The URL can be used to link to this page

Agenda 10/28/2014 Item #16D 710/28/2014 16.D.7. EXECUTIVE SUMMARY Recommendation to award the Invitation To Bid No. 14 -6248 "Pharmacy Services" to Woolley's Pharmacy, Inc. and Collier Health Services, Inc. and waive minor irregularities in the solicitation. OBJECTIVE: To provide prescription services for the indigent and uninsured community residents of Collier County. CONSIDERATIONS: Section 125.01, Florida Statutes requires all Florida counties to provide short term assistance to uninsured county residents to alleviate illness and prolonged disabilities with prescription and medical services. Since 2009, Collier Health Services in Immokalee has been providing these services. In 2013, the agreement with Sunshine Pharmacy was terminated and Woolley's Pharmacy began providing pharmacy services in Naples. Both agreements were extended to October 2014. On August 27, 2014, the Purchasing Department posted the Invitation To Bid (ITB) and notifications of this bidding opportunity were sent electronically to ninety -nine (99) vendors. Twenty (20) vendors downloaded bid packages, and three (3) vendors submitted bids by the deadline of September 9, 2014. The results are as follows: Vendor AWP +/- % Markup Fixed Price for Generic List Attached Woolley's Pharmacy -10% off Brand $4.00 -15% off Generic Collier Health Services 10% Markup Various (majority less than $4.00) Pebblebrook Pharmacy 15% Markup $3.00 The solicitation requested a percentage markup on Average Wholesale Price (AWP) and a flat fee for a specified list of generic prescription medicines. The three bidders submitted different lists and were not readily comparable. Therefore, staff recommends award to the two lowest responsive bidders overall (AWP discounts and generic fixed drug pricing) to Woolley's Phannacy, Inc. and Collier Health Services, Inc. Historical invoice comparison reflected over half of the dispensed drugs pricing were based on the AWP. Staff also recommends, in the best interest of the County, that the Board waive a change from the solicitation that stated the intent to award on a Primary /Secondary basis to awarding to multiple firms at two County locations: Woolley's Pharmacy is located in East Naples and Collier Health Services is in Immokalee. Staff recommends the Board waive this minor irregularity and allow award of this contract to the two vendors. This will allow participants to choose the most convenient location to their health care facility and residence. The solicitation was issued with grant requirements in preparation for future funding, however, the Pharmacy Services are not grant funded at this time. If grant funding is established for these services, the required forms will be requested. FISCAL IMPACT: Funds for these services are budgeted in the Client Assistance cost center within Housing, Human and Veteran Services' General Fund (001) budget. Historically the County spends approximately $60,000 annually for this service. GROWTH MANAGEMENT IMPACT: There is no growth management impact associated with this Executive Summary. Packet Page -1488- 10/28/2014 16.D.7. LEGAL CONSIDERATIONS: This item is approved as to form and legality and requires a majority vote for Board approval.- ERP RECOMMENDATION: That the Board of County Commissioners award Invitation to Bid No. 14 -6248 "Phannacy Services" to Collier Health Services, Inc. and Woolley's Pharmacy, Inc. and waive the minor irregularities as set forth under the CONSIDERATIONS Section. Prepared by: Louise Pelletier, Case Management Supervisor, Housing, Human and Veteran Services Packet Page -1489- 10/28/2014 16.D.7. COLLIER COUNTY Board of County Commissioners Item Number: 16.16.D.16.D.7. Item Summary: Recommendation to award the Invitation To Bid No. 14 -6248 "Pharmacy Services" to Woolley's Pharmacy, Inc. and Collier Health Services, Inc. Meeting Date: 10/28/2014 Prepared By Name: PelletierLouise Title: Supervisor - Case Management, Housing, Human & Veteran Services 10/6/2014 11:28:50 AM Submitted by Title: Supervisor - Case Management, Housing, Human & Veteran Services Name: PelletierLouise 10/6/2014 11:28:51 AM Approved By Name: GrantKimberley Title: Director - Housing, Human and Veteran S, Housing, Human & Veteran Services Date: 10/6/2014 12:1 8:37 PM Name: TownsendAmanda Title: Director - Operations Support, Public Services Division Date: 10/6/2014 3:49:10 PM Name: BrilhartBrenda Title: Procurement Specialist, Purchasing & General Services Date: 10/7/2014 2:16:22 PM Name: MarkiewiczJoanne Title: Director - Purchasing /General Services, Purchasing & General Services Date: 10/9/2014 7:33:12 AM Name: JohnsonScott Packet Page -1490- 10/28/2014 16.D.7. Title: Manager - Procurement, Purchasing & General Services Date: 10/9/2014 1:39:14 PM Name: AlonsoHailey Title: Operations Analyst, Public Services Division Date: 10/10/2014 2:58:55 PM Name: MaeEsther Title: Accountant, Senior, Community & Human Services Date: 10/13/2014 2:42:51 PM Name: CarnellSteve Title: Administrator - Public Services, Public Services Division Date: 10/13/2014 5:01:07 PM Name: PepinEmily Title: Assistant County Attorney, CAO Litigation Date: 10/16/2014 4:45:13 PM Name: KlatzkowJeff Title: County Attorney, Date: 10/17/2014 9:35:57 AM Name: FinnEd Title: Management/Budget Analyst, Senior, Transportation Engineering & Construction Management Date: 10/20/2014 2:53:06 PM Name: OchsLeo Title: County Manager, County Managers Office Date: 10/21/2014 8:40:29 AM Packet Page -1491- 10/28/2014 16.D.7. A G R E E M E N T 14-6248 for Pharmacy Services THIS AGREEMENT, made and entered into on this day of 2014, by and between Woolley's Pharmacy, Inc., authorized to do business in the State of Florida, whose business address is 6350 Davis Blvd., Naples, Florida 34104, (the "Contractor ") and Collier County, a political subdivision of the State of Florida, (the "County "): WITNESSETH: 1. COMMENCEMENT. This Agreement shall commence on Date of Board award. 2. CONTRACT TERM. The Contract shall be for a two (2) year period, commencing on date of Board award and terminating two (years) from that date. 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 not less than ten (10) days 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 ninety (90) days. The County Manager, or his designee, shall give the Contractor written notice of the County's intention to extend the Agreement term not less than ten (10) days prior to the end of the Agreement term then in effect. 3. STATEMENT OF WORK. The Contractor shall provide Pharmacy Services as provided in Exhibit A - "Scope of Work," which is hereby incorporated by reference, in accordance with the terms and conditions of ITB #14 -6248 and the Contractor's proposal referred to herein and made an integral part of this Agreement. County residents utilizing this contract may acquire services from either awarded Pharmacy based on convenience to their health care facility and residence. This Agreement contains the entire understanding between the parties and any modifications to this Agreement shall be mutually agreed upon in writing by the Contractor and the County Project or Contract Manager or his designee, in compliance with the County Purchasing Ordinance and Purchasing Procedures in effect at the time such services are authorized. 4. COMPENSATION. The County shall pay the Contractor for the performance of this Agreement as set forth in Exhibit B "Cost Schedule ", attached to and made an integral part of this Agreement. Any item that is not included in Exhibit B "Cost Schedule" as of the effective date of this Agreement, hereinafter "Unlisted Items ", shall be available for purchase when it is added to an updated list by the Contractor, and provided to the County. The Contractor may add any Unlisted Items in order to accommodate future purchases by the County. When an Unlisted Item is added to an updated list, the pricing shall be in accordance with the terms of this Agreement. Packet Page -1492- 0 10/28/2014 16.D.7. Any County agency may purchase products and services under this contract, provided sufficient funds are included in their budget(s). 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 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 contract. 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. 4.2 The Average Wholesale Price (AWP) list will be provided with itemized invoice by the Contractor on a monthly basis. 4.3 Maximum Allowable Cost (MAC) List. If at any time after the award of this contract, the cost of the listed generic drugs have increased and exceeded the fixed price listed in Exhibit B -1, the Contractor may submit in writing, along with back -up documentation, a request for an increase or removal of item(s) from the list (MAC). The County's Project Manager, or designee, will determine if a request for cost increase is acceptable. If price increase is accepted, the item will then be invoiced per the Average Wholesale Price (AWP) markup as provided in Exhibit B -1, attached hereto. 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: Woolley's Pharmacy, Inc. 6350 Davis Blvd. Naples, FL 34104 Attention: Matthew Cammuso Telephone: 239- 775 -9908 Facsimile: 239 -775 -2094 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 Purchasing Department 3327 Tamiami Trail, East Naples, Florida 34112 Attention: Joanne Markiewicz, Director, Procurement Services Telephone: 239- 252 -8907 Facsimile: 239 - 252 -6480 Packet Page -1493- �C]* 10/28/2014 16.D.7. 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 /Subconsultants. 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 contract of the Contractor. Should the Contractor fail to correct any such violation, conduct, or practice to the satisfaction of the County within twenty -four (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 ten (10) 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 Contract 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. Packet Page -1494- CA 10/28/2014 16.D.7. 12. INSURANCE. The Contractor shall provide insurance as follows: Aft A. Commercial General Liability Coverage shall have minimum limits of $2,000,000 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. Workers' Compensation: Insurance covering all employees meeting Statutory Limits in compliance with the applicable state and federal laws. The coverage must include Employers' Liability with a minimum limit of $500,000 for each accident. C. Professional Liability: Shall be maintained by the Contractor to ensure its legal liability for claims arising out of the performance of professional services under this Agreement. Contractor waives its right of recovery against County as to any claims under this insurance. Such insurance shall have limits of not less than $1,000,000 each claim and in the aggregate. 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 Consultant from its insurer, and nothing contained herein shall relieve Contractor of this requirement to provide notice. Contractor shall ensure that all subcontractors/ Consultants comply with the same insurance requirements as the awarded firm. 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 Packet Page -1495- CA 10/28/2014 16.D.7. 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. CONTRACT ADMINISTRATION. This Agreement shall be administered on behalf of the County by the Department of Housing, Human and Veteran Services /Social Services Program. 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 CONTRACT. This Contract consists of the following component parts, all of which are as fully a part of the contract as if herein set out verbatim: Exhibit A - "Scope of Work," Exhibit B - "Cost Proposal," Exhibit C - "Supplemental General Grant Terms and Conditions," and Insurance Certificate(s). 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 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 contract held by the individual and/or firm for cause. 19. IMMIGRATION LAW COMPLIANCE. 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) -(d) and (3))). 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. Packet Page -1496- CA 10/28/2014 16.D.7. 20. 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. 21. ADDITIONAL ITEMS /SERVICES. Additional items and /or services may be added to this Agreement in accordance with the Purchasing Ordinance and Purchasing Procedures 22. 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. 23. 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. 24. CONTRACT STAFFING. The Contractor's personnel and management to be utilized for this project 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 contract. The Contractor shall assign as many people as necessary to complete the required services on a timely basis, and each person assigned shall be available for an amount of time adequate to meet the required service delivery dates. 25. ORDER OF PRECEDENCE. In the event of any conflict between or among the terms of any of the Contract Documents, the terms of the Agreement shall take precedence over the terms of all other Contract Documents, except the terms of any Supplemental Conditions shall take precedence over the Agreement. To the extent any conflict in the terms of the Contract Documents cannot be resolved by application of the Supplemental Conditions, if any, or the Agreement, the conflict shall be resolved by imposing the more strict or costly obligation under the Contract Documents upon the Contractor at County's discretion. 26. 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. Packet Page -1497- 0 10/28/2014 16.D.7. 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. ATTEST: Dwight E. Brock, Clerk of Courts Dated: (SEAL) First Witness TType /print witness nameT Second Witness TType /print witness nameT Approved as to Form and Legality: Assistant County Attorney Print Name BOARD OF COUNTY COMMISSIONERS COLLIER COUNTY, FLORIDA Bv: Tom Henning, Chairman Woolley's Pharmacy, Inc. Contractor Signature TType /print signature and titleT Packet Page -1498- CA 10/28/2014 16.D.7. 14 -6248 "Pharmacy Services" EXHIBIT A "SCOPE OF WORK" 1. Each of the Contracted pharmacists must possess a current license from the Florida State Board of Pharmacy in accordance with Revised Statutes of the State of Florida, and shall maintain said license in good standing for the duration of the contract. 2. The Contractor must be able to fill outpatient prescriptions as needed each day for the duration of the contract within the normal work hours of 8:30 am to 5:00 pm, M -F. 3. The Contractor shall provide at no additional cost to the County, pharmacy services at locations in areas which are not evacuated during a disaster, and be prepared to accept telephonic requests from the County Emergency Operations Center and fill such requests. Collier County Housing, Human and Veteran Services Department /Social Services Program will be responsible for the pick -up and delivery of any such prescriptions. 4. The Contractor shall be able to provide Generic equivalent drugs when one is available to fill the prescriptions. Prescriptions are limited to a 30 -day supply. 5. The Contractor shall provide electronic transfer of invoices (billing) to a designated email address at least monthly per Clerk of Court's Finance standards. Such electronic data transfer capability shall be operational at contract start -up and the first billing shall be forthcoming within four (4) weeks after start up of contract. The Contractor shall provide a contact name and phone number for technical assistance when file format problems arise. 6. All of the Contractor's pharmacy locations shall be connected on a common network using the same database in order to monitor patient information and manage the formulary. In addition, all locations must be connected to the central system that contains client information. All clients will be given a voucher to provide to the pharmacy. Any physician can write a prescription; this includes Primary Care, specialists, emergency room physicians, dentists, etc. Collier County Housing and Human Services /Social Services will not pay for prescriptions if the client does not present a voucher which shows a valid begin and end date of eligibility. 7. Under the Health Insurance Portability and Accountability Act (HIPAA) of 1996, Contractor is expected to adhere to the same standards as the County and other HIPAA covered entities regarding the protection and non- authorized disclosure of Protected Health Information (PHI). The Contractor shall use File Transfer Protocol (FTP), or other HIPAA compliant compatible programs to transfer encrypted client information (automatically) to pharmacy database at least twice daily, without breaking security; full file transfer shall be done weekly. Contractor must comply with HIPAA 834 file format. It is highly desirable that the Contract Manager be a pharmacist. 9. The Contractor shall identify rebates that are forthcoming and any savings realized from manufacturer's rebates shall be credit against the County's monthly invoice. Packet Page -1499- c9 10/28/2014 16.D.7. 10. Payments shall be made in accordance with the Local Government Prompt Payment Act from a joint revolving account for the payment of services provided. 11. The Contractor shall fill all medications to patients for self - administration in accordance with all applicable Federal, State and Local laws. 12. The Contractor shall update and make readily retrievable at any time, all outpatient and drug data within the outpatient profile as each prescription is filled or refilled. The contractor shall automatically monitor drug allergies and interactions according to data available for each patient. 13. The Contractor shall provide monthly Utilization and Administrative reports including number of prescriptions filled, covered individuals, utilizing individuals including physician dispensing profiles and other reports. 14. The Contractor must immediately advise the County whenever abuse, drug seeking or fraudulent behavior is suspected. 15. The Contractor shall provide to the County any manufacturer's no cost, discounted or promotional health care items, which may be provided to them during the period of the contract. 16. The Contractor shall be available for periodic site visits by Collier County staff, to any of their locations, in order to monitor the quality of services provided. 17. The Contractor must respond within twenty -four (24) hours in writing via fax, email or letter, to all questions presented by the Collier County Housing, Human and Veteran Services Department. 18. The Contractor shall provide outpatient - packaging materials, including labeling, that meets all applicable laws and regulations. Labeling for outpatient packaging shall include: a. Patient Name b. Date of Dispensing c. Prescription Number d. Physician's Name e. Instructions for Patient Use f. Name and Strength of Drug g. Number of Doses Dispensed 19. The contractor shall maintain all outpatient drug profiles on a computerized dispersing system. Each outpatient drug profile must include: a. Patient Name b. Address / Phone d. Birth Date/ Social Security Number e. Sex f. Allergies g. Prescription Number Drug data within each outpatient drug profile must include: a. Drug Name Packet Page -1500- G 10/28/2014 16.D.7. b. Drug Strengths c. Amount Ordered d. Amount Dispensed e. Instructions for Use f. Refills Authorized g. Physician Information h. Times and Dates Filled Electronic invoice data must include, but may not be limited to: a. Patients Identification Number assigned by HHVS b. Control # c. Medication name d. Strength e. Quantity f. Date Filled (MM /DD /YY) g. Generic h. Retail Price i. Cost j. Total Price Due Packet Page -1501- DIC) 10/28/2014 16.D.7. 