: Task Assignment End Date:
Type of Services: Storage Tank System Compliance Verification Program
Method of Payment:
El Fixed Rate r4 Lump Sum 0 Cost Reimbursement El Cost Plus(any combinat1on of these) El Advance Funded
Deliverables Including Minimum Performance Standards Payment Amount
Per Task Assi•nment
Method of Procurement 0 ITB El RFP ITN El SOO Reference#
Single/Sole Source Emergency Certification
Other(Specify) Exempt—Local Government
Management Controls:
(a) All the above information is true and correct;the undersigned management represents that controls are in place to insure
that goods/services are received and payments are made in accordance with contract terms.
(b) All completed work will be verified in a certified statement signed by the contract manager or higher authority prior to payment
The undersigned understands that the office of the State Chief Financial Officer reserves the right to either appoint special
contract monitors or to conduct periodic site post-audits of any contracts,
Management Name(please print)
Management Approval Signature
Management Approval Date
Form DEP 55.213.TA(rev.1(103) Summary of Contractual Services Agreement/Purchase Order for Task Assignments,DEP Contract No. GC690 , Page 1 of 4
Dtstneubon: Onginal. Contacts Section,MS#93:Two(2)Copies:Finance&Accounting-Connors Disbursements Section,MS#78
t•se'