14 -6248 "Pharmacy Services" EXHIBIT B "COST SCHEDULE" 1. The following generic drugs will be offered at $4.00 per 30 day dose (See attached list following this page, as Exhibit B-1). 2. All Drugs not listed on Exhibit B-1 shall be priced according to the following formulas based on McKesson Average Wholesale Price (AWP): Brand Name Medications: AWP minus 7.5% ( -7.5 %) Generic Medication: AWP minus 12.5% (- 12.5 %) D , �Ao Packet Page -1502- EXHIBIT B -1 10/28/2014 16.D.7. Allergies & Cold and Flu Benzonatate 100mg cap ... ............ 14...... 42 Loratadine 10mg tab ................. 30...... 90 Promethazine DM syrup . . . . . . . . . . . . . 120ml .... 360ml Antibiotic Treatments Amoxicillin 125mg/5ml susp (80ml bottle)' ......1....... 3 Amoxicillin 125mg /Smi susp (100ml bottle)' .....1....... 3 Amoxicillin 125mg /5ml susp 0 50m bottle)' .....1....... 3 Amoxicillin 200mg /5ml susp (50ml bottle)' ......1....... 3 Amoxicillin 200mg /5mi susp* (75ml bottle)' .....1....... 3 Amoxicillin 200mg /5mi susp* (100ml bottle)' ..... 1....... 3 Amoxicillin 250mg /5ml susp (80ml bottle)' ......1....... 3 Amoxicillin 250mg /5mi susp (100ml bottle)' , ....1....... 3 Amoxicillin 250mg /5mi susp (1 50ml bottle)' .....1....... 3 Amoxicillin 400mg /5ml susp (50ml bottle)' ......1....... 3 Amoxicillin 400mg /5ml susp* (75ml bottle)' .....1....... 3 Amoxicillin 400mg /5ml susp* (100ml bottle)'. . . . .1 ....... 3 Amoxicillin 250mg cap ................ 30...... 90 Amoxicillin 500mg cap........ ...... 30...... 90 Cephalexin 250mg cap. . .............. 28...... 84 Cephalexin 500mg cap ................ 30...... 90 Ciprofloxacin 250mg tab ... ............14...... 42 Ciprofloxacin 500mg tab . .............. 20...... 60 Penicillin VK 250mg tab ... ............ 28...... 84 Penicillin VK 125mg/5ml susp (100m1 bottle)'.....1....... 3 Penicillin VK 125mg/5ml susp (200ml bottle)'. . . . .1 ....... 3 Penicillin VK 250mg /5mi susp (100ml bottle)' ..... 1....... 3 SMZ TMP 400mg -80mg tab . ............ 28...... 84 SMZ TMP DS 800mg -160mg tab........... 20...... 60 Arthritis & Pain Allopurinol 100mg tab ................ 30...... 90 Allopurinoi 300mg tab ................ 30...... 90 Baclofen 10mg tab* ................. 30...... 90 Cyclobenzaprine 5mg tab .............. 30...... 90 Cyclobenzaprine 10mg tab .......... ... 30...... 90 Dexamethasone 05mg tab ............. 30...... 90 Dexamethasone 0.75mg tab . .......... . . 12...... 36 Dexamethasone 4mg tab ...............6...... 18 Diciofenac DR 75mg tab* .............. 60......180 Ibuprofen 100mg /5mi susp* . . . . . . . . . . . 120ml .... 360ml Ibuprofen 400mg tab ................ 90......270 ibuprofen 600mg tab* ............ I ... 60......180 Ibuprofen 800mg tab ................ 30...... 90 Indomethacin 25mg cap* .............. 60......180 Meloxicam 7.5mg tab ................ 30...... 90 Meloxicam 1 5m tab ................. 30...... 90 Naproxen 375mg tab* .. .............. 60......180 Naproxen 500mg tab* ................ 60......180 Asthma Albuterol 2mg tab .................. 90......270 Albuterol 4mg tab ... . ..... .. ....... 60......180 Albuterol 2mg/5ml syrup .......... , .120ml .... 360ml Albuterol 0.083% nebulizer soln* (25x3ml vials)*. ....... 3 -iellbuterol05 %:nebulizersoln* ZOrr l,bottle)'.:. Ipratropiurn 0.02% nebulizer soln* (25x2.5 ml vials)' .1....... 3 Prescription Program includes up to a 30-day supply for $4 and a 90-day supplyfor $10 of some covered generic drugs at commonly prescribed dosages. Higher dosages cost more. Prices for some drugs covered by the Prescription Program maybe higher and may vary In some states. Restrictions apply. See Program Details or yourWalrnart Pharmacist for details. Free language assistance services available for prescription drug information at Walmart and Sam's Club pharmacies In New York. Contact your Walmart or Sam's Club pharmacy for details *Prices maybe higher in CA, HI. MN, MT, PA, TN and WI. Revised 9/5/2014 Home Delivery Service is not available through SamsClubcom. Prepackaged drugs are covered only In unit sizes specified on Drug Ust. See Program Details oryour Walmart Pharmacist for details. 02014 Wal -Mart Stores, Inc I Page 1 of 5 Packet Page -1503- Walmart :,%, care aw�ey. LM 6nte.. (�D 10/28/2014 16.D.7. 64, 30-day S10,90-day 64.30 -day 510, 90 =day Cholesterol Ranitidine 300mg tab .............. .. 30...... 90 Lovastatin 10mg tab .....................30...... 90 Lovastatin 20mg tab* ........... ..... 30...... 90 Diabetes Giimepiride 1 mg tab ............ ..... 30...... 90 Giimepiride 2mg tab ................. 30...... 90 Giimepiride 4mg tab ................. 30...... 90 Glipizide 5mg tab .................. 30...... 90 Glipizide 10mg tab* ... I ............. 60......180 236ml.... Glyburide 2.5mg tab ................. 30...... 90 Glyburide 5mg tab (blue) .............. 30...... 90 Glyburide 5mg tab (green) ........... ... 30...... 90 Glyburide, micronized 3mg tab ........... 30...... 90 Glyburide, micronized 6mg tab ........... 30...... 90 Metformin 500mg tab ................ 60......180 90 Metformin 850mg tab ................ 60......180 Metformin 1000mg tab* ............. . 60......180 Metformin 500mg ER tab* ............... 60......180 Ear Health Anti pyrine/Benzocai ne otic* (1 5ml bottle)" ......1....... 3 Fungal Infections Fluconazole 150mg tab.. ............... 1....... 3 Nystatin cream* (15gm tube)' ............... 1....... 3 Nystatin cream* (30gm tube)" ............... 1....... 3 Terbinafine 250mg tab * ...................30...... 90 Gastrointestinal Health Cimetidine 800mg tab* ............... 30...... 90 Cytra2 solution . . . . . . . . . . . . . . . . . . 180ml .... 540ml Dicyclomine 10mg cap . . . . . . . . . . . . . . . . 90......270 Gentamicin 0.3% op. soln (5ml bottle)" ......... Dicyclomine 20mg tab ................ 60......180 1....... 3 Famotidine 20mg tab ................ 60......180 0.1 % op. ointment* (3.5gm tube)' ............ Lactulose syrup* ................. 236ml.... 708ml Metoclopramide 10mg tab ............. 60......180 Pilocarpine 1 % op. soin* (1 5ml bottle)' ......... Metoclopramide syrup ............. . 60m1, ...180ml 1....... 3 Promethazine 25mg tab* ............. . 12...... 36 Promethazine plain syrup *......... ...180ml .... 540ml Ranitidine 150mg tab ........... ..... 60......180 Tobramycin 0.3% op. soin (5ml bottle)" ......... Glaucoma & Eye Care Atropine Sulfate 1 % op. soin* (5ml bottle)' ...... 1....... 3 Erythromycin op. ointment (3.5gm tube)' *....... 1....... 3 Gentak 03% op. soln .................... 5...... 15 Gentamicin 0.3% op. soln (5ml bottle)" ......... 1....... 3 Levobunolol 0.5% op soln (5ml bottle)'......... 1....... 3 Neomycin /Polymyxin /Dexamethasone 90 0.1 % op. ointment* (3.5gm tube)' ............ 1....... 3 Neomycin /Polymyxin /Dexa metha so ne Benazepril 10mg tab .............. ... 0.1 % op. susp* (5ml bottle)' ................ 1....... 3 Pilocarpine 1 % op. soin* (1 5ml bottle)' ......... 1....... 3 Pilocarpine 2% op. soln* (1 5ml bottle)' ......... 1....... 3 Poiymyxin Sulfate /rMP op. soin* (10ml bottle) ".... 1....... 3 Sulfacet Sodium 10% op. soin* (15mi bottle)'..... 1....... 3 Timolol Maleate 0.25% op. soin (5ml bottle)' ..... 1....... 3 Timolol Maleate 0.5% op soin (5ml bottle)' ...... 1....... 3 Tobramycin 0.3% op. soin (5ml bottle)" ......... 1....... 3 Heart Health & Blood Pressure Atenolol - Chlorthalidone 100mg . . . . . . . . . . . 30...... 90 Atenolol 25mg tab .................. 30...... 90 Atenolol 50mg tab .................. 30...... 90 Atenolol 1 00m tab ................. 30...... 90 Benazepril 5mg tab ........... ....... 30...... 90 Benazepril 10mg tab .............. ... 30...... 90 Benazepril 20mg tab ................. 30...... 90 Benazepril 40mg tab ................. 30...... 90 Bisoprolol -HCTZ 2.5mg- 6.25mg tab ......... 30...... 90 Bisoproiol -HCTZ 5mg- 6.25mg tab .......... 30...... 90 Bisoprolol -HCTZ 10mg- 6.25mg tab ......... 30. , .... 90 Carvedilol 3.125mg tab ............... 60......180 Carvedilol 6.25mg tab ................ 60......180 Carvedilol 12.5mg tab ....... . . .... .. . 60......180 Carvedilol 25mg tab ................. 60......180 Clonidine 0.1 mg tab ................. 30...... 90 Clonidine 0.2mg tab ................. 30...... 90 Enalapril -HCTZ 5mg-1 2.5mg tab* .......... 30...... 90 Enalapril 2.5mg tab .................. 30...... 90 Enalapril 5mg tab ................... 30...... 90 Prescription Program Includes up to a 30-day supply for $4 and a 90-day supplyfor $10 of some covered generic drugs at commonly prescribed dosages. Higher dosages cost more. Prices for some drugs covered by the Prescription Program may be higher and may vary in some states. Restrictions apply. See Program Details or your Walmart Pharmacist for details. Free language assistance services available for prescription drug information at Walmart and Sam's Club pharmacies In New York. Contact your Walmart or Sam's Club pharmacy for details Revised 9/52014 • Prices may be higher in CA, HI, MN, MT, PA,TN and Wt. Home Delivery Service is not available through SamsClub.com. Prepackaged drugs are covered only In unit sizes specified on Drug l.Ist See Program Details or your Walmart Pharmacist for details. 02014 Wal -Mart Stores, Inc. I Page 2 of 5 Packet Page -1504- Wafmart :,' %. s,...on.r•u.. b.ete.. 10/28/2014 16.D.7. Furosemide 80mg tab ................ 30...... 90 Guanfacine 1 mg tab ............ , .. 30...... 90 Hydralazine 10mg tab ........... ..... 30.... , 90 Hydralazine 25mg tab ................ 30...... 90 Hydrochlorothiazide(HCTZ)12.5mg cap....... 30... , .. 90 Hydrochlorothiazide (HCTZ) 25mg tab ....... 30...... 90 Hydrochlorothiazide (HCTZ) 50mg tab ....... 30...... 90 Indapamide 1.25mg tab ...... ......... 30...... 90 Indapamide 2.5mg tab ...... . .... ..... 30...... 90 Isosorbide Mononitrate 30mg ER tab *........ 30.... , , 90 Isosorbide Mononitrate 60mg ER tab *........ 30...... 90 Lisinopril -HCTZ 10mg-1 2.5mg tab.......... 30.. i ... 90 Lisinopril -HCTZ 20mg-1 2.5mg tab* ......... 30...... 90 Lisinopril -HCTZ 20mg -25mg tab* ..... ..... 30...... 90 Lisinopril 2.5mg tab ................. 30...... 90 Lisinopril 5mg tab . ............ ..... 30..... , 90 Lisinopril 10mg tab ............. ..... 30...... 90 Lisinopril 20mg tab .................. 30...... 90 Methyldopa 250mg tab * ............... 60......180 90 MetoprololTartrate 25mg tab ....... ..... 60......180 90 Metoprolol Ta rtrate 50mg tab .. , .... .... , 60.... , .180 90 Metoprolol Tartrate 1 00m tab* ........... 60, .....180 90 Propranolol 10mg tab ...... .......... 60......180 90 Propranolol 20mg tab ................ 60......180 90 Propranolol 40mg tab ................ 60......180 90 Propranolol 80mg tab ................ 60......180 Sotalol HCL 80mg tab * ................ 30...... 90 Spironolactone 25mg tab * ... . .. .. . . . ... 30...... 90 Terazosin 1mg cap . ............ ..... 30...... 90 Terazosin 2mg cap ............. ..... 30...... 90 Terazosin 5mg cap ........... ....... 30...... 90 Terazosin 10mg cap ................. 30...... 90 Triamterene -HCTZ 75mg -50mg tab ......... 30...... 90 Triamterene -HCTZ 37.5mg -25mg tab ........ 30, . , ... 90 Verapamil 80mg tab ................. 30...... 90 Verapamil 120mg tab ................ 30...... 90 Warfarin 1 mg tab ............ ....... 30...... 90 Warfarin 5mg tab* .... . ............. 30...... 90 Warfarin 6mg tab . .................. 30...... 90 Warfarin 7.5mg tab .................. 30...... 90 Warfarin 10mg tab .................. 30...... 90 Men's Health Finasteride 5mg 30 Mental Health Amitriptyline 10mg tab ...................30...... 90 Amitriptyline 25mg tab ............... 30.. , ... 90 Amitriptyline 50mg tab ... ............ 30...... 90 Amitriptyline 75mg tab ............... 30...... 90 Amitriptyline 1 00m tab ............... 30...... 90 Benztropine 2mg tab ...... ........... 30...... 90 Buspirone 5mg tab .................. 60.. , , , .180 Buspirone 10mg tab* ................ 60. , ....180 Carbamazepine 200mg tab* ............. 60. , ....180 Citalopram 20mg tab ................. 30...... 90 Citalopram 40mg tab ................. 30, , .... 90 Fluphenazine 1 mg tab ................ 30...... 90 Haloperidol 0.5mg tab ................ 30.. , .. , 90 Haloperidol 1 mg tab ................. 30...... 90 Haloperidol 2mg tab ................. 30, ..... 90 Haloperidol 5mg tab ................. 30...... 90 Lithium Carbonate 300mg cap* ........... 90......270 Nortriptyline 10mg cap ... .... . ....... 30...... 90 Nortriptyline 25mg cap ............... 30...... 90 Paroxetine 10mg tab* ..... ........... 30...... 90 Paroxetine 20mg tab* ................ 30...... 90 Prochlorperazine 10mg tab ......... . ... 30...... 90 Trazodone 50mg tab ......... ........ 30...... 90 Trazodone 100mg tab ................ 30...... 90 Trazodone 150mg tab ................ 30...... 90 Trihexyphenidyl 2mg tab ........ . ..... 60......180 Prescription Program Includes up to a 3&-day supply for $4 and a 90-day supply for $10 of some covered generic drugs at commonly prescribed dosages. Higher dosages cost more. Prices for some drugs covered by the Prescription Program maybe higher and may vary in some states. Restrictions apply. See Program Details or your Walmart Phannadst for details. Free language assistance services available for prescription drug Information at Walmart and Sam's Club pharmacies in New York. Contact your Walmart or Sam's Club pharmacy for details. "Prices maybe higher in CA, HI, MN, MT, PA, TN and W4 Revised 9/5/2014 " Home Delivery Service is not available through SamsCiub com. Prepackaged drugs are covered only In unit sizes specified on Drug List See Program Details or your Walmart Pharnacistfor details. 02014 Wal -Mart Stores, Inc I Page 3 of 5 Packet Page -1505- Walmart sawmoreyuw b.a.r. � �� o 10/28/2014 16.D.7. 4 90-d sill', 30-day s 10, a y $4,3o-day 610, 90 -day Skin Conditions Estradiol 2mg tab ................ . .. 30...... 90 Gentamicin 0.1% cream (15gm tube)'.......... 1....... 3 Gentamicin 0.1 % ointment (15gm tube)'........ 1....... 3 Hydrocortisone 1% cream (28.35 -30g tube)' ..... 1....... 3 Hydrocortisone 2.5% cream (30gm tube)' ....... 1.. , .. , . 3 Silver Sulfadiazine I% cream* (50gm tube)' ...... 1....... 3 Triamcinolone 0.025% cream (15gm tube)' ...... 1..... , . 3 Triamcinolone 0.025% cream (80gm tube)' ...... 1....... 3 Triamcinolone 0.1%cream (15gm tube)'..... , .. 1....... 3 Triamcinolone 0.1% cream (80gm tube)'........ 1....... 3 Triamcinolone 0.1% ointment (15gm tube)'...... 1....... 3 Triamcinolone 0.1% ointment (80gm tube)t...... 1....... 3 Triamcinolone 0.5% cream (15gm tube)t........ 1....... 3 Thyroid Conditions Levothyroxine 25mcg tab .................30...... 28' 90 Levothyroxine 50mcg tab .............. 30...... 90 Levothyroxine 75mcg tab .............. 30...... 90 Levothyroxine 88mcg tab .............. 30...... 90 Levothyroxine 100mcg tab .... .. ........ 30...... 90 Levothyroxine 112mcg tab .... . ......... 30. , .... 90 Levothyroxine 125mcg tab .............. 30...... 90 Levothyroxine 137mcg tab .... ..... . .... 30.. , ... 90 Levothyroxine 150mcg tab .... .......... 30... , .. 90 Levothyroxine 175mcg tab* ............. 30...... 90 Levothyroxine 200mcg tab* ............. 30...... 90 Viruses Acyclovir 200mg cap ....................30...... 90 Vitamins & Nutritional Health Folic Acid 1 mg tab ......................30...... 90 Mag 64 64mg tab* ........ .......... 60......180 Magnesium Oxide 400mg tab .. ........ 30. , .... 90 Prenatal Plus qty 30* .... ... .......... 30...... 90 Sodium Fluoride .25mg chewable* (120ct bottle)'.. 1..... N/A Women's Health Estradiol 0.5mg tab ............. . .......30...... 90 Estrad iol 1 mg tab ......... ..........30... , .. 90 MedroxyprogesteroneAcetate 2.5mg tab ... ... 30.. , ... 90 Medroxyprogesterone Acetate 5mg tab....... 30, , .... 90 Medroxyprogesterone Acetate 10mg tab ... ... 10. , .... 30 Levonorgestrel /Ethinyl Estradiol u 28' Kurvelo . .; . 28 Norethindrone USP 035mg : . '28' Enskyce, 28 lencyda.. ;. 28 Pirmel la .1/35. 28 Pirimella 7/7/7 28 Sprintec. `28 Tri- Sprintec , .... 28 r •� Alendronate;50D 35mg tab 4_: 12.:: Alendronate50Q 70mg tab 4.:; 2 . Clomiphene'50mg tab 3 15 Other Medical Conditions Chlorhexidine Gluconate 0.12% soln (473ml bottle)* . • .1........ 3 Isoniazid 300mg tab ............ . .... 30...... 90 Lidocaine 2% viscous solution (100ml bottle)* ....1....... 3 Megestrol 20mg tab * ......... ........ 30.... , , 90 Phenazopyridine 100mg tab* .............6.... , , 18 Prednisone 2.5mg tab * . ....... ........ 30.... , . 90 Prednisone 5mg tab * ................. 30...... 90 Prescription Program includes up to a 30-day supply for $4 and a 90 -day supply for $10 of some covered generic drugs at commonly prescribed dosages. Higher dosages cost more. Prices for some drugs covered by the Prescription Program may be higher and may vary In some states. Restrictions apply. See Program Details or your Walmart Pharmacist for details, Free language assistance services available for prescription drug information at Walmart and Sam's Club pharmacies In New York. Contact your Walmart or Sam's Club pharmacy for details. • Prices may be higher In CA, HI, MN, MT, PA, TN and WL Revised 9/5/2014 " Home Delivery Service is not available through SamsClub.com. Prepackaged drugs are covered only in unit sizes specified on Drug LIsL See Program Details oryour Walmart Pharmacist for details, Walmart -4t. 02014 Wal -Mart Stores, Inc l Page 4 of 5 S—, w. am« I Packet Page -1506- cl-0) Walmart's Prescription Program Details 1. Walmart's Prescription Program (the'Programl is available at all Walmart, Sam's Club and Neighborhood Market pharmacies in the United States ('Walmart Retail Pharmadesl, except in North Dakota, as set forth below In Sections 3 and 4. The Program is also available through Walmart Mail Service ('Walmart Will Service"), as set forth below in Section 5. 2. The Program applies only to certain generic drugs at commonly prescribed dosages. Higher dosages cost more. You may obtain a list of generic dugs and dosages covered under the Program at Walmart Retail Pharmacies (the"Retall Drug List") and through Walmart Mail Service (the"Mal Service Drug List' on Walmart. com or at Walmart Retail Pharmacies The Retail Drug List and Mail Service Drug Ust may change and also may vary by state. Not all formulations of a drug (for example, enteric - coated, extended or timed release formulations) are covered under the Program Program pricing not available when a covered drug Is dispensed as part of a compound 3. Under the Program at Walmart Retail Pharmacies, $4 is the price for up to a 30 -day supply of certain covered generic drugs at commonly prescribed dosages (the *$4 Retail Program"). $10 Is the price of a 90-day supply of certain covered generic drugs at commonly prescribed dosages (the'$10 Retail Program'. Not al drugs covered by the $4 Retail Program are covered by the $10 Program Prices for quantities between a 30-day supply and a 90-day supply of dugs covered by both the $4 Retail Program and $10 Retail Program are prorated based on the $4 Program price, but will not exceed $10. Prices for quantities greater than a 90-day supply of drugs covered by the $10 Retail Program are prorated based on the $10 Program price Prorated pricing is not available under the Program for prepackaged drugs For pricing policies relating to prepackaged drugs (such as tubes vials or bottles), see Section 6. 4. Underthe Program at Walmart Retail Pharmacies, $91s the price for up to a 3D-day supply of certain women% health and other covered generic dugs at commonly prescribed dosages (the 19 Retail Program'. $24 Is the price for a 90-day supply of certain women% health and other covered generic drugs at commonly prescribed dosages (the "$24 Retail Program'. Not all dugs covered bythe $9 Retail Program are covered by the $24 Retail Program. Prices for quantities between a 30-day supply and a 90 -day supply of drugs covered by both the $9 Program and $24 Retail Program are prorated based on the $9 Program price, but will not exceed $24. Prices for quantities greater than a 90-day supply of drugs covered by the $24 Retail Program are prorated based on the $24 Program price Prorated pricing Is not available under the Program for prepackaged drugs For pricing policies relating to prepackaged drugs, see Section 6. S. Underthe Program through Walmart Mail Service, $10 is the price for mall delivery of a 90-day supply of certain generic drugs at commonly prescribed dosages C$10 Mail Service Program'. $241s the price for mall delivery of certain women% health and certain other covered drugs at commonly prescribed dosages ($24 Mail Service 10/28/2014 16.D.7. Program'. Not all drugs covered by the S 10 Retail Program are covered by the $10 Mai Service Program; not all drugs covered by the $24 Retail Program are covered by the $24 Mail Service Program See Mall Service Drug Ust for a list of drugs covered by the $10 Mal Service Program and $24 Mail Service Program Walmart Mail Service covers both initial fills and refills Delivery of covered drugs is available only through Walmart Mali Service and is not available at Walmart, Sam %Club, and Neighborhood Market retail pharmacies. Delivery underthe Program through Walmart Mal Service is limited to Ua addresses by First -Class Mail; expedited delivery is also available for an additional charge Some health plans do not cover Walmart Mail Service or 90 -day supplies Prices for quantities greater than a 90 -day supply of dugs covered by the $10 Mail Service Program and the $24 Mail Service Program are prorated based on the $10 and $24 Program price, respectively. Prices for quantities less than a 90-day supply are not prorated under either the $10 Mail Service Program or the $24 Mail Service Program. Prorated pricing is not available under the Program for prepackaged drugs. For pricing policies relating to prepackaged drugs, see Section 6. 6. Prepackaged dugs are covered under the Program only In the unit sizes specified on the Retail Drug List and Mail Service Drug List Prepackaged drugs are dispensed based on the quantities prescribed and unit sizes In stock at the dispensing pharmacy. Unit sizes not specified on the Retail Drug List or Mail Service Drug Ust are not covered underthe Program. Multi-unit purchases are charged at a per unit price, based on the price per unit size dispensed, unless otherwise specified. Prepackaged drugs dispensed in unit sizes not specified on the Retail Drug Ust and Mail Service Drug List may be priced higher, even if equivalent quantities of the drug are available in specified unit sizes. Prorated pricing is not available under the Program for prepackaged drugs 7. Prices of certain drugs covered by the Program may be higher in some states, as noted on the Retail Drug Ust and Mail Service Drug List & Program pricing may be limited to select manufacturers of a covered drug and is available as kmg as supplies from such manufacturers are in stock atthe dispensing pharmacy. 9. You may pay less or more than the Program price, depending on the terms o>fyour health plan. Prescriber permission may be required to change a 30-day prescription to a 90-day prescription. Certain plans, Including govemment- funded programs, may not cover a 90-day supply. 10. For purchases made at Walmart Retail Pharmacies, prescriptions must initially be filled in person, and refills must be picked up in store There are no substitutions. Purchases made through Walmart Mail Service may be ordered at Walmart Retail Pharmacies, by phone or through waimartcom, 11. These Program Details are subject to change without advance notice. Changes to these Program Details may be made only in writing. Prescription Program includes up to a 30-day supply for $4 and a 90 -day supply for 510 of some covered generic drugs at commonly prescribed dosages. Higher dosages cost more. Prices for me drugs covered by the Prescription Program maybe higher and may vary in some states. Restrictions apply. See Program Details or your MIrnart Pharmacist for details. Free language assistance so services available for prescription drug information at Walmart and Sam's Club pharmacies In New York. Contact your Walmart or Sam's Club pharmacy for details • Prices maybe higher In CA. HI, MN, MT PA TN and WI. Revised 9/5/2014 Home Delivery Service is not available through SamsClub.corr Prepackaged drugs are covered only in unit sizes spedfied on Drug List See Program Details oryour Walmart Pharmacist for details. ®2014 Wal -Mart Stores, Inc. Walmart Page 5 Of 5 L— u.wh. i Packet Page -1507- D110 3 10/28/2014 16.D.7. 14 -6248 "Pharmacy Services" EXHIBIT C "Supplemental General Grant Terms and Conditions" (Following this page) Packet Page -1508- Cq 10/28/2014 16.D.7. Exhibit C Supplemental General Grant Terms and Conditions The supplemental conditions contained in this section are intended to cooperate with, to supplement, and to modify the general conditions and other specifications. In cases of disagreement with any other section of this contract, the Supplemental Conditions shah govern. Flow Down of Terms and Conditions from the Grant Agreement Subcontracts; If the vendor subcontracts any of the work required under this Agreement,. a copy of the signed subcontract must be forwarded to the Department for review and approval. The vendor agrees to include in the subcontract that (1) the subcontractors is bound by the terms of this Agreement, (ii) the subcontractor is bound by all applicable state and federal laws and regulations, and (iii) the subcontractor shall hold the Department and Recipient harmless against all claims of whatever nature arising out of the subcontractor's performance of work under this Agreement, to the extent allowed and required by law. The recipient shall document in the quarterly report the subcontractor's progress in performing its work under this agreement. For each subcontract, the Recipient shall provide a written statement to the Department as to whether the subcontractor is a minority vendor as defined in Section 288.703, Fla. Stat. Packet Page -1509- D1q 10/28/2014 16.D.7. Exhibit C Supplemental General Grant Terms and Conditions 1. Administrative, 2. contractual, or legal remedies Unless otherwise provided in this contract, all claims, counter- claims, disputes and other matters in question between the local government and the contractor, arising out of or relating to this contract, or the breach of it, will be decided by arbitration, if the parties mutually agree, or in a Florida court of competent jurisdiction. 3. Energy Conservation Requirements - The Energy Conservation requirements are applicable to all contracts and subcontracts. The Contractor shall comply with any mandatory standards and policies relating to energy efficiency contained in the State Energy Conservation Plan issued in compliance with the Energy Policy and Conservation Act (42 U.S.C. Section 6201) 4. Access to Records and Reports - The vendor agrees to maintain all books, records, accounts and reports required under this contract for a period of not less than three -years after the date of termination or expiration of this contract, except in the event of litigation or settlement of claims arising from the performance of this contract, in which case Vendor agrees to maintain same until the Purchaser, the Grantor Administrator, the Comptroller General, or any of their duly authorized representatives, have disposed of all such litigation, appeals, claims or exceptions related thereto. S. No Government Obligation to Third Parties - Applies to all contracts. The Purchaser and Vendor acknowledge and agree that, notwithstanding any concurrence by the Federal Government in or approval of the solicitation or award of the underlying contract, absent the express written consent by the Federal Government, the Federal Government is not a party to this contract and shall not be subject to any obligations or liabilities to the Purchaser, Vendor, or any other party (whether or not a party to that contract) pertaining to any matter resulting from the underlying contract. It is further agreed that the clause shall not be modified, except to identify the subcontract who will be subject to its provisions. 6. Clean .Air Act, Federal Water Pollution Control Act, Executive Order 11738, and US EPA Regulations Contracts and subgrants of amounts in excess of $100,000 shall contain a provision that requires the Contractor or recipient to comply with all applicable standards, orders, or requirements issued pursuant to the Clean Air Act (42 U.S.C. 7401- 7671q) and the Federal Water Pollution Control Act as amended (33 U.S.C. 1251 - 1387). Violations must be reported to the Federal awarding agency and the Regional Office of the Environmental Protection Agency (EPA). 7. Energy Policy and Conservation Act - The contractor shall comply with any mandatory standards and policies relating to energy efficiency which are contained in the F I o r i d a state energy conservation plan issued in compliance with the Energy Policy and Conservation Act (Pub. L. 94 -163, 89 Stat. 871). 8. Debarment and Suspension (Executive Orders 12549 and 12689) - Contract awards that exceed the small purchase threshold and certain other contract awards shall not be made to parties listed on the government wide Excluded Parties List System in the System for Award Management (SAM), in accordance with the OMB guidelines at 2 CFR 180 that implement Executive Orders 12549 (3 CFR Part 1986 Comp., p. 189) and 12689 (3 CFR Part 1989 Comp., p. 235), "Debarment and Suspension." The Excluded Parties List System in SAM contains the names of parties debarred, suspended, or otherwise excluded by agencies, as well as parties declared ineligible under statutory or regulatory authority other than Executive Order 12549. 9. Byrd Anti- Lobbying Amendment (31 U.S.C. 1352) - Vendors must certify it will not and has not used Federal appropriated funds have been paid or will be paid, by or to any person or organization for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. The certification includes any lobbying with non - Federal funds that takes place in connection with obtaining any federal award. Packet Page -1510- �9n 10/28/2014 16.D.7. Exhibit C Supplemental General Grant Terms and Conditions 10. Procurement of Recovered Materials - (a) In accordance with Section 6002 of the Solid Waste Disposal Act, as amended by the Resource Conservation and Recovery Act, the Contractor shall procure Items designated in guidelines of the Environmental Protection Agency (EPA) at 40 CFR Part 247 that contain the highest percentage of recovered materials practicable, consistent with maintaining a satisfactory level of competition. The Contractor shall procure items designated in the EPA guidelines that contain the highest percentage of recovered materials practicable unless the Contractor determines that such items: (1) are not reasonably available in a reasonable period of time; (2) fall to meet reasonable performance standards, which shall be determined on the basis of the guidelines of the National Institute of Standards and Technology, if applicable to the Item; or (3) are only available at an unreasonable price. (b) Paragraph (a) of this clause shall apply to items purchased under this contract where: (1) the Contractor purchases In excess of $10,000 of the item under this contract; or (2) during the preceding. Federal fiscal year, the Contractor: (1) purchased any amount of the items for use under a contract that was funded with Federal appropriations and was with a Federal agency or a State agency or agency of a political subdivision of a State; and (II) purchased a total of in excess of $10,000 of the Item both under and outside that contract. 11. Disadvantaged Business Enterprise (DBE) - Vendors shall not discriminate on the basis of race, color, national origin, or sex in the performance of this contract. Vendors shall make a good faith effort to assure that registered disadvantaged business enterprises are used as sources of supplies, equipment, construction, and services as much as possible. Each vendor shall identify the anticipated level of participation by DBE's in the project and report its actual OBE participation (if any)." The offeror will be required to report its DBE participation obtained through race- neutral means throughout the period of performance and required to convey all changes in anticipated levels of participation to the County in a timely manner. The vendor is required to pay its DBE subcontractors performing work related to this contract for satisfactory performance of that work no later than 30 days after the vendor's receipt of payment for that work from Collier County. In addition, the vendor is required to return any retainage payments to those subcontractors within thirty (30) days after the subcontractor's work related to this contract is satisfactorily completed. The vendor must promptly notify Collier County, whenever a DBE subcontractor performing work related to this contract is terminated or falls to complete Its work, and must make good faith efforts to engage another DBE subcontractor to perform at least the same amount of work. The vendor may not terminate any DBE subcontractor and perform that work through Its own forces or those of an affiliate without prior written consent of Collier County, 12. Equal Employment Opportunity - Except as otherwise provided under 41 CFR Part 60, all contracts that meet the definition of "federally assisted construction contract" in 41 CFR Part 60 -1.3 must include the equal opportunity clause provided under 41 CPR 60- 1.4(b), in accordance with Executive Order 11246, "Equal Employment Opportunity" (30 FR 12319, 12935, 3 CFR Part, 1964— 1965 Comp., p. 339), as amended by Executive Order 11375, "Amending Executive Order 11246 Relating to Equal Employment Opportunity," and implementing regulations at 41 CFR part 60, "Office of Federal Contract Compliance Programs, Equal Employment Opportunity, Department of Labor." §60 -4.3 Equal opportunity clauses. (a) The equal opportunity clause published at 41 CFR 60- 1.4(a) of this chapter is required to be included in, and is part of, all nonexempt Federal contracts and subcontracts, including construction contracts and subcontracts. The equal opportunity clause published at 41 CFR 60 -1.4 (b) is required to be included in, and is a part of, all nonexempt federally assisted construction contracts and subcontracts. In addition to the clauses described above, all Federal contracting officers, all applicants and all nonconstruction contractors, as applicable, shall include the specifications set forth in this section in all Federal and federally assisted construction contracts in excess of $10,000 to be performed in geographical areas designated by the Director pursuant to §60 -4.6 of this part and in construction subcontracts in excess of $10,000 necessary in whole or in part to the performance of nonconstruction Federal contracts and subcontracts covered under the Executive order. STANDARD FEDERAL EQUAL EMPLOYMENT OPPORTUNITY CONSTRUCTION CONTRACT SPECIFICATIONS (EXECUTIVE ORDER 11246) 1. As used in these specifications: a. "Covered area" means the geographical area described in the solicitation from which this contract resulted; Packet Page -1511- G D 10/28/2014 16.D.7. Exhibit C Supplemental General Grant Terms and Conditions b. "Director" means Director, Office of Federal Contract Compliance Programs, United States Department of Labor, or any person to whom the Director delegates authority; c. "Employer identification number" means the Federal Social Security number used on the Employer's Quarterly Federal Tax Return, U.S. Treasury Department Form 941. d. "Minority" includes: (1) Black tail persons having origins in any of the Black African racial groups not of Hispanic origin); (ii) Hispanic (all persons of Mexican, Puerto Rican, Cuban, Central or South American or other Spanish Culture or origin, regardless of race); (iii) Asian and Pacific Islander (all persons having origins in any of the original peoples of the Far East, Southeast Asia, the Indian Subcontinent, or the Pacific Islands); and (iv) American Indian or Alaskan Native (all persons having origins in any of the original peoples of North America and maintaining identifiable tribal affiliations through membership and participation or community identification). 2. Whenever the Contractor, or any Subcontractor at any tier, subcontracts a portion of the work involving any construction trade, it shall physically include in each subcontract in excess of $10,000 the provisions of these specifications and the Notice which contains the applicable goals for minority and female participation and which is set forth in the solicitations from which this contract resulted. 3. If the Contractor is participating (pursuant to 41 CFR 60 -4.5) in a Hometown Plan approved by the U.S. Department of Labor in the covered area either individually or through an association, its affirmative action obligations on all work in the Plan area (including goals and timetables) shall be in accordance with that Plan for those trades which have unions participating in the Plan. Contractors must be able to demonstrate their participation in and compliance with the provisions of any such Hometown Plan. Each Contractor or Subcontractor participating in an approved Plan is individually required to comply with Its obligations under the EEO clause, and to make a good faith effort to achieve each goal under the Plan in each trade in which it has employees. The overall good faith performance by other Contractors or Subcontractors toward a goal in an approved Plan does not excuse any covered Contractor's or Subcontractor's failure to take good faith efforts to achieve the Plan goals and timetables. 4. The Contractor shall implement the specific affirmative action standards provided in paragraphs 7 a through p of these specifications. The goals set forth in the solicitation from which this contract resulted are expressed as percentages of the total hours of employment and training of minority and female utilization the Contractor should reasonably be able to achieve in each construction trade in which it has employees in the covered area. Covered Construction contractors performing construction work in geographical areas where they do not have a Federal or federally assisted canstuction contract shall apply the minority and female goals established for the geographical area where the work is being performed. Goals are published periodically in the Federal Register in notice form, and such notices may be obtained from any Office of Federal Contract Compliance Programs office or from Federal procurement contracting officers. The Contractor is expected to make substantially uniform progress in meeting its goals in each craft during the period specified. 5. Neither the provisions of any collective bargaining agreement, nor the failure by a union with whom the Contractor has a collective bargaining agreement, to refer either minorities or women shall excuse the Contractor's obligations under these specifications, Executive Order 11246, or the regulations promulgated pursuant thereto. 6. In order for the nonworking training hours of apprentices and trainees to be counted in meeting the goals, such apprentices and trainees must be employed by the Contractor during the training perm, and the Contractor must have made a commitment to employ the apprentices and trainees at the completion of their training, subject to the availability of employment opportunities. Trainees must be trained pursuant to training programs approved by the U.S. Department of Labor. 7. The Contractor shall take specific affirmative actions to ensure equal employment opportunity. The evaluation of the Contractor's compliance with these specifications shall be based upon its effort to achieve maximum results from its actions. The Contractor shall document these efforts fully, and shall implement affirmative action steps at least as extensive as the following: a. Ensure and maintain a working environment free of harassment, intimidation, and coercion at all sites, and in all facilities at which the Contractor's employees are assigned to work. The Contractor, where possible, will assign two or more women to each construction project. The Contractor shall specifically ensure that all foremen, superintendents, and other on -site supervisory personnel are aware of and carry out the Contractor's obligation to maintain such a working environment, with specific attention to minority or female individuals working at such sites or in such facilities. b. Establish and maintain a current list of minority and female recruitment sources, provide written notification to minority and female recruitment sources and to community organizations when the Contractor or Its unions have Packet Page -1512- (Do 10/28/2014 16.D.7. Exhibit C Supplemental General Grant Terms and Conditions employment opportunities available, and maintain a record of the organizations' responses. c. Maintain a current file of the names, addresses and telephone numbers of each minority and female off - the - street applicant and minority or female referral from a union, a recruitment source or community organization and of what action was taken with respect to each such Individual. If such individual was sent to the union hiring hall for referral and was not referred back to the Contractor by the union or, if referred, not employed by the Contractor, this shall be documented in the file with the reason therefor, along with whatever additional actions the Contractor may have taken. d. Provide Immediate written notification to the Director when the union or unions with which the Contractor has a collective bargaining agreement has not referred to the Contractor a minority person or woman sent by the Contractor, or when the Contractor has other information that the union referral process has impeded the Contractor's efforts to meet its obligations. e. Develop on-the job training opportunities and /or participate in training programs for the area which expressly include minorities and women, including upgrading programs and apprenticeship and trainee programs relevant to the Contractor's employment needs, especially those programs funded or approved by the Department of Labor, The Contractor shall provide notice of these programs to the sources compiled under 7b above. f. Disseminate the Contractor's EEO policy by providing notice of the policy to unions and training programs and requesting their cooperation in assisting the Contractor In meeting its EEO obligations; by including it in any policy manual and collective bargaining agreement; by publicizing it in the company newpaper, annual report, etc.; by specific review of the policy with all management personnel and with all minority and female employees at least once a year; and by posting the company EEO policy on bulletin boards accessible to all employees at each location where construction work Is performed. g. Review; at least annually, the company's EEO policy and affirmative action obligations under these specifications with all employees having any responsibility for hiring, assignment, layoff, termination or other employment decisions including specific review of these items with onsite supervisory personnel such as Superintendents, General Foremen, etc., prior to the initiation of construction work at any job site. A written record shall be made and maintained identifying the time and place of these meetings, persons attending, subject matter discussed, and disposition of the subject matter. h. Disseminate the Contractor's EEO policy externally by including it in any advertising in the news media, specifically including minority and female news media, and providing written notification to and discussing the Contractor's EEO policy with other Contractors and Subcontractors with whom the Contractor does or anticipates doing business. i. Direct its recruitment efforts, both oral and written, to minority, female and community organizations, to schools with minority and female students and to minority and female recruitment and training organizations serving the Contractor's recruitment area and employment needs. Not later than one month prior to the date for the acceptance of applications for apprenticeship or other training by any recruitment source, the Contractor shall send written notification to organizations such as the above, describing the openings, screening procedures, and tests to be used in the selection process. j. Encourage present minority and female employees to recruit other minority persons and women and, where reasonable, provide after school, summer and vacation employment to minority and female youth both on the site and in other areas of a Contractor's work force. k. Validate all tests and other selection requirements where there is an obligation to do so under 41 CFR Part 60 -3. 1. Conduct, at least annually, an inventory and evaluation at least of all minority and female personnel for promotional opportunities and encourage these employees to seek or to prepare for, through appropriate training, etc., such opportunities. m. Ensure that seniority practices, job classifications, work assignments and other personnel practices, do not have a discriminatory effect by continually monitoring all personnel and employment related activities to ensure that the EEO policy and the Contractor's obligations under these specifications are being carried out. n. Ensure that all facilities and company activities are nonsegregated except that separate or single -user toilet and necessary changing facilities shall be provided to assure privacy between the sexes. o. Document and maintain a record of all solicitations of offers for subcontracts from minority and female construction contractors and suppliers, including circulation of solicitations to minority and female contractor associations and other business associations. p. Conduct a review, at least annually, of all supervisors' adherence to and performance under the Contractor's EEO policies and affirmative action obligations. 8. Contractors are encouraged to participate in voluntary associations which assist in fulfilling one or more of their 5 Packet Page -1513- C 10/28/2014 16.D.7. Exhibit C Supplemental General Grant Terms and Conditions affirmative action obligations (7a through p). The efforts of a contractor association, joint contractor- union, contractor - community, or other similar group of which the contractor is a member and participant, may be asserted as fulfilling anyone or more of its obligations under 7a through p of these Specifications provided that the contractor actively participates in the group, makes every effort to assure that the group has a positive impact on the employment of minorities and women in the industry, ensures that the concrete benefits of the program are reflected in the Contractor's minority and female workforce participation, makes a good faith effort to meet its individual goals and timetables, and can provide access to documentation which demonstrates the effectiveness of actions taken on behalf of the Contractor. The obligation to comply, however, is the Contractor's and failure of such a group to fulfill an obligation shall not be a defense for the Contractor's noncompliance. 9. A single goal for minorities and a separate single goal for women have been established. The Contractor, however, is required to provide equal employment opportunity and to take affirmative action for all minority groups, both male and female, and all women, both minority and non- minorlty. Consequently, the Contractor may be in violation of the Executive Order if a particular group is employed in a substantially disparate manner (for example, even though the Contractor has achieved its goals for women generally, the Contractor may be in violation of the Executive Order if a specific minority group of women is underutilized). 10. The Contractor shall not use the goals and timetables or affirmative action standards to discriminate against any person because of race, color, religion, sex, or national origin. 11. The Contractor shall not enter into any Subcontract with any person or firm debarred from Government contracts pursuant to Executive Order 11246. 12. The Contractor shall carry out such sanctions and penalties for violation of these specifications and of the Equal Opportunity Clause, including suspension, termination and cancellation of existing subcontracts as may be imposed or ordered pursuant to Executive Order 11246, as amended, and its implementing regulations, by the Office of Federal Contract Compliance Programs. Any Contractor who falls to cant' out such sanctions and penalties shall be in violation of these specifications and Executive Order 11.246, as amended. 13. The Contractor, in fulfilling its obligations under these specifications, shall implement specific affirmative action steps, at least as extensive as those standards prescribed in paragraph 7 of these specifications, so as to achieve maximum results from its efforts to ensure equal employment opportunity. If the Contractor fails to comply with the requirements of the Executive Order, the implementing regulations, or these specifications, the Director shall proceed in accordance with 41 CFR 60 -4.8. 14. The Contractor shall designate a responsible official to monitor all employment related activity to ensure that the company EEO policy is being carried out, to submit reports relating to the provisions hereof as may be required by the Government and to keep records. Records shall at least include for each employee the name, address, telephone numbers, construction trade, union affiliation if any, employee identification number when assigned, social security number, race, sex, status (e.g., mechanic, apprentice trainee, helper, or laborer), dates of changes in status, hours worked per week in the indicated trade, rate of pay, and locations at which the work was performed. Records shall be maintained in an easily understandable and retrievable form; however, to the degree that existing records satisfy this requirement, contractors shall not be required to maintain separate records. 15. Nothing herein provided shall be construed as a limitation upon the application of other laws which establish different standards of compliance or upon the application of requirements for the hiring of local or other area residents (e.g., those under the Public Works Employment Act of 1977 and the Community Development Block Grant Program). 13. Termination 1. TERMINATION FOR DEFAULT. 1. Contractor shall be considered in material default of the Agreement and such default shall be considered cause for Owner to terminate the Agreement, in whole or in part, as further set forth in this Section, if Contractor: (1) fails to begin the Work under the Contract Documents within the time specified herein; or (2) fails to properly and timely perform the Work as directed by the Project Manager or as provided for in the approved Progress Schedule; or (3) performs the Work unsuitably or neglects or refuses to remove materials or to correct or replace such Work as may be rejected as unacceptable or unsuitable; or (4) discontinues the prosecution of the Work; or (5) falls to resume Work which has been suspended within a reasonable time after being notified to do so; or (6) becomes insolvent or Is declared bankrupt, or commits any act of bankruptcy; or (7) allows any final judgment to stand against it unsatisfied for more than ten (10) days; or (8) makes an assignment for the benefit of creditors; or (9) fails to obey any applicable codes, laws, ordinances, rules or regulations with respect to the Work; or (10) materially breaches any other provision of the Contract Documents. g Packet Page -1514- (q) 10/28/2014 16.D.7. Exhibit C Supplemental General Grant Terms and Conditions 2. Owner shall notify Contractor in writing of Contractor's default(s). If Owner determines that Contractor has not remedied and cured the default(s) within seven (7) calendar days following receipt by Contractor of said written notice or such longer period of time as may be consented to by Owner in writing and in its sole discretion, then Owner, at Its option, without releasing or waiving its rights and remedies against the Contractor's sureties and without prejudice to any other right or remedy it may be entitled to hereunder or by law, may terminate Contractor's right to Proceed under the Agreement, in whole or in part, and take possession of all or any portion of the Work and any materials, tools, equipment, and appliances of Contractor, take assignments of any of Contractor's subcontracts and purchase orders, and complete all or any portion of Contractor's Work by whatever means, method or agency which Owner, in its sole discretion, may choose, 3. If Owner deems any of the foregoing remedies necessary, Contractor agrees that it shall not be entitled to receive any further payments hereunder until after the Project is completed. All moneys expended and all of the costs, losses, damages and extra expenses, including all management, administrative and other overhead and other direct and indirect expenses (including Design Professional and attorneys' fees) or damages incurred by Owner incident to such completion, shall be deducted from the Contract Amount, and if such expenditures exceed the unpaid balance of the Contract Amount, Contractor agrees to pay promptly to Owner on demand the full amount of such excess, including costs of collection, attorneys' fees (including appeals) and interest thereon at the maximum legal rate of interest until paid. If the unpaid balance of the Contract Amount exceeds all such costs, expenditures and damages incurred by the Owner to complete the Work, such excess shall be paid to the Contractor. The amount to be paid to the Contractor or Owner, as the case may be, shall be approved by the Project Manager, upon application, and this obligation for payment shall survive termination of the Agreement, 4. The liability of Contractor hereunder shall extend to and include the full amount of any and all sums paid, expenses and losses incurred, damages sustained, and obligations assumed by Owner in good faith under the belief that such payments or assumptions were necessary or required, in completing the Work and providing labor, materials, equipment, supplies, and other Items therefore or re- letting the Work, and in settlement, discharge or compromise of any claims, demands, suits, and judgments pertaining to or arising out of the Work hereunder. S. If, after notice of termination of Contractor's right to proceed pursuant to this Section, it is determined for any Amok reason that Contractor was not in default, or that its default was excusable, or that Owner is not entitled to the remedies against Contractor provided herein, then the termination will be deemed a termination for convenience and Contractor's remedies against Owner shall be the same as and limited to those afforded Contractor under Section 19 below, 6. In the event (i) Owner fails to make any undisputed payment to Contractor within thirty (30) days after such payment is due or Owner otherwise persistently falls to fulfill some material obligation owed by Owner to Contractor under this Agreement, and (ii) Owner has failed to cure such default within fourteen (14) days of receiving written notice of same from Contractor, then Contractor may stop its performance under this Agreement until such default is cured, after giving Owner a second fourteen (14) days written notice of Contractor's intention to stop performance under the Agreement. If the Work is so stopped for a period of one hundred and twenty (120) consecutive days through no act or fault of the Contractor or its Subcontractors or their agents or employees or any other persons Performing portions of the Work under contract with the Contractor or any Subcontractor, the Contractor may terminate this Agreement by giving written notice to Owner of Contractor's intent to terminate this Agreement. If Owner does not cure Its default within fourteen (14) days after receipt of Contractor's written notice, Contractor may, upon fourteen (14) additional days' written notice to the Owner, terminate the Agreement and recover from the Owner . payment for Work performed through the termination date, but in no event shall Contractor be entitled to payment for Work not performed or any other damages from Owner. 2. TERMINATION FOR CONVENIENCE AND RIGHT OF SUSPENSION. 1. Owner shall have the right to terminate this Agreement without cause upon seven (7) calendar days written notice to Contractor. In the event of such termination for convenience, Contractor's recovery against Owner shall be limited to that portion of the Contract Amount earned through the date of termination, together with any retainage withheld and reasonable termination expenses incurred, but Contractor shall not be entitled to any other or further recovery against Owner, including, but not limited to, damages or any anticipated profit on portions of the Work not performed. 2. Owner shall have the right to suspend all or any portions of the Work upon giving Contractor not less than two (2) Calendar days' prior written notice of such suspension. If all or any portion of the Work is so suspended, CA Packet Page -1515- a C 10/28/2014 16.D.7. Exhibit C Supplemental General Grant Terms and Conditions Contractor's sole and exclusive remedy shall be to seek an extension of time to Its schedule in accordance with the procedures set forth in the Contract Documents. In no event shall the Contractor be entitled to any additional compensation or damages. Provided, however, if the ordered suspension exceeds six (6) months, the Contractor shall have the right to terminate the Agreement with respect to that portion of the Work which Is subject to the ordered suspension, CERTIFICATIONS AND FORMS THE FOLLOWING DOCUMENTS NEED TO BE RETURNED WITH SOLICIATION DOCUMENTS BY DEADLINE TO BE CONSIDERED RESPONSIVE 1, Certification Regarding Debarment, Suspension, and Other Responsibility Matters Primary Covered Transactions 2. General Grant Clauses 3. Disclosure of Lobbying Activities Packet Page -1516- 9 10/28/2014 16.D.7. Exhibit C Supplemental General Grant Terms and Conditions (1) The prospective primary participant certifies to the best of its knowledge and belief, that it and its principals: (a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency; (b) Have not within a three -year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; (c) Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State or local) with commission of any of the offenses enumerated in paragraph (1)(b) of this certification; and (d) Have not within a three -year period preceding this application /proposal had one or more public transactions (Federal, State or local) terminated for cause or default. (2) Where the prospective primary participant is unable to certify to any of the statements in this certification, such Prospective participant shall attach an explanation to this proposal, Name Project Name Title Project Number Firm Tax ID Number Street Address DUNS Number City, State, Zip Packet Page -1517- 0 10/28/2014 16.D.7. Exhibit C - Supplemental General Grant Terms and Conditions General Grant Clauses On behalf of my firm, I acknowledge, and agree to perform all of the specifications and grant requirements identified in this solicitation document(s). Vendor /Contractor Name S c Date Z.(o A 6 1 Authorized Signature Address � AA, j. �r�w. ; Solicitation Contract # is Packet Page -1518- q 10/28/2014 16.D.7. Exhibit C Supplemental General Grant Terms and Conditions 7) CERTIFICATION REGARDING LOBBYING (To be submitted with each bid or offer exceeding $100,000) The undersigned ( Contractor) certifies, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for making lobbying contacts to an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form - -LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions [as amended by "Government wide Guidance for New Restrictions on Lobbying," 61 Fed. Reg. 1413 (1/19/96). Note: Language In paragraph (2) herein has been modified in accordance with Section 10 of the Lobbying Disclosure Act of 1995 (P.L. 104 -65, to be codified at 2 U.S.C. 1601, et seq.)) (3) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by 31, U.S.C. § 1352 (as amended by the Lobbying Disclosure Act of 1995). Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. [Note: Pursuant to 31 U.S.C. § 1352(c)(1)- (2)(A), any person who makes a prohibited expenditure or fails to file or amend a required certification or disclosure form shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such expenditure or failure.) The Contractor, certifies or affirms the truthfulness and accuracy of each statement of Its certification and disclosure, if any. In addition, the Contractor understands and agrees that the provisions of 31 U.S.C. A 3801, et seq., apply to this certification and disclosure, if any. Signature of Contractor's Authorized Official 4'" / s Name and Title of Contractor's Authorized Official L / Z-6 i Ll Date 11 Packet Page -1519- CA 10/28/2014 16.D.7. A G R E E M E N T 14-6248 for Pharmacy Services THIS AGREEMENT, made and entered into on this day of 2014, by and between Collier Health Services, Inc., authorized to do business in the State of Florida, whose business address is 1454 Madison Avenue West, Immokalee, Florida 34142, (the "Contractor ") and Collier County, a political subdivision of the State of Florida, (the "County "): WITNESSETH: COMMENCEMENT. This Agreement shall commence on Date of Board award. 2. CONTRACT TERM. The Contract shall be for a two (2) year period, commencing on date of Board award and terminating two (years) from that date. 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 not less than ten (10) days 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 ninety (90) days. The County Manager, or his designee, shall give the Contractor written notice of the County's intention to extend the Agreement term not less than ten (10) days prior to the end of the Agreement term then in effect. 3. STATEMENT OF WORK. The Contractor shall provide Pharmacy Services as provided in Exhibit A - "Scope of Work," which is hereby incorporated by reference, in accordance with the terms and conditions of ITB #14 -6248 and the Contractor's proposal referred to herein and made an integral part of this Agreement. County residents utilizing this contract may acquire services from either awarded Pharmacy based on convenience to their health care facility and residence. This Agreement contains the entire understanding between the parties and any modifications to this Agreement shall be mutually agreed upon in writing by the Contractor and the County Project or Contract Manager or his designee, in compliance with the County Purchasing Ordinance and Purchasing Procedures in effect at the time such services are authorized. 4. COMPENSATION. The County shall pay the Contractor for the performance of this Agreement as set forth in Exhibit B "Cost Schedule ", attached to and made an integral part of this Agreement. Any item that is not included in Exhibit B "Cost Schedule" as of the effective date of this Agreement, hereinafter "Unlisted Items ", shall be available for purchase when it is added to an updated list by the Contractor, and provided to the County. The Contractor may add any Unlisted Items in order to accommodate future purchases by the County. When an Unlisted Item is added to an updated list, the pricing shall be in accordance with the terms of this Agreement. Packet Page -1520- r� 10/28/2014 16.D.7. Any County agency may purchase products and services under this contract, provided sufficient funds are included in their budget(s). 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 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 contract. 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. 4.2 The Average Wholesale Price (AWP) list will be provided with itemized invoice by the Contractor on a monthly basis. 4.3 Maximum Allowable Cost (MAC) List. If at any time after the award of this contract, the cost of the listed generic drugs have increased and exceeded the fixed price listed in Exhibit B-1, the Contractor may submit in writing, along with back -up documentation, a request for an increase or removal of item(s) from the list (MAC). The County's Project Manager, or designee, will determine if a request for cost increase is acceptable. If price increase is accepted, the item will then be invoiced per the Average Wholesale Price (AWP) markup as provided in Exhibit B -1, attached hereto. 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. 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: Collier Health Services, Inc. 1454 Madison Avenue West Immokalee, Florida 34142 Attention: Mike Ellis, CEO Telephone: 239- 658 -3000 Facsimile: 239- 658 -3050 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 Purchasing Department 3327 Tamiami Trail, East Naples, Florida 34112 Attention: Joanne Markiewicz, Director, Procurement Services Telephone: 239 -252 -8907 Facsimile: 239- 252 -6480 Packet Page -1521- C�1 bi 10/28/2014 16.D.7. 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 /Subconsultants. 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 contract of the Contractor. Should the Contractor fail to correct any such violation, conduct, or practice to the satisfaction of the County within twenty-four (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 ten (10) 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 Contract 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. Packet Page -1522- i� 10/28/2014 16.D.7. i 12. INSURANCE. The Contractor shall provide insurance as follows: A. Commercial General Liability Coverage shall have minimum limits of $2,000,000 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. Workers' Compensation: Insurance covering all employees meeting Statutory Limits in compliance with the applicable state and federal laws. The coverage must include Employers' Liability with a minimum limit of $500,000 for each accident. C. Professional Liability: Shall be maintained by the Contractor to ensure its legal liability for claims arising out of the performance of professional services under this Agreement. Contractor waives its right of recovery against County as to any claims under this insurance. Such insurance shall have limits of not less than $1,000,000 each claim and in the aggregate. 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 Consultant from its insurer, and nothing contained herein shall relieve Contractor of this requirement to provide notice. Contractor shall ensure that all subcontractors/ Consultants comply with the same insurance requirements as the awarded firm. 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 i Packet Page -1523- l o) 10/28/2014 16.D.7. 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. CONTRACT ADMINISTRATION. This Agreement shall be administered on behalf of the County by the Department of Housing, Human and Veteran Services /Social Services Program. 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 CONTRACT. This Contract consists of the following component parts, all of which are as fully a part of the contract as if herein set out verbatim: Exhibit A - "Scope of Work," Exhibit B - "Cost Proposal," Exhibit C - "Supplemental General Grant Terms and Conditions," and Insurance Certificate(s). 17. SUBTECT 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 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 contract held by the individual and /or firm for cause. 19. IMMIGRATION LAW COMPLIANCE. 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) -(d) and (3))). 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. Packet Page -1524- 10/28/2014 16.D.7. 20. 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. 21. ADDITIONAL ITEMS /SERVICES Additional items and /or services may be added to this Agreement in accordance with the Purchasing Ordinance and Purchasing Procedures 22. 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. 23. 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. 24. CONTRACT STAFFING. The Contractor's personnel and management to be utilized for this project 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 contract. The Contractor shall assign as many people as necessary to complete the required services on a timely basis, and each person assigned shall be available for an amount of time adequate to meet the required service delivery dates. 25. ORDER OF PRECEDENCE. In the event of any conflict between or among the terms of any of the Contract Documents, the terms of the Agreement shall take precedence over the terms of all other Contract Documents, except the terms of any Supplemental Conditions shall take precedence over the Agreement. To the extent any conflict in the terms of the Contract Documents cannot be resolved by application of the Supplemental Conditions, if any, or the Agreement, the conflict shall be resolved by imposing the more strict or costly obligation under the Contract Documents upon the Contractor at County's discretion. 26. 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. Packet Page -1525- ��} 10/28/2014 16.D.7. 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: COLLIER COUNTY, FLORIDA Dwight E. Brock, Clerk of Courts Dated: (SEAL) First Witness TType /print witness names Second Witness TType /print witness nameT Approved as to Form and Legality: Assistant County Attorney Print Name �4:.. By: Tom Henning, Chairman Collier Health Services, Inc. Contractor Signature TType /print signature and titleT Packet Page -1526- coo 10/28/2014 16.D.7. 14-6248 "Pharmacy Services" EXHIBIT A "SCOPE OF WORK" 1. Each of the Contracted pharmacists must possess a current license from the Florida State Board of Pharmacy in accordance with Revised Statutes of the State of Florida, and shall maintain said license in good standing for the duration of the contract. 2. The Contractor must be able to fill outpatient prescriptions as needed each day for the duration of the contract within the normal work hours of 8:30 am to 5:00 pm, M -F. 3. The Contractor shall provide at no additional cost to the County, pharmacy services at locations in areas which are not evacuated during a disaster, and be prepared to accept telephonic requests from the County Emergency Operations Center and fill such requests. Collier County Housing, Human and Veteran Services Department/ Social Services Program will be responsible for the pick -up and delivery of any such prescriptions. 4. The Contractor shall be able to provide Generic equivalent drugs when one is available to fill the prescriptions. Prescriptions are limited to a 30 -day supply. 5. The Contractor shall provide electronic transfer of invoices (billing) to a designated email address at least monthly per Clerk of Court's Finance standards. Such electronic data transfer capability shall be operational at contract start-up and the first billing shall be forthcoming within four (4) weeks after start up of contract. The Contractor shall provide a contact name and phone number for technical assistance when file format problems arise. 6. All of the Contractor's pharmacy locations shall be connected on a common network using the same database in order to monitor patient information and manage the formulary. In addition, all locations must be connected to the central system that contains client information. All clients will be given a voucher to provide to the pharmacy. Any physician can write a prescription; this includes Primary Care, specialists, emergency room physicians, dentists, etc. Collier County Housing and Human Services /Social Services will not pay for prescriptions if the client does not present a voucher which shows a valid begin and end date of eligibility. 7. Under the Health Insurance Portability and Accountability Act (HIPAA) of 1996, Contractor is expected to adhere to the same standards as the County and other HIPAA covered entities regarding the protection and non- authorized disclosure of Protected Health Information (PHI). The Contractor shall use File Transfer Protocol (FTP), or other HIPAA compliant compatible programs to transfer encrypted client information (automatically) to pharmacy database at least twice daily, without breaking security; full file transfer shall be done weekly. Contractor must comply with HIPAA 834 file format. 8. It is highly desirable that the Contract Manager be a pharmacist. 9. The Contractor shall identify rebates that are forthcoming and any savings realized from manufacturer's rebates shall be credit against the County's monthly invoice. Packet Page -1527- �C 10/28/2014 16.D.7. 10. Payments shall be made in accordance with the Local Government Prompt Payment Act from a joint revolving account for the payment of services provided. 11. The Contractor shall fill all medications to patients for self - administration in accordance with all applicable Federal, State and Local laws. 12. The Contractor shall update and make readily retrievable at any time, all outpatient and drug data within the outpatient profile as each prescription is filled or refilled. The contractor shall automatically monitor drug allergies and interactions according to data available for each patient. 13. The Contractor shall provide monthly Utilization and Administrative reports including number of prescriptions filled, covered individuals, utilizing individuals including physician dispensing profiles and other reports. 14. The Contractor must immediately advise the County whenever abuse, drug seeking or fraudulent behavior is suspected. 15. The Contractor shall provide to the County any manufacturer's no cost, discounted or promotional health care items, which may be provided to them during the period of the contract. 16. The Contractor shall be available for periodic site visits by Collier County staff, to any of their locations, in order to monitor the quality of services provided. 17. The Contractor must respond within twenty -four (24) hours in writing via fax, email or letter, to all questions presented by the Collier County Housing, Human and Veteran Services Department. 18. The Contractor shall provide outpatient - packaging materials, including labeling, that meets all applicable laws and regulations. Labeling for outpatient packaging shall include: a. Patient Name b. Date of Dispensing c. Prescription Number d. Physician's Name e. Instructions for Patient Use f. Name and Strength of Drug g. Number of Doses Dispensed 19. The contractor shall maintain all outpatient drug profiles on a computerized dispersing system. Each outpatient drug profile must include: a. Patient Name b. Address / Phone d. Birth Date /Social Security Number e. Sex f. Allergies g. Prescription Number Drug data within each outpatient drug profile must include: a. Drug Name Packet Page -1528- c��l 10/28/2014 16.D.7. b. Drug Strengths c. Amount Ordered d. Amount Dispensed e. Instructions for Use f. Refills Authorized g. Physician Information h. Times and Dates Filled w Electronic invoice data must include, but may not be limited to: a. Patient's Identification Number assigned by HHVS b. Control # c. Medication name d. Strength e. Quantity f. Date Filled (MM /DD /YY) g. Generic h. Retail Price i. Cost j. Total Price Due Packet Page -1529- 10/28/2014 16.D.7. 14-6248 "Pharmacy Services" EXHIBIT B "COST SCHEDULE" 1. The following generic drugs will be offered at a maximum of $4.00 per 30 day dose (See attached list following this page, as Exhibit B-1). 2. All Drugs not listed on Exhibit B-1 shall be priced according to the following formulas based on McKesson Average Wholesale Price (AWP): All Medications: AWP plus 10% Packet Page -1530- r� 10 10/28/2014 16.D.7 EXHIBIT B -1 HEALTHCARE NETWORK OF SOUTHWEST FLORIDA EXHIBIT 81 DRUG PRICING LIST BASED ON MCKESSON 9/8/2014 F. ... ACTAVIS CHILD IBU PBERRY 402 .... _. _ ACYGAVIR GP 200MG TEV 100@ _ v 10 0 MG /SML 200 -• ORAL SUSP �" -- 00472125594 �_ _ -. - ..., $3;66 52.22 $2.22 $0.555 ALBUTEROL INH 0.083% WAT 25 - - MG CAPSULE OUM3894001 ,...... -.. --•__� $97.20 _ _ .... _..__ _ ,- $3:40 _ . _. $3.40 $OA34 .. ALBUTPROL 25 MG/3ML VIAL -NEB 00593379783 530.75 $1.59 ........ $0.061 SYRP2MG /SMLCl/P160Z@ .. -. . 2MG /5 ML - -__ SYRUP 00603100858_ $30.79 $1.96 $1.98 $0.126 ALBUTEROL TAD 2MG MYU4 100@ 2MG TABLET _ 00378025501 $1 756.6! $62.90 - - $62.11 -- $0.629 ALBUTEROL TAB 4MG MYLN 100® .....- _ 4 MG -_ _ TABLET 00378057201 51,756.63 $75.11 $0.751 ALENORONAT SOD TB 35MG CARA 4@ _ 95 MG TABLET 41616063768 _ $61.99 93 $0.73 .._ .$75.11 $0.73 $D.1B3 ALENDRONATE TAB 70MG APX 4 _ 70 MG _. _..5MG- -- TABLET _ - 6_0505259604 $81.95 $0.14 $0,14 $0.035 AMILOR+HCTZ T85 /SO MYLN SOD@ 50MG..._._ TABLET ..00378057705.. - .- - 5579.53 - .....569.00 - $69A0 $0.138 AMITRIP TAB 100MG SAN _. _ ... .,,__ lam? „- _ - AMITii1P TAB 10MG SAN 10006,6 _„ 100 MG - TABLET ..._ . _ .. ..._._ - -- 00761149001 __ _.... �.,. - $141.88 ._...._.._._._... ... .- ,$0:68 _ $0.68 $_0.007 10 MG TABIET OD761146610 $177.45 5791 $791 $6.0,67 AMITFIIP TAB 25MG SAN 1000@ _ 25 MG .. TABLET __...- 00781148710 $339.30 $7.42 $7.42 $0.00) AMITRIPTAB SOMG SAN 100@ 50 MG TABLET -'------ -._..._ 00781148801 _... $71.64 -.. $093 .. ...._.. - $0.83 ._... .._. $0.008 AMITRIP TAB 75MG Q/P 111 -_.. _.. .. _ 7.. MG _. _... ._. TABLET 00603221S21 ._._....___,_..__ $190.80 $2.04 $2.04 $0.020 XI AMOXICIL GP 250MG SAN 100 @ 250 MG CAPSULE 00781202001 -_ _.._. _ $24.89 $0.63 ..... _._.. $0.63 - $0,006 AMOXICIL CAP SOOMG SAN 12X30@ _.. SDO MG CAPSULE 00781261376_ $156.28 $6,74 $6.74 $0.019 AMOXICIL O/S 200 /SML AUROSOML@ 200 MG /SML SUSP RECON _ 65662007050 $459 _ $0.67 $0.67 $0.670 AMOXICIL 0/S 250MG SAN 150ML@ 250 MG /SML .. SUSP RECON 00781604155 $7.06 $150 $0.3DO AMO %ICIL OS 400MG D 750E R/R 400 MG/ SUSP RECON 43598020751 $793 - $0.78 ,$1.50 - - - $0.78 -- - - - $0.760 AMOXICIL SUS 125MG TEV 150ML@ 125 MG /SML SUSP RECON 00099415080_ $4,73 $1.72 $1.72 $0944 ATENOLTABl00MGTEV500 100 MG TABLET 00093075305 _ $610.11 $359 $3.59 $0.007 ATENOL TAB 25MG MYLN 10000 25 MG TABLET - 00378021810 - $817,50 $11.29 $0.011 ATENOL TAB SDMG TEV 100 @ 50 MG TABLET 00093075201 $83.42 _ _511.29 ,._.._ $0.30 _. $0,30 $0,009 ATENOLKHL TAB SC /25 MYL 100@ 200MG -25MG - TABLET " -- _ - 00378206401 °-- 5211.65 $$.16 $5.16 50.052 ATROP SUL O/S 1% 2ML AKOR 12 0.01 DROPS -• - -._ _. 17478021420 _ . $71.76 _ _. $33.83 _.. _ $33.83 _. .. $2.819 BACLOFEN TAB SOMG QUAL 90 _ _. .._.. _ 10 MG __. TABLET - 00603240602 .__.. _ $53.67 $1.46 $1.46 $0.016 BENAZEP TAB SMG SAN 100@ 5 MG TABLET .._._.. 00185050501 ._.._ --- ._____--____._. $100.91 _..... $1.64 ._.. $1.64 ...... $0.016 BENAZEPR TAB 40MG AURO 100@ 40 MG TABLET 65862011801 $105.11 $2.64 $2.64 $0.026 BENAZEPRILTB IOMG SOLC 100 _.. _. 10 MG TABLET 63547033610 ___.. $105.00_ -- ..._._. $1.46 _. _ $1.46 _ $0.035 BENAZEPRIL TB 20MG SOLC 1D0 _... 20 MG _.,.._ ..,.-- TABLET -.__.. .__ 43547033710 $105.00 $173 $1.73 $0.017 CAP ZVD 100 . BENVROP OG - 100 MG - CAPSULE 68382024701 $101.33 $3,64 $3.64 $0.036 ES TAB 2 BENZTROP MES TAB 2MG PUV 100@ P ._.- ._ .. 2MG . -._. ..__.. TABLET ... 50111039501 _. $24.29 $5.83 $0.058 BISOPR TAB 30/6 25MG SAN 90@ _ 10•fidSMG ..,,. „ TABLET 00185070730 _..._. _ $34.24 -_- _$5.83 $0_93 - $093 - $Doll .Bt50Pq TAB 2 5/6.25MG MYLN100@ BISOPR+HCTZ SMG /6.25MGNIC100@ . -. 2.5.6 25MG TABLET 00378050101 $137.94_ - $3.54 _ __.. $3.54 _... .._ _ .. $0.035 5 -625MG TABLET ... 29900019801..... _.___ .. _. $112.75 $339 $3.39 $0.034 BUMETAN TAB O.SMG TEV 100@ ..,... BUMETAN TAB 1MG TEV 100@ 0.5 MG - ,..,,.__TABLET _.. �OOD93423201 $99.67 $1.66 50.017 1 MG TABLET 00093423301 _ $137.31 $2.10 $2.10 $0,021 BUSPIR TAB IOMG TEV SOD@ 10 MG TABLET 00093005405 5652.33 1 $18,49 $18.49 $0.037 BUSPIR TAB SMG TEV,100@ ,$.MG _. TABLET 00093005301 $77.12 $2.42 - - $2.42 $0.024, GPTOPR TAB 100MG WEST 100 100 MG TABLET 00143117401 $380.63 $1.97 $1.97 .024 $0.020 GPTOPR TAB 12.SMG WEST 100 12.5 MG TABLET 00143117101 $155.82 $0.75 $0.75 $O,OOg -- CAPTOPRTAB 25MG MY L 100@ 25 MG TABLET 00378301201 $166.95 $28.18 $28.18 $0.282 CAPTOPR. TAB SOMG WEST 100 50 MG TABLET .-- 00143117901 -..._.. 5289.87 _.. 51.09 .__. $1.09 $0,011 GRBAMAZ TAB 200MG APX 100 __ _ -.._ _ 200 MG TABLET 60505018300 $159.92 $2.96 $2.96 $0.030 CARDIZEM TAB 30MG 100 30 MG TABLET 00167077147 $489.04 - - $0.97 $0.97 $0.010 GRDIZEM TAB 60MG 100 60 MG TABLET .....__ 00187077247 __ -. $767.29 $L1.97 $0.97 GRVEDILOL TAB l.125MG GR300@ 3.125 MG TABLET __._..__-- 57664024288 ...__...__. $21131. _. $1.20 $1.20 _$0.010 ._... $O.W 2 GRVEDILOL TB 32.SMG TEV 100@ __ _- 12.5 MG TABLET TABLET 00093729501 $213.69 $1.52 $0.015 GRVEOILOL T8 25MG TEV 500@ 25 MG TABLET ._ __. 00099729605 __._. _ $1,041.74 _$152 ._ _ -. $9.86 $9.86 -- $0.020 GRVEDILOL TS 6,25MG GLEN 100@ 6.25 MG - TABLET _ 68462016301 5210.13 $2.59 $2.59 $0.026 CEPHALD(GPSDQMG WEST 100 500 MG GPSOLE 00143989701 $134.75 $2.15 -- $2.15 $0.022 CEPHALEX O/5 250 /SMLLUPI300ML@ 250 MG /SML sus SUSP RECON ..._. 68160012402 $51.25 $6.71 $6.71 $1.007 ,CHLORHEX GLUG OR HIT 16 ._. OZQr! _. 0.0012 MOUTHWASH __. 50383072016 ___.__ $10.50 ... -.. 52.11 .__ ...... $2.11 . 50.132... CIMETID TAB BOOMG MYL 100@ GPRO O /50L 500MG /SMLIDOML 800 MG TABLET 0037 --- 1 _ $416AO 520.96 $20.96 50.210 500 MG /SML $US MC REC 50419077301 $15856 $57,32 $57.32 $57.320 5% CIPRO O /SOL 5% 250MG /SML 1000E 250 MG /SML._ _ _ SUS MC REC 50419077701 $135.44 548.93 $48.93 $48.930 ,CITALOPRAM HBR TS 40MG TCIR100@ 40 MG TABLET 13668001101 _ $27797 $2.41 - $2.41 -- - $0.024 GTALOPRAM TAB 20MG AURO 500@ 20 MG TABLET ._ 65862000605 _..,. $1 241.71_ $8.47 $8.47 50.017 CLOMIPH CITR TAB SOMG TEV 10@ 50 MG TABLET 00093004109 $68.55 $1.50 ...___ ...$1.S0 $0.150 CLONIDINE TAB O.IMG MUT 100@. Q,1 MG TABLET 53489021501 $25.90 $1.06 $0.011 MUT 1D0@ INE TAB 0MG 0.2 MG TABLET 53489021601 S3735 _$1.06 $0.95 $0.95 50.010 CORGA CORGARD TAB 20MG 300 1 20 MG TABLET 60793080001 $431.46. 54.6) $4,67 50.047 CYCLOBE TABB 40 MG TABLET _. - 60793080101 _ $500.60 $4.72 $4,72- $0047 CYCLOBENZ TAB lOMG MYL 1000@ 10M M 10 MG TABLET 00378075110 $1,091.50 $8 -32 $g,;2 $O,OOg C'YCLDBEN2 TAB SMG CAD 1000 SMG .. TABLET _ 59746021110 $1,642.50 $43.63 -- -. - -- $43.83 - $0.044 CYTRA•290L 1602@ _334•S_DOMG SOLUTION _.. 60258000116 $14,24 S3.18 $3.18 $0.199 DEXAMETH TAB O.SMG UO ROX 100@ 0.5 MG TABLET -_ _ 00054817925 _ _.._ $26.72 $3.28 53.28 $0.033 OEXAMETH TqB 0.75MG BOX 100@ 0.75 MG TABLET _. 0005018025 53699 $4.81 54.81 $0.048 DEXAMETH TAB 4MG LID ROX300p 4 MG TABLET _ 00054817525 566:26 -- $9.37 $3.37 $0.034 DICYCLOM CAP - - MYL 100@ 10 MG CAPSULE 00378161001 $2638 $2.03 $2.03 $Q.QID DICYCLOM TAB 20MG MYL 10D@ 20 MIS TABLET 00378162001 - $35.50 $3.08 -- 3.08 $9.08 -_ - $0.031 DIGOXIN TAB 0.125MG LANN 1006 125 MCG ..._ TABLET ..... 00527132403 -- - $230.00 $ $2 .08 $0.228 DIGOXIN TAB 0,25MG LANN 100@ 250MCG TABLET __. 00527132501 __. 5230.00 $21.22 - $21.22 $0.212. DILTIAZEM TAB 120MG MYL 100 @ - _. 120 MG TABLET 00378052501 $151.81 $8.75 $8.75 $0.086 DILTIAZEM TAB 90MG MYL loop 90 MG TABLET 00378013501 5112.75 56.99 $6.99 $0.070 DOXAZOSIN TAB 1MG TEV 1001 -- _ - - 1 MG TABLET 00093612003 $134.86 $14.07 $14.07 $0.141 DOXAZOSIN TAB 2MG TEV 1000 2MG TABLET _ _.. _ 00093872101 ..__..._ $134.86 $12.86 $12.86 $0.129 DOXA2051N TAB 4MG TEV 300@ 4MG TABLET 00093812201 $141.55 $17.63 $17.63 $0.176 DOXAZOSIN TAB BMG TEV 100@ 8 MG TABLET 00093812301 S14&64 $7.81 $7.81 $0.078 DOXYCYC HVC CAP 300MG WEST 50@ 100 MG CAPSULE 00143314250 S276.67 $0.76 $44,76 50.895 Packet Page -1531- t 10/28/2014 16.D.7. DOXYCYC HYC CAP SOMG MLR 50 j 50 MG CAPSULE 53489011802 $112.66 536.46 $36.46 $0,729 ENALAPR MALTS 2.5MG TEV 100@ _ 2.5 MG TABLET 00093002601 $145.74 $5.07 $5.07 $0.051 'ENALAPR TAB 10MG WOCK 10040 20M TABLET _ . _ 64679092502_ - $11791 $3.18 $3.1.8 $0.032 ENALAPR TAB 20MG WOCK 1DDO 20 MG TABLET 64679092602 $16764 $397 $3.97 - -- $0.040 ENALAPR TAB SMG WOCK 100 5 MG TABLET 64679092402^ --.__.. $112 20 - $3.09 . $3.09 ... $0.031 _ ENALAPR TB SMG /12.SMG TAR 100@ - -.. _ SMG-12.SMG _ TA BLET ,..-- 51572404501 _I_....... $109.60 $0.71 $0.71 50.007 ERYTHR 0/0 0.5% 1GM UD S&L 50@ _ S MG /G _ DINT. (G) 24206091019 $820 73 $41.31 $41.31 . $0.826 ESTRADIOL TAB 0.5MG BARR 1000 0 S MG TABLET , 00555089902 $29.01 $3.31 $3.31 $0.033 'ESTRADIOL TAB SMG BARR 1000 1 MG� _ TABLET 00555088602 $35.79 .. $325 $3.25 $0.033 ESTRADIOL TAB 2MG BARR 100@ 2 MG _- TABLET ODS55088702 $49.55 " $4.30 _ $4.30 $0.043 FAMOTID TAB 20MG ZEN 1000 _ _ 26 MG TABLET 00172572860 $173.00 $1S3 $1.53 $0.015 FINASTER TAB SMG AURO 5000 S MG TABLET 65862014905 _ 51,563.25 $13.90 $13.90 50.028 'FLUOGNON CR 0.05% TEV 3DGM@ 0.0005 CREAM (G) 00093026230 $9L10 $5.24 $524 $5.240 FLUORIDE CHW TO O.SMG UB1000@ 0.5(1.1)MG TAB CHEW _ 51862017110 $140.80 $9.69 $9.69 50410 FLUOXET CAP 20MG PLIV 1000 _ _ 20 MG CAPSULE 50111064801 $26691 $L07 - $1.07 $0.031 FLUOXET CAP 40MG AURO 30@ 40 MG CAPSULE 65862019430 $160.09 $1.46 $1.46 $0.049 FLUOXET CAP 40MG AURO 30@ 40 MG CAPSULE 65862019430 $160.09 $1.46 $1.46 50.049 FLUOXET TAR 10MG PAR 30@ 10 MG TABLET 49884073411 $81.93 $1.19 $1.19 50.040 FLUPHENAZ TO iMG SAN 1000 1 MG TABLET 00781143601 $49.75 $4.47 $4.47 $0.045 FOLIC ACID TO SMG Ci/P 1000@ 1 MG TABLET 00603316232 $79.49 $726 $7.26 $0.007 FUROSEM TAB 20MG ROX 100@ 20 MG TABLET 000$4429725 $14.30 $0.35 $0.35 $0.009 FUROSEM TAB 40MG ROX 1004.0 _ 40 MG TABLET 00054429925 $16.30 $0.42 $0.42 $0.004 FUROSEM TA880MG ROX 100@ 80 MG TABLET 00054430125 $43.70 $0.12 $0.12 $0.001 GENTAMIC OINT0.1 %PERK I5GM@ 0.001 OINT (G) 45802004695 $3252 _ _ $8.64 $8.64 $8.640 'GENTAMIC OPH SOL GENTAK SML _ _ 0.003 _ _ DROPS _ 17478028910 $19.18 _ $297 $297 52.970 GENTAMIC SUL OPHD3 %OAC SML 0.003 _ DROPS 60758018805 $8.75 $136 $1.36 $1.360 GUMEPIR TAB 1MG ACC 100 _ _ _ 1 MG TABLET 16729000101 $40.15 $1.02 51.02 SO.010 GLIMEPIR TAB 2MG DR/R 500@ 2MG TABLET 55.111032_105 $315.6$ $5.18 $5.18 $0.010_ 'GUMEPIR TAB 4MG DR /R S00@ 4MG TABLET _ 551110322_0_5 _ _ $7.28 _ $7.28 $0.015 GUPIZIOE TAB 10MG SAN 100@ 10 MG TABLET 00781145301 _$595.73 $58._50 _ $0.19 $0.19 $0.002 GUPIZIDE TAB 5MGSAN 1000@ 5 MG TABLET 00781145210 $316.40 54.85 $4.85 SO.D05 GLYBURIDE M TAB 2.SMG TEV 90 2.S MG TABLET 00093634398 $41.34 $1.78 $1.78 $0.020 • GLYBURIDE MET 5/5DO ACT S00@ 5 MG -SOOMG TABLET OD22827S350 _ $502.93 S3.06 53.08 $0.006 GUANFAC TAB 1MG WAT 100@ 1 MG TABLET WS91044401 $87.20 $3.138 $3.08 $0.031 HALOP TAB O.SMG SAN IOD@ 0.5 MG TABLET 00781199101 $32.55 $8.79 $8.79 50.088 HALOP TAB IMG UD MMP 100 1 MG TABLET 00904592361 $79.81 57.18 57.18 $0.072 HALOP TAB 2MG UD SAN 10DO _ 2 MG TABLET 00781139313 $60.19 $17.49 $17.49 $0475 HALOP TAB SMG SAN 100@ -.. - -..... ... __.. _ SMG TABLET 00781139601 $102.38 $12.38 $1238 $0.124 ........_ HYDRAL TAB 20MG PLIV 100@ _..... _ 10 MG ,_..... TABLET _.. __ 50111039801 _....._. _.. .......... $41.13 _... $1.96 - .. _. $1.96 $0.020 HYDRAL TAB 25MG PAR _100@ -l-11 11 25 MG TABLET 49884002701 $50.83 $1.69 $1.69 $0.017 HYDROCHL CAP I2.SMG WAT 50049 12.5 MIS CAPSULE 00593034705 $2OL64 54.78 $4.78 $0 .010 HYDROCHL TB 50MG UD IVA 100 50 MG TABLET 001722DB 10 $17.54 $1.D0 51.00 $0.010 HYDROCORT AC CRM 1 %ACTA30GM@ 0.01 CREAM (G) 00472034356 $348 $0.76 50.76 $0.760 HYDROCORT SUPP 25MG PADD 12@ 25 MG SUPP.RECT 00574709012 $173.10 $5.48 $SAS $0.457 ISUPROF TAB 400MG DR /R 100@ 400 MG TABLET_ 55111068201 $20.50 $1.53 $1.55 SO.015 IBUPROF TAB 600MG OR /R 100@ 600 MG TABLET 55111068301 $29.04 $1.27 $1.27 $0.013 IBUPROF TAB 800MG DR/R 1DD@ 800 MG TABLET 55111068401 $38.10 $2.27 $2.27 $0.023 INDAPAM TAB 1.25MG MYLN 1DO@ 1.25 MG TABLET 00378006901 $142.12 $4.38 $4.38 50.044 INDAPAM TAB 2.SMG MYLN SOD@ 2.5 MG TABLET 00378008001 $154.94 $5.28 55.28 $0.053 INDOMET CAP 25MG CAMS 100 25 MG CAPSULE 31722054201 $38.00 $2.63 $2.63 $0.026 IPRATRO NEB SGLPK 0.02%NEPH300 0.2 MG /ML SOLUTION 00497980101 $39.60 $4.07 _ $4.07 $0.136 IPRATRO /ALB 0.5 /3MG SAN3MLSXS@ 0.5 -3M0 /3 AMPUL -NEB 00781714664 $65.61 $1.90 $1.90 $0.063 ISONLAZID TB 300MG BARR 3049 300 MG TABLET 00555007111) $10.15 $2.15 $2.15 $0.072 ISOSOR MON ER TO 30MG KRE 1000 30 MG ER 24H 62175012837 $51.64 $8.06 $8.06 $0.081 ISOSOR MON ER TB 60MG KRE 1D0@ _ 60 MG _TAB TAB OR 24H 62175011937 $54.34 $9.25 $9.25 $0.093 KLARON LOT 30% 40Z 0.1 SUSPENSION 00197519804 $307.48 $1.14 $1.14 $1.140 LACTULOSE SOL 1OG /15MLHI- T16Z!@ 10 GAS ML. _ _ SOLUTION 50383077916 536.50 $2.83 $2.83 $0.177 LEVOBUN HCL OPH 0.5% PAC SML MOOS_ DROPS 60758006005 $16.64 $0.93 $0.93 $0.930 LEVOTHYROX 1SDMCG SAN 1000@ 150 MCG TABLET 00781$18710 $706.16 S18755 $18.55 $0.019 LEVOTHYROX TAB 125MCG SAN 9D@ - 125 MCG TABLET 00781518692 $61.75 $5.04 $5.04 $0.056 LEVOTHYROX TAB 137MCG SAN 9040 137 MCG .. TABLET 00781519192 $62.61 $5.04 S5.04 $0.056 LEVOTHYROX TAB 175MCG SAN 9049 175MCG TABLET _ 00781518692 575.55 $5.04 $5.04 $0.056 LEVOTHYROX TAB 20OMCG SAN 90LD _ 200 MCG TABLET 00781518992 $75.69 $5.04 $5.04 $0456 LEVOTWYROX TAB 88MCG SAN 90@ B8 MCG TABLET 00781518392 $52.28 $0.01 $0.01 50.000 LEVOTHYROX TO 112MCG SAN 9040 112 MCG TABLET 00781538592 $60.91 $5.04 $5.D4 $0.056 .LEVOTHYROX TB ICMCG SAN 1000@ 100 MCG TABLET 00781518416 $58526 $6.02 $6.02 $0.006 LEVOTHYROX TO 25MCG SAN 100040 25 MCG TABLET 00782SIR010 $455.14 $0.03 $0.03 LEVOTHYROX TB SOMCG SAN 1ODD@ 50 MCG TABLET 00781518130 $516.66 $14.78 $14.78 $0.015 LEVOTHYROX T8 75MCS SAN 3000@ 75 MCG TABLET 007815_18210 $57095 $15.08 $15.08 $0.015 LIDOCA HCL 0S 2% Q/P IDOML@ 0,02 _ SOLUTION 00603139364 $1420 $0.94 $0.94 $0.940 USINOPR TAB 10MG WAT 1000 SO MG TABLET ODS91040701 $9892 $0.30 $0.30 $0.003 LISINOPR TAB 2.SMG EON 300@ 2.5 MG TABLET _.00185002501 56495 $0.50 SOSO S0.D05 LISINOPR TAB 20MG WAT 1000@ 20 MG TABLET ;00591040810_ $1,052.80 $10.83 $10.83 $0.011 4ISINOPR TAB 5MG SAN 10040 5 MG TABLET 00185540001 $97 25 11 SO.54 $0.005 USINOPR +HCTZ 30/12.5 LUPI300@ 10 -12SMG TABLET 68180051801 $112.04 _$0.54 $LS8 $1.38 $0.014 USINOPR +HCTZ 20/12.5 LUPI300@ - 2-042.5 MIS - -- TABLET 68180051901 5121.28 $2.02 $2.02 $0.020 USINOPR +HCTZ 26 /25IVA 100E 20.25MG TABLET 00172503260 $120.90 $1.98 -- - $1.98 - - - $0.020 LITHOBID TAB 300MG IDO 300 MG TABLET ER 62559028001 $594.00 $0.01 $0.01 $0.000 LORATADINE TAB 20MG PER 100@ 10 MG TABLET _ 45B02D65078. $30.07, $2.57 52.57 $0.026 LOSARTAN P /HYD 100/25 TEV 30@ IDOMG -25MG TABLET 00093736856 $102.23 51.35 $1.35 $0.045 '. LOVASTAT TAB 10MG LUPt 100 10 MG TABLET 68180046701 . $194.55 $2.81 ...... . $2.81 $0.028 LOVASTAT TAB 20MG SAN 100@ 20 MG TABLET 00185007201 5237.28 $1.80 $1.80 $0.018 Packet Page -1532- 10/28/2014 16.D.7. MAG 64 TAB PoS 600 64 MG TABLET ER 68585000575 $8.65. _ _- - $4.42 $4.42 $0.074 MAGNESIUM OXID TAB VIRR 120@ 400 MG TABLET 76439021712 _ $10.89 $1.85 $1.85 $0.015 MEDROXYPR TAB 10MG GRE 100@ 10 MG TABLET 5976237_4202 $49.14 $1.46 $1.46 $0.015 MEDROXYPR TAB 5MG GRE 1DO f 5 MG . TABLET 59762374101 $47,25 $194 _ $2.94 $0.029 MEGESTR TAB 20MG PAR 3001,0,_. .,,. 20 MG .....,- TABLET 49584028901 $69.20 $5.56_ - $5.56 $0.056 MELOXICAM TAB 1SMG ZYD 100 . 15 MG TABLET 68382005101 4 S48AS $1.52 51.52 $0.015 MELOXICAM TAB 7.SMG UNIC 100 7 5 MG TABLET _ 29300012401 $31_6.67 $0.97 _ $0.97 50.010 METFORM ER TAB SOOMG SAN 300 500 MG TAB ER 24H 00185441601 $71.50 $1.58 $1.58 $0.016 METFORM IR TAB 850MG AMN 100 - _ _ 850 MG __ TABLET 65]62017410 $119.70 S0.t9 $0.49 $0.005 METFORM TAB 100DMG TEV 1000@ _. _ 1000 MG ..SOD TABLET 000937214' $1,450.60 $15.44 _ $15.44 $0.015 METFORM TAB SOOMG CARA 90 -..._ .__._ �....__._._._ ._ MG _........ TABLET °_- 57664039749 .__- _._.-- $6896 -__ _ _._ __. $S.Sb ....- $1.16 _.. 50.013 METHYLD TAB 25OMG TEV 30081 25046 TABLET -...._ 00093293101 _.. $38.40 ...,. $3.94 ___. $0.039 METOC.- P SYRP SMG MOR 1602@ ..__ - 5MG /5 ML SOLUTION 60432062216 $19.25 $231 $23! $0.144 METOCLOPR TAB lOMG TEV 500 10 MG TABLET 00033270305 $130.25 $9.04 $9.04 $0.018 METOPROL TB TRT SDMG TEV 1004 SO MG TABLET _ 00093073301 _ $5530 $0.64 $0.64 $0,006 METOPROL TB TT 1 Ri 50 MG 1111. 1 TABLET . . . $0.006 METOPROL TRT TB 2SMG RAN 30.0080 25 MG TABLET _ 69304057410 $235.22 $10.74 $10.74 $0.011 MICRON GLYB TO 3MG STA 300 3 MG _6 TABLET 67253046110 $63.86 $048 $0.48 $0.005 MICRON GLYB TO ISMS STA 100 NAPROXEN TAB MG TABLET 67255046230 1. $107.32 _ $2.59 -- $2.59 - - $0.026 375MG TEV 1000 .. 475 MG - _ TABLET 00093014801 $106.40 $2.01 $2.01 $0.020 NAPRDXEN TAB IO TEV 100 SOO MG TABLET 00099014901 $129.40 _ _ $2.33 $2.13 $0.021 NEOMYrpULY B +DEX 0/0 FAL3.SGM@ 3.5 SOK 1 OINT. (G) 61314063136 $44,00 50.01 $0.01 $0,010 NEOSPOPoN G.U. IRRIG AMP SO 40.2OWML AMPUL 61570004710 $36628 $0.10 $0.10 $0.010 NYSTATIN OS 50DMU SML UDP /A100 100000 /ML ORALSUSP 0012147853S $133.25 _ $74.52 $74.52 $0.745 OXYBUTYNIN TAB SMG UO UOL 100 6 MG TABLET . -._ _ 51079062620 ._.._.. $44,59 $10.97 _.. $10.97 ........ SO.110 PAMELOR CAP 20MG 30 10 MG CAPSULE 00406991003 5839.65 50.29 $0.29 50.010 PAMELOR CAP 2SMG 30 25 MG CAPSULE 00406991103 $856.44_ $029 $0.29 $D.O10 DAROXETIN TAB lOMG AUTO 30.0 _ 10 MG TABLET 13107015430 $78.55 $1.09 $1.09 $0.036 PAROXETIN TAB 20MG GRE 30 20 MG TABLET 59762181001 $79_!0 $0.35 $035 $0.012 PENICIL -V POT TB 250MG GRESDO 250 MG TABLET 59762153401 $23.48T 51.66 $1.66 $0.017 PEN ICIL-VK O/S L25MG TEV 2CMLE0 - 125 MG /SML_.__- SOLN RECON 00093412574 $5.64 ` -_ -52.16 $2.16 - $0.324 PEN IGL -VK 0/5 25OMG TEV 2CML@ 250 MG /SML SOLN RECON OOD93412774 $6.23 _$2.40 - $2.40 $0.360 PMENAZ TAB 200MG AKY 100 _ 200 MG - .TABLET. 65162052010 $205.14 _... $538 -$S.SB $0.054 '. PHENAZ TAB 200MG AKY 100@ 200 MG TABLET 65162052010 $205.14 $5.38_ $5.38 _ $0.054 PILGCAR OPMT SOL 2 %FAL 1520@ 0.02 DROPS 61914020415 $95.13 _ $50.93 $50.33 $50.330 PILOCAR 05 lOMG /ML AKOR 15ML 1. 0.01 .. DRPS 17478022312 $44.70 $16.30 $16.30 $16.300 PRAVAST NA TAB lOMG APX 90@ 30 MG _ TAB- LET 60505016809 $28933 $16.19 $16.19 50.180 PRAVAST $00 TAB 40MG GLEN 500@1 40 MG TABLET 68462019705 _ $4397.20 $23.67 $23.67 $0,047 PRAVAST TAB 20MG TEV 90@ .,, ., - 20MG. TABLET 00093720198 _. _ $29444 $10.23 - $10.23 $0.114 - PRA2DSIN CAP iMG MYL 100.0 1 MG CAPSULE , $74.62 $7.31 $7.31 $0.073 PREDNISON TAB lOMG UD ROX ]DO¢ 10 MG TABLET _003781101,01 00054001720 $26.70 50.98 50.98 $0.010 PRE DNISON TAB 2.5MG ROX 1000 2.5 MG TABLET 00054474225 $1648 $3.18 $3.18 $0.032 PREDNISON TAB 20MG UD ROX 20 MG __ TABLET 00054001820 $2849 _ _ $5.15 $5.15 $0.052 PREDNISON TAB SMG ROX 10001,1 @ 5MG TABLET 00054472831 5223.86 $16.41 _ 516,41 $0.016 PRENATAL 1 PLUS 1 TB AKY 100 27 MG-1 MG TABLET 65162066810 $36.25 $3.89 $3.89 $0.039 - PROCHLORP TAB 10MG TEV 10083 _ 10 MG _ TABLET 00093965201 _ $15734 $0.56 $0.56 $0.006 PROCT02 HC CRM 2S% IRIS 30GM -. .. 0.025 CREAM/APPL 64980030130 $5739 _ $5.53 $5.53 $5.530 PROMETH DM SYRP O/P 16OZQ. 15. 625/5_. SYRUP _.._._ _...,_.....__.._.. 006D31566S8 _. -.. ._ _ ._ $21.64_ _....... - $3.33 _ $0.208 PROMETH NCLTB 2SMG CARA 3001,1 25 MG TABLET_ 57664010686 $50_liq„ ..._ _ ...__._. $1.06 $1.06 $0.011 DROMETH SYRP 6.25 /SMLQ/P 402 @_ ._. __ _, ,,.. _. -� -.. 6.25MG /SML .._ -_'10 SYRUP _ 00505158454 _ $735 5038 50.58 $0.580 PROPRAN TAB SOMG PUV 100 ® MG TABLET 50111046701 $99.55 $030 $0,30 $0.003 PROPRAN TAB 20MG _MYLN 100@ _ 20 MG TABLET 00378_0_163_01 $26.75 $2.62 $2.62 $0.026 PROPRAN TAB 40MG PLIV 100 40 MG TABLET .__ _ 50111_046901 X5 _ $69.15 _ $OAS _ $0,005 PROPRAN TAB 80MG 1000 80 MG TABLET 01110 4 7 101 $63.39 „_$0.45 $1.22 $1.22 $0.012 PROYERA TAB 2SMG 100 _ 100 _ _ 2.S MG TABLET 00009006404 $164.14 $1.09 $1.09 $0.011 .RANITID TAB 150MG IVA 60 150 MG - TABLET 00172435749 . $95.30 $2.41 $2,41 $0.040 RANITIO TAB 300MG WOCK 100@ 300 MG TABLET 64679074204 $27013 $2.06 $2.06 $0.021 SILVADENE CRM 1 %TBE 20GM 001 CREAM (G) 61570013120 $9.98 $0`64 $0.64 - S0,54p 50TALOL HCI TAB 80MG APX 100 _., 80 MG TABLET 6DSOSOOY000 $256.21 $2.93 $0.029 SPIRONOL TAB 25MGACTA 100 25 MG TABLET 00228280311 „ _,. $45.94 .. _ _ -$2.93 $1 ^35 $1.35 50.014 SULFAM +TRI OS CHRY AUR0473MLAP 200- 40MG /S ORALSUSP 65862049647 $21530 _ _ $13.40 $1340 $0.838 SULFAM +TRI TO 400 /80MG AURO100 400MG•BOMG TABLET 65862041901 $66.45 $2.79 $2.79 50.028 SULFAM +TRI TB 800 /160MGAUROSOO -- 800 -160 MG TABLET _ 6_S.M....w0420_ 05 _.. _ $44.60 11.71 _ $11.71 $0.023 7AMOXIFEN CIT TAB 3MG 634560 0 lO.MG TABLET 00.591247260 $11.6 54A5 _ $4A5 $0.074 TAMOXIFEN CITR TB 20MG MYL 300 20 MG TABLET 00378027493 _ $113.65 _$. _ $4.57 $4.57 50.152 TERALOSIN CAP ]OMG SAN 100@ 30 MG CAPSULE 00781205401 $160.38 - $1.77 $1,77 SO 018 TERA20SIN CAP 1MG SAN 100.0 _ _. 1 MG CAPSULE 0078]205101 $16038 $2.25 $2.25 $0.023 TERAZOSIN CAP 2MG SAN 100@ 2 MG CAPSULE 00781205201 $160.38 $1.43 $1.43 $0.014 TERAZOUN CAP SMG SAN 300 5 MG CAPSULE 00781205301 '_ 5160.38 $L52 $1.52 $0.015 TERBINAF TAB 250MG LAMB 30 250 MG _ TABLET 31722020930 $390.70 $2.95 $2.95 50.098 TIMOLOL OPH SOL 025% FAL SML@ 0.0025 DROPS 61314022605 $15.00 _ $0.79 50.79 $0.790 TIMOLOL OPH SOL D.5 %AKOR 1SML 0.005 DROPS 17478028812 $11.20 $2.93 52.43 $2.930 TOBREX DROP 0.3% OT 5ML 0.003 DROPS 00065064305 $97.92 - $032 $0.32 $0.320 TRAZOD TAB 1ODMG PUV 1D0@ .... .._ 100 MG TABLET 50111043401 $73.25 $I.21 $2.21 $0.022 TRAZOD TAB 150MG PLIV 100(@1 150 MG TABLET 50111044101 _ $146.91 54,45 $4.45 $0.045 TRAZOD TAB SOMG PLIV 1000 _-- $0 MG TABLET 50111043301 $56.52 $1.16 $1.16 $0.012 TRIAM4HCTZ TB 75/50 MYL 1001_ ..._ 7S MG -SOMG .... -.. TABLET _. -._ 00378135501 _-- _...-__ $11132 _ SO-97 50.97 $0.010 TRIAMCIN CRM 0.025% PERK 15GM@ ... ... 0.00025 CREAM (G) -'.._ 45802006335 $4.45 $0.50 $0.50 .. $0.500 TRIAMCIN CRM 0.5% FOUG 15GM@ 0.005 CREAM (G) 00168063215 $IL30 $2.32 $2.32 $2.320 TRIAMCIN OINT 0.1% PEAR I%M@ 0.001 DINT. (G) 45802005535 __. _- $5.57 $0.59 - $0.59 $0.590 TRIHEXPH TAB 2MG WAT 100@1 2MG _ TABLET 00_591533501 $1629 $2.97 $2.97 $0.030 TRI- SPRINTEC TAB BARB 6X28@ 7DAYSX3 26 TABLET0055590185B $295.94 $10.68 $1018 $0.065 <+ Packet Page - 1533 - "Aa =`v 10/28/2014 16.D.7. TRI-SPRINTEC TAB BARR 6X289 7DAYSX3 28 TABLET 00555901858 $235:94 $10.88 $10.88 $0.065 VERAPAM TAB 120MG WHTWAT 100@ 120 MG TABLET 0059_1034501 _ $66.43 $4.31 $4.31 $0.D43 VERAPAM TAB BOMG MYLN 1000 60 MG TABLET _ 00378051201 $39.11 $3.58 $3.56 $0.036 WARFARIN SOD TAB 1MG BARR 100@ 1 MG TABLET 00555083102 $61.26 $2.36 $2.36 $0.024 WARFARIN SOD TAB 4MG BARR 10060 4 MG TABLET 00555087402 $66.41 $2.53 $2.63 50.026 WARFARIN SOD TB 10MG ZYD 100 10 MG TABLET 68382005901 $98.56 $2.46 $2.46 $0.025 WARFARIN 500 TO 2MG ZYO 100 2 MG TABLET 65382005301 $63.40 $2.40 $2.4D $0.024 WARFARIN SOD T8 3MG ZYD 100 3 MG � TABLET 6838200540_1 $65.40 $2A4 $2.44 $0.024 WARFARIN SOD TO SMG ZYD 100 S MG TABLET 58382005601 $66.80 - - $2.33 $2.33 $0.013 WARFARIN SOD TO 6MG ZYD 100 . _. 6 MG __. TABLET_ _. 68362005701 $92.30 $2.55 $2.55 $0.026 WARFARIN SOD TO 7.SMG ZYD 100 7.5 MG . TABLET _. 68362005801` _.� $94.69 _ $2.M.._ -_ _.- ...., $2.44 $0.024 WARFARIN TAB 2.5MG ZYD- 100 2.5 MG �_- _ _ TABLET ^ 68382006401 - �T65463099110 ._ $64.50 - $2.38 $2.38 -' 50.024 ZYLOPRIM TAB 100MG 100 100 MG TABLET $175.22 $0.97 $0.97 $0.010 ZYLOPRIM TAB 300MG 100 300 MG TABLET 65483099310 $479.93 $0.97 $0.97 $0.010 Packet Page -1534- S 10/28/2014 16.D.7. 14 -6248 "Pharmacy Services" EXHIBIT C' "Supplemental General Grant Terms and Conditions" (Following this page) v kia Packet Page -1535- c��? 10/28/2014 16.D.7. Exhibit C Supplemental General Grant Terms and Conditions The supplemental conditions contained in this section are intended to cooperate with, to supplement, and to modify the general conditions and other specifications. In cases of disagreement with any other section of this contract, the Supplemental Conditions shall govern. \� Flow Down of Terms and Conditions from the Grant Agreement Subcontracts: If the vendor subcontracts any of the work required under is Agreement, a copy of the signed subcontract must be forwarded to the Department for review and approval. The vendor agrees to include in the subcontract that (1) the subcontractors is bound by the terms of this Agreement, (ii) the subcontractor is bound by all applicable state and federal laws and regulations, and (Iii) the subcontractor shall hold the Department and Recipient harmless against all claims of whatever nature arising out of the subcontractor's performance of work under this Agreement, to the extent allowed and required by law. The recipient shall document in the quarterly report the subcontractor's progress in performing its work under this agreement. For each subcontract, the Recipient shall provide a written statement to the Department as to whether the subcontractor is a minority vendor as defined in Section 288.703, Fla. Stat. Packet Page -1536- G 10/28/2014 16.D.7. Exhibit C Supplemental General Grant Terms and Conditions I. Administrative, 2. contractual, or legal remedies Unless otherwise provided in this contract, all claims, counter - claims, disputes and other matters in question between the local government and the contractor, arising out of or relating to this contract, or the breach of it, will be decided by arbitration, if the parties mutually agree, or in a Florida court of competent jurisdiction. 3. Energy Conservation Requirements - The Energy Conservation requirements are applicable to all contracts and subcontracts. The Contractor shall comply with any mandatory standards and policies relating to energy efficiency contained in the State Energy Conservation Plan issued in compliance with the Energy Policy and Conservation Act (42 U.S.C. Section 6201) 4. Access to Records and Reports - The vendor agrees to maintain all books, records, accounts and reports required under this contract for a period of not less than three years after the date of termination or expiration of this contract, except in the event of litigation or settlement of claims arising from the performance of this contract, in which case Vendor agrees to maintain same until the Purchaser, the Grantor Administrator, the Comptroller General, or any of their duly authorized representatives, have disposed of all such litigation, appeals, claims or exceptions related thereto. 5. No Government Obligation to Third Parties - Applies to all contracts. The Purchaser and Vendor acknowledge and agree that, notwithstanding any concurrence by the Federal Government in or approval of the solicitation or award of the underlying contract, absent the express written consent by the Federal Government, the Federal Government is not a party to this contract and shall not be subject to any obligations or liabilities to the Purchaser, Vendor, or any other party (whether or not a party to that contract) pertaining to any matter resulting from the underlying contract. It is further agreed that the clause shall not be modified, except to identify the subcontract who will be subject to its provisions. 6. Clean Air Act, Federal Water Pollution Control Act, Executive Order 11738, and US EPA Regulations - Contracts and subgrants of amounts in excess of $100,000 shall contain a provision that requires the Contractor or recipient to comply with all applicable standards, orders, or requirements issued pursuant to the Clean Air Act (42 U.S.C. 7401- 7671q) and the Federal Water Pollution Control Act as amended (33 U.S.C. 1251- 1387). Violations must be reported to the Federal awarding agency and the Regional Office of the Environmental Protection Agency (EPA). 7. Energy Policy and Conservation Act - The contractor shall comply with any mandatory standards and policies relating to energy efficiency which are contained in the F I o r i d a state energy conservation plan issued in compliance with the Energy Policy and Conservation Act (Pub. L. 94 -163, 89 Stat. 871). S. Debarment and Suspension (Executive Orders 12549 and 12689) - Contract awards that exceed the small purchase threshold and certain other contract awards shall not be made to parties listed on the government wide Excluded Parties List System in the System for Award Management (SAM), in accordance with the OMB guidelines at 2 CFR 180 that implement Executive Orders 12549 (3 CFR Part 1986 Comp., p. 189) and 12689 (3 CFR Part 1989 Comp., p. 235), "Debarment and Suspension." The Excluded Parties List System in SAM contains the names of parties debarred, suspended, or otherwise excluded by agencies, as well as parties declared ineligible under statutory or regulatory authority other than Executive Order 12549. 9. Byrd Anti - Lobbying Amendment (31 U.S.C. 1352) - Vendors must certify it will not and has not used Federal appropriated funds have been paid or will be paid, by or to any person or organization for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement The certification includes any lobbying with non - Federal funds that takes place in connection with obtaining any Federal award. Gio Packet Page -1537- 10/28/2014 16.D.7. Exhibit C Supplemental General Grant Terms and Conditions 10. Procurement of Recovered Materials - (a) In accordance with Section 6002 of the Solid Waste Disposal Act, as amended by the Resource Conservation and Recovery Act, the Contractor shall procure items designated in guidelines of the Environmental Protection Agency (EPA) at 40 CFR Part 247 that contain the highest percentage of recovered materials practicable, consistent with maintaining a satisfactory level of competition. The Contractor shall procure items designated in the EPA guidelines that contain the highest percentage of recovered materials practicable unless the Contractor determines that such items: (1) are not reasonably available in a reasonable period of time; (2) fail to meet reasonable performance standards, which shall be determined on the basis of the guidelines of the National Institute of Standards and Technology, if applicable to the item; or (3) are only available at an unreasonable price. (b) Paragraph (a) of this clause shall apply to items purchased under this contract where: (1) the Contractor purchases in excess of $10,000 of the item under this contract; or (2) during the preceding Federal fiscal year, the Contractor: (i) purchased any amount of the items for use under a contract that was funded with Federal appropriations and was with a Federal agency or a State agency or agency of a political subdivision of a State; and (ii) purchased a total of in excess of $10,000 of the item both under and outside that contract. 11. Disadvantaged Business Enterprise (DBE) - Vendors shall not discriminate on the basis of race, color, national origin, or sex in the performance of this contract. Vendors shall make a good faith effort to assure that registered disadvantaged business enterprises are used as sources of supplies, equipment, construction, and services as much as possible. Each vendor shall identify the anticipated level of participation by DBE's in the project and report its actual DBE participation (if any)." The offeror will be required to report Its DBE participation obtained through race - neutral means throughout the period of performance and required to convey all changes in anticipated levels of participation to the County in a timely manner. The vendor is required to pay its DBE subcontractors performing work related to this contract for satisfactory performance of that work no later than 30 days after the vendor's receipt of payment for that work from Collier County. In addition, the vendor is required to return any retainage payments to those subcontractors within thirty (30) days after the subcontractor's work related to this contract is satisfactorily completed. The vendor must promptly notify Collier County, whenever a DBE subcontractor performing work related to this contract is terminated or fails to complete Its work, and must make good faith efforts to engage another DBE subcontractor to perform at least the same amount of work. The vendor may not terminate any DBE subcontractor and perform that work through its own forces or those of an affiliate without prior written consent of Collier County. 12. Equal Employment Opportunity - Except as otherwise provided under 41 CFR Part 60, all contracts that meet the definition of "federally assisted construction contract" in 41 CFR Part 60-1.3 must include the equal opportunity clause provided under 41 CFR 60- 1.4(b), in accordance with Executive Order 11246, "Equal Employment Opportunity" (30 FR 12319, 12935, 3 CFR Part, 1964— 1965 Comp., p. 339), as amended by Executive Order 11375, "Amending Executive Order 11246 Relating to Equal Employment Opportunity," and implementing regulations at 41 CFR part 60, "Office of Federal Contract Compliance Programs, Equal Employment Opportunity, Department of Labor." §60 -4.3 Equal opportunity clauses. (a) The equal opportunity clause published at 41 CFR 60- 1.4(a) of this chapter is required to be included in, and is part of, all nonexempt Federal contracts and subcontracts, including construction contracts and subcontracts. The equal opportunity clause published at 41 CFR 60 -1.4 (b) is required to be included in, and is a part of, all nonexempt federally assisted construction contracts and subcontracts. In addition to the clauses described above, all Federal contracting officers, all applicants and all nonconstruction contractors, as applicable, shall include the specifications set forth in this section in all Federal and federally assisted construction contracts in excess of $10,000 to be performed in geographical areas designated by the Director pursuant to §60 -4.6 of this part and in construction subcontracts in excess of $10,000 necessary in whole or in part to the performance of nonconstrucction Federal contracts and subcontracts covered under the Executive order. STANDARD FEDERAL EQUAL EMPLOYMENT OPPORTUNITY CONSTRUCTION CONTRACT SPECIFICATIONS (EXECUTIVE ORDER 11246) 1. As used in these specifications: a. "Covered area" means the geographical area described in the solicitation from which this contract resulted; Packet Page - 1538 - 10/28/2014 16.D.7. Exhibit C Supplemental General Grant Terms and Conditions b. "Director" means Director, Office of Federal Contract Compliance Programs, United States Department of Labor, or any person to whom the Director delegates authority; c. "Employer identification number" means the Federal Social Security number used on the Employer's Quarterly Federal Tax Return, U.S. Treasury Department Form 941. d. "Minority" includes: (f) Black (all persons having origins in any of the Black African racial groups not of Hispanic origin); (!I) Hispanic (all persons of Mexican, Puerto Rican, Cuban, Central or South American or other Spanish Culture or origin, regardless of race); (iii) Asian and Pacific Islander (all persons having origins in any of the original peoples of the Far East, Southeast Asia, the Indian Subcontinent, or the Pacific Islands); and (iv) American Indian or Alaskan Native (all persons having origins in any of the original peoples of North America and maintaining identifiable tribal affiliations through membership and participation or community identification). 2. Whenever the Contractor, or any Subcontractor at any tier, subcontracts a portion of the work involving any construction trade, it shall physically include in each subcontract in excess of $10,000 the provisions of these specifications and the Notice which contains the applicable goals for minority and female participation and which is set forth in the solicitations from which this contract resulted. 3. If the Contractor is participating (pursuant to 41 CFR 60 -4.5) in a Hometown Plan approved by the U.S. Department of Labor in the covered area either individually or through an association, Its affirmative action obligations on all work In the Plan area (including goals and timetables) shall be in accordance with that Plan for those trades which have unions participating in the Plan. Contractors must be able to demonstrate their participation in and compliance with the provisions of any such Hometown Plan. Each Contractor or Subcontractor participating in an approved Plan is individually required to comply with its obligations under the EEO clause, and to make a good faith effort to achieve each goal under the Plan in each trade in which it has employees. The overall good faith performance by other Contractors or Subcontractors toward a goal in an approved Plan does not excuse any covered Contractor's or Subcontractor's failure to take good faith efforts to achieve the Plan goals and timetables. 4. The Contractor shall implement the specific affirmative action standards provided in paragraphs 7 a through p of these specifications. The goals set forth in the solicitation from which this contract resulted are expressed as percentages of the total hours of employment and training of minority and female utilization the Contractor should reasonably be able to achieve in each construction trade in which it has employees in the covered area. Covered Construction contractors performing construction work in geographical areas where they do not have a Federal or federally assisted constuction contract shall apply the minority and female goals established for the geographical area where the work is being performed. Goals are published periodically in the Federal Register in notice form, and such notices may be obtained from any Office of Federal Contract Compliance Programs office or from Federal procurement contracting officers. The Contractor is expected to make substantially uniform progress in meeting its goals In each craft during the period specified. 5. Neither the provisions of any collective bargaining agreement, nor the failure by a union with whom the Contractor has a collective bargaining agreement, to refer either minorities or women shall excuse the Contractor's obligations under these specifications, Executive Order 11246, or the regulations promulgated pursuant thereto. 6. In order for the nonworking training hours of apprentices and trainees to be counted in meeting the goals, such apprentices and trainees must be employed by the Contractor during the training period, and the Contractor must have made a commitment to employ the apprentices and trainees at the completion of their training, subject to the availability of employment opportunities. Trainees must be trained pursuant to training programs approved by the U.S. Department of Labor. 7, The Contractor shall take specific affirmative actions to ensure equal employment opportunity. The evaluation of the Contractor's compliance with these specifications shall be based upon its effort to achieve maximum results from its actions. The Contractor shall document these efforts fully, and shall implement affirmative action steps at least as extensive as the following: a. Ensure and maintain a working environment free of harassment, intimidation, and coercion at all sites, and in all facilities at which the Contractor's employees are assigned to work. The Contractor, where possible, will assign two or more women to each construction project. The Contractor shall specifically ensure that all foremen, superintendents, and other on -site supervisory personnel are aware of and cant' out the Contractor's obligation to maintain such a working environment, with speck attention to minority or female individuals working at such sites or in such facilities. b. Establish and maintain a current list of minority and female recruitment sources, provide written notification to minority and female recruitment sources and to community organizations when the Contractor or its unions have 4 Packet Page -1539- ��'Iz 10/28/2014 16.D.7. Exhibit C Supplemental General Grant Terms and Conditions employment opportunities available, and maintain a record of the organizations' responses. c. Maintain a current file of the names, addresses and telephone numbers of each minority and female off- the - street applicant and minority or female referral from a union, a recruitment source or community organization and of what action was taken with respect to each such individual. If such individual was sent to the union hiring hall for referral and was not referred back to the Contractor by the union or, if referred, not employed by the Contractor, this shall be documented in the file with the reason therefor, along with whatever additional actions the Contractor may have taken. d. Provide immediate written notification to the Director when the union or unions with which the Contractor has a collective bargaining agreement has not referred to the Contractor a minority person or woman sent by the Contractor, or when the Contractor has other information that the .union referral process has impeded the Contractor's efforts to meet its obligations. e. Develop on- the -job training opportunities and /or participate in training programs for the area which expressly Include minorities and women, including upgrading programs and apprenticeship and trainee programs relevant to the Contractor's employment needs, especially those programs funded or approved by the Department of Labor. The Contractor shall provide notice of these programs to the sources compiled under 7b above. f. Disseminate the Contractor's EEO policy by providing notice of the policy to unions and training programs and requesting their cooperation in assisting the Contractor in meeting its EEO obligations; by including it in any policy manual and collective bargaining agreement; by publicizing it in the company newpaper, annual report, etc.; by specific review of the policy with all management personnel and with all minority and female employees at least once a year; and by posting the company EEO polity on bulletin boards accessible to all employees at each location where construction work is performed. g. Review, at least annually, the company's EEO policy and affirmative action obligations under these specifications with all employees having any responsibility for hiring, assignment, layoff, termination or other employment decisions including specific review of these items with onsite supervisory personnel such as Superintendents, General Foremen, etc., prior to the initiation of construction work at any job site. A written record shall be made and maintained identifying the time and place of these meetings, persons attending, subject matter discussed, and disposition of the subject matter. h. Disseminate the Contractor's EEO policy externally by including it in any advertising in the news media, specifically including minority and female news media, and providing written notification to and discussing the Contractor's EEO policy with other Contractors and Subcontractors with whom the Contractor does or anticipates doing business. I. Direct its recruitment efforts, both oral and written, to minority, female and community organizations, to schools with minority and female students and to minority and female recruitment and training organizations serving the Contractor's recruitment area and employment needs. Not later than one month prior to the date for the acceptance of applications for apprenticeship or other training by any recruitment source, the Contractor shall send written notification to organizations such as the above, describing the openings, screening procedures, and tests to be used in the selection process. j. Encourage present minority and female employees to recruit other minority persons and women and, where reasonable, provide after school, summer and vacation employment to minority and female youth both on the site and in other areas of a Contractor's work force. k. Validate all tests and other selection requirements where there is an obligation to do so under 41 CFR Part 60 -3. I. Conduct, at least annually, an inventory and evaluation at least of all minority and female personnel for promotional opportunities and encourage these employees to seek or to prepare for, through appropriate training, etc., such opportunities. m. Ensure that seniority practices, job classifications, work assignments and other personnel practices, do not have a discriminatory effect by continually monitoring all personnel and employment related activities to ensure that the EEO policy and the Contractor's obligations under these specifications are being carried out. n. Ensure that all facilities and company activities are nonsegregated except that separate or single -user toilet and necessary changing facilities shall be provided to assure privacy between the sexes. o. Document and maintain a record of all solicitations of offers for subcontracts from minority and female construction contractors and suppliers, including circulation of solicitations to minority and female contractor associations and other business associations. p. Conduct a review, at least annually, of all supervisors' adherence to and performance under the Contractor's EEO policies and affirmative action obligations. 8. Contractors are encouraged to participate in voluntary associations which assist in fulfilling one or more of their Packet Page -1540- 10/28/2014 16.D.7. Exhibit .0 - Supplemental General Grant Terms and Conditions affirmative action obligations (7a through p). The efforts of a contractor association, joint contractor- union, contractor - community, or other similar group of which the contractor is a member and participant, may be asserted as fulfilling any one or more of its obligations under 7a through p of these Specifications provided that the contractor actively participates in the group, makes every effort to assure that the group has a positive impact on the employment of minorities and women in the industry, ensures that the concrete benefits of the program are reflected in the Contractor's minority and female workforce participation, makes a good faith effort to meet Its individual goals and timetables, and can provide access to documentation which demonstrates the effectiveness of actions taken on behalf of the Contractor. The obligation to comply, however, is the Contractor's and failure of such a group to fulfill an obligation shall not be a defense for the Contractor's noncompliance. 9. A single goal for minorities and a separate single goal for women have been established. The Contractor, however, is required to provide equal employment opportunity and to take affirmative action for all minority groups, both male and female, and all women, birth minority and non - minority. Consequently, the Contractor may be in violation of the Executive Order if a particular group is employed in a substantially disparate manner (for example, even though the Contractor has achieved its goals for women generally, the Contractor may be in violation of the Executive Order if a specific minority group of women is underutilized). 10. The Contractor shall not use the goals and timetables or affirmative action standards to discriminate against any person because of race, color, religion, sex, or national origin. 11. The Contractor shall not enter Into any Subcontract with any person or firm debarred from Government contracts pursuant to Executive Order 11246. 12, The Contractor shall carry out such sanctions and penalties for violation of these specifications and of the Equal Opportunity Clause, including suspension, termination and cancellation of existing subcontracts as may be imposed or ordered pursuant to Executive Order 11246, as amended, and its implementing regulations, by the Office of Federal Contract Compliance Programs. Any Contractor who fails to carry out such sanctions and penalties shall be in violation of these specifications and Executive Order 11246, as amended. 13. The Contractor, in fulfilling its obligations under these specifications, shall implement specific affirmative action steps, at least as extensive as those standards prescribed in paragraph 7 of these specifications, so as to achieve maximum results from its efforts to ensure equal employment opportunity. If the Contractor fails to comply with the requirements of the Executive Order, the implementing regulations, or these specifications, the Director shall proceed in accordance with 41 CFR 60 -4.8. 14. The Contractor shall designate a responsible official to monitor all employment related activity to ensure that the company EEO policy is being carried out, to submit reports relating to the provisions hereof as may be required by the Government and to keep records. Records shall at least include for each employee the name, address, telephone numbers, construction trade, union affiliation if any, employee identification number when assigned, social security number, race, sex, status (e.g., mechanic, apprentice trainee, helper, or laborer), dates of changes in status, hours worked per week in the indicated trade, rate of pay, and locations at which the work was performed. Records shall be maintained in an easily understandable and retrievable form; however, to the degree that existing records satisfy this requirement, contractors shall not be required to maintain separate records. 15. Nothing herein provided shall be construed as a limitation upon the application of other laws which establish different standards of compliance or upon the application of requirements for the hiring of local or other area residents (e.g., those under the Public Works Employment Act of 1977 and the Community Development Block Grant Program). 13. Termination 1. TERMINATION FOR DEFAULT. 1. Contractor shall be considered in material default of the Agreement and such default shall be considered cause for Owner to terminate the Agreement, in whole or in part, as further set forth in this Section, if Contractor: (1) fails to begin the Work under the Contract Documents within the time specified herein; or (2) fails to properly and timely perform the Work as directed by the Project Manager or as provided for in the approved Progress Schedule; or (3) performs the Work unsuitably or neglects or refuses to remove materials or to correct or replace such Work as may be rejected as unacceptable or unsuitable; or (4) discontinues the prosecution of the Work; or (5) fails to resume Work which has been suspended within a reasonable time after being notified to do so; or (6) becomes insolvent or is declared bankrupt, or commits any act of bankruptcy; or (7) allows any final judgment to stand against it unsatisfied for more than ten (10) days; or (8) makes an assignment for the benefit of creditors; or (9) fails to obey any applicable codes, laws, ordinances, rules or regulations with respect to the Work; or (10) materially breaches any other provision of the Contract Documents. Packet Page -1541- �l 10/28/2014 16.D.7. Exhibit C Supplemental General Grant Terms and Conditions 2. Owner shall notify Contractor in writing of Contractor's default(s). If Owner determines that Contractor has not remedied and cured the default(s) within seven (7) calendar days following receipt by Contractor of said written notice or such longer period of time as may be consented to by Owner in writing and in its sole discretion, then Owner, at its option, without releasing or waiving its rights and remedies against the Contractor's sureties and without prejudice to any other right or remedy it may be entitled to hereunder or by law, may terminate Contractor's right to proceed under the Agreement, in whole or in part, and take possession of all or any portion of the Work and any materials, tools, equipment, and appliances of Contractor, take assignments of any of Contractor's subcontracts and purchase orders, and complete all or any portion of Contractor's Work by whatever means, method or agency which Owner, in its sole discretion, may choose. 3. If Owner deems any of the foregoing remedies necessary, Contractor agrees that it shall not be entitled to receive any further payments hereunder until after the Project is completed. All moneys expended and all of the costs, losses, damages and extra expenses, including all management, administrative and other overhead and other direct and indirect expenses (including Design Professional and attorneys' fees) or damages incurred by Owner incident to such completion, shall be deducted from the Contract Amount, and if such expenditures exceed the unpaid balance of the Contract Amount, Contractor agrees to pay promptly to Owner on demand the full amount of such excess, including costs of collection, attorneys' fees (including appeals) and interest thereon at the maximum legal rate of interest until paid. If the unpaid balance of the Contract Amount exceeds all such costs, expenditures and damages incurred by the Owner to complete the Work, such excess shall be paid to the Contractor. The amount to be paid to the Contractor or Owner, as the case may be, shall be approved by the Project Manager, upon application, and this obligation for payment shall survive termination of the Agreement. 4. The liability of Contractor hereunder shall extend to and include the full amount of any and all sums paid, expenses and losses incurred, damages sustained, and obligations assumed by Owner in good faith under the belief that such payments or assumptions were necessary or required, in completing the Work and providing labor, materials, equipment, supplies, and other items therefore or re- letting the Work, and in settlement, discharge or compromise of any claims, demands, suits, and judgments pertaining to or arising out of the Work hereunder. 5. If, after notice of termination of Contractor's right to proceed pursuant to this Section, it is determined for any reason that Contractor was not in default, or that its default was excusable, or that Owner is not entitled to the remedies against Contractor provided herein, then the termination will be deemed a termination for convenience and Contractor's remedies against Owner shall be the same as and limited to those afforded Contractor under Section 19 below. 6. In the event (1) Owner falls to make any undisputed payment to Contractor within thirty (30) days after such payment is due or Owner otherwise persistently fails to fulfill some material obligation owed by Owner to Contractor under this Agreement, and (ii) Owner has failed to cure such default within fourteen (14) days of receiving written notice of same from Contractor, then Contractor may stop its performance under this Agreement until such default is cured, after giving Owner a second fourteen (14) days written notice of Contractor's intention to stop performance under the Agreement. If the Work is so stopped for a period of one hundred and twenty (120) consecutive days through no act or fault of the Contractor or its Subcontractors or their agents or employees or any other persons performing portions of the Work under contract with the Contractor or any Subcontractor, the Contractor may terminate this Agreement by giving written notice to Owner of Contractor's intent to terminate this Agreement. If Owner does not cure its default within fourteen (14) days after receipt of Contractor's written notice, Contractor may, upon fourteen (14) additional days' written notice to the Owner, terminate the Agreement and recover from the Owner payment for Work performed through the termination date, but in no event shall Contractor be entitled to payment for Work not performed or any other damages from Owner. 2. TERMINATION FOR CONVENIENCE AND RIGHT OF SUSPENSION. 1. Owner shall have the right to terminate this Agreement without cause upon seven (7) calendar days written notice to Contractor. In the event of such termination for convenience, Contractor's recovery against Owner shall be limited to that portion of the Contract Amount earned through the date of termination, together with any retainage withheld and reasonable termination expenses incurred, but Contractor shall not be entitled to any other or further recovery against Owner, including, but not limited to, damages or any anticipated profit on portions of the Work not performed. 2. Owner shall have the right to suspend all or any portions of the Work upon giving Contractor not less than two (2) calendar days' prior written notice of such suspension. If all or any portion of the Work is so suspended, Packet Page -1542- 10/28/2014 16.D.7. Exhibit C Supplemental General Grant Terms and Conditions Contractor's sole and exclusive remedy shall be to seek an extension of time to its schedule in accordance with the procedures set forth in the Contract Documents. In no event shall the Contractor be entitled to any additional compensation or damages. Provided, however, if the ordered suspension exceeds six (6) months, the Contractor shall have the right to terminate the Agreement with respect to that portion of the Work which is subject to the ordered suspension. CERTIFICATIONS AND FORMS THE FOLLOWING DOCUMENTS NEED TO BE RETURNED WITH SOLICIATION DOCUMENTS BY DEADLINE TO BE CONSIDERED RESPONSIVE 1. Certification Regarding Debarment, Suspension, and Other Responsibility Matters Primary Covered Transactions 2. General Grant Clauses 3. Disclosure of Lobbying Activities 8 �9 Packet Page -1543- � 10/28/201416. D.7. Exhibit C Supplemental General Grant Terms and Conditions Certification` Regarding -Debarment,..Suspensioh iand'Other Responsibility Matters Primary Covered Transactions (1) The prospective primary participant certifies to the best of its knowledge and belief, that it and its principals: (a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency; (b) Have not within a three -year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; (c) Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State or local) with commission of any of the offenses enumerated in paragraph (i)(b) of this certification; and (d) Have not within a three -year period preceding this application /proposal had one or more public transactions (Federal, State or local) terminated for cause or default. (2) Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. L. �-RKy PH- 49M4-c.y &O2vt C.t S Name Project Name C/o -- '6 -�4- g Title Project Number COLI -ie> Henci w Smllr -errw �� "_ l-7ct- 1.7-17 Firm Tax ID Number (4 tt M*-DISoN AVE D$S o19511 Street Address DUNS Number City, State, Zip Packet Page -1544- 0 C' 9 10/28/2014 16.D.7. Exhibit C Supplemental General Grant Terms and Conditions General Grant Clauses On behalf of my firm, I acknowledge, -and agree to perform all of the specifications and grant requirements identified in this solicitation documen�00. —d Vendor /Contracto Name"�'� Date ✓ -''` Authorized Signature Address Solicitation Contract # i Packet Page -1545- 10 I 10/28/2014 16.D.7. Exhibit C Supplemental General Grant Terms and Conditions CERTIFICATION REGARDING LOBBYING (To be submitted with each bid or offer exceeding $100,009) The undersigned dj /(t1 9 el 1 fPtV,4e ( Contractor) certifies, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for making lobbying contacts to an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form - -LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions [as amended by "Government wide Guidance for New Restrictions on Lobbying," 61 Fed. Reg. 1413 (1/19/96). Note: Language in paragraph (2) herein has been modified in accordance with Section 10 of the Lobbying Disclosure Act of 1995 (P.L. 104 -65, to be codified at 2 U.S.C. 1601, etseq.)] (3) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by 31, U.S.C. § 1352 (as amended by the Lobbying Disclosure Act of 1995). Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. [Note: Pursuant to 31 U.S.C. § 1352(c)(1)- (2)(A), any person who makes a prohibited expenditure or fans to file or amend a required certification or disclosure form shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such expenditure or failure.] r`l ; ;. The Contractor, . c ia %�fl� 1try%LeJ certifies or affirms the truthfulness and accuracy of each statement of its certification and disclosure, if any. In addition, the Contractor understands and agrees that the prg�ons -af 31 U.S.C. A 3801, etseq., apply to this certification and disclosure, if any. Signature of Contractor's Authorized Official 2�1.�► �� Name and Title of Contractor's Authorized Official ; Date 11 Packet Page -1546- G 'v nj n 77 ID v v oa rD N v1 V PM: Louise Pelletier ITB 14 -6248 Notices: 99 PS: Brenda Brilhart Pharmacy Services Pkgs Downloaded: 20 Bids: 3 Woollov's Pharmary Cnllior 14C.ifh Q. —i— DESCRIPTION QTY UNIT PRICE AMOUNT UNIT PRICE AMOUNT UNIT PRICE AMOUNT Average Wholesale Price (AWP) Markup Brand Name AWP Pricing Source 20,000 -12.5% $ 17,500.00 McKesson 10% $ 22,000.00 McKesson 15% $ 23,000.00 Cardinal Health Maximum Allowable Cost $ 4.00 Majority under $4 $ 3.00 TOTAL $ 17,504.00 $ 22,000.00 $ 23,003.00 v V-1-Y - 11wTaea racing Tor t3eneric Avvv - -io "/n ano tirana Awr -10% - averaged for comparison purposes.= -12.5% Bid Requirements: Licenses Y N Immigration Law Affidavit/MOU /Profile Y/N Y/y W -9 Y Y Insurance Y Y Granting Agency Requirements: - Certification Regarding Debarment, Suspension and Other Responsibility Matters N N - Supplemental General Grant Terms & Clauses N N - Declaration of Debarment N N Brenda Brilhart, Procurement Strategist Diana DeLeon, Witness Date: 9/9/14 Y Y/Y Y Y O N Oo N O .p